Academic journal article Phi Delta Kappan

School Nurses: An Investment in Student Achievement: Students Enter School with a Variety of Mental and Physical Health Needs, and School Nurses Are on the Front Line of Addressing Them

Academic journal article Phi Delta Kappan

School Nurses: An Investment in Student Achievement: Students Enter School with a Variety of Mental and Physical Health Needs, and School Nurses Are on the Front Line of Addressing Them

Article excerpt

Juaquin has his head down again. Is he asleep (again) or not feeling well (again)? Nevaeh is back after being gone for nearly three weeks at the beginning of the school year. Will she be able to catch up? Clara made it to class, but she seems distracted. Can she focus on today's lesson? And so it goes. Every teacher confronts such questions, and all teachers worry about those students who appear to be struggling with health issues and other challenges in their personal lives. But when students don't show up in class, or when they show up but their minds seem to be elsewhere, what are teachers to do?

According to state and national data, chronic absenteeism --which has a profoundly negative effect on student achievement--is closely correlated with ongoing and/or unmet health care needs (U.S. Department of Education, 2016). For example, in a recent survey of high school students in Florida, 92.4% of respondents indicated that health reasons were "sometimes" or "usually" the cause of their absences (Brundage, Castillo, & Batsche, 2017).

Among the various home and community factors that influence students' ability to learn, the availability of local health services stands out as one of the most important. However, the nature and quality of those services matter just as much as their availability. As detailed in the widely praised Whole Child, Whole School, Whole Community model developed by ASCD and the Centers for Disease Control and Prevention (CDC, 2014), student health care must not be left to a single doctor or clinic working in isolation. It takes a well-coordinated team to meet students' health needs effectively, and no member of that team is more critical than the school nurse.

For example, a school nurse is perfectly positioned to perform an initial assessment of Juaquin's needs to determine whether he might have a chronic condition like diabetes, an acute tooth infection that's causing pain, mental distress caused by a chaotic family situation, or some other reason for being tired and unwell. As a member of the school attendance team, the nurse could have flagged Neveah's early absences and followed up to see if she had a serious illness, a transportation issue, or another problem. And the nurse could have checked in privately with Clara to see if her distraction might have to do with being bullied, skipping breakfast, struggling with anxiety, coping with a physical ailment, and so on.

Traditional assumptions about school nursing --focusing on ice, lice, and Band-Aids--often cause nurses' work to be misunderstood and devalued. However, the World Health Organization has found that schools are one of the most consistent and appropriate locations to address young people's health needs (Baltag, Pachyna, & Hall, 2015). And as a growing body of evidence points to the complex ways in which health and learning are connected, it becomes ever more clear that the proper role of school nurses goes well beyond dealing with mild bumps and bruises (NASN, 2015).

With nearly 20% of students entering school with a chronic health condition, such as asthma, life-threatening allergies, diabetes, and seizure disorders (U.S. Health Resources and Services Administration, 2016), school nurses provide direct care (checking blood glucose, providing treatments) to students with these needs; empower students to manage their own chronic conditions; and work with students' healthcare providers, school staff, and the community to coordinate students' needs. At the same time, school nurses can detect illness early, prevent its spread, and identify students at risk, while also advocating for the well-being of the entire community.

Nurses also help students stay in school: A student is more likely to be able to go back to class (instead of being dismissed early) when seen by a school nurse, compared to a non-licensed health professional (Pennington & Delaney, 2008). A school nurse has the knowledge and expertise to assess the issue and determine if it is a health concern that the nurse can address so the student can stay in school. …

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