Academic journal article Journal of School Health

The School Nurse's Role in Managing Athletic Injuries

Academic journal article Journal of School Health

The School Nurse's Role in Managing Athletic Injuries

Article excerpt

The School Nurse's Role in Managing Athletic Injuries

Injury prevention, assessment, and rehabilitation of high school athletes constitute important issues. Catalyzed by the emergence of women's sports, the number of sports sponsored by schools as well as the number of participating students has increased during the past decade. The National Federation of State High School Association cites the increasing number of females participating in high school athletics as the primary reason for the increase.


In 1971, 294,015 girls participated in competitive sports in the U.S.; by 1985 the number increased to 1.8 million. [1] As participation increases, so does the potential for athletic injuries. A study of high school athletic injuries occurring during competitive events and supervised play in Oklahoma reported an injury rate of 25.4 per 1,000 boys and 27.4 per 1,000 girls. [2] Another study found injury rates higher for boys than girls, and sports-related injuries accounted for almost one-half of the reported injuries. [3]

Several individuals assume responsibility for prevention, recognition, and acute injury care of high school athletes. "Who is qualified to render athletic care?" Coaches, the most frequently cited primary source of athletic health care, were mentioned in 77% of public secondary schools and 32% of four-year colleges as the person most responsible for health care of athletes. [4] Because the coach's attention generally focuses on the game, athletic trainers at secondary schools would be ideal. Carey [5] reported athletic trainers have had more education, training, and experience in sports medicine than other health care providers. Certified athletic trainers and school nurses completed a sports trauma management inventory which indicated athletic trainers are more knowledgeable than school nurses about athletic injury recognition and management. However, appointment of athletic trainers to all junior and senior high schools seems unlikely given personnel and budgetary restrictions.

School administrators often are unaware of educational requirements to be an athletic trainer. The Seattle Public Schools [6] reported success in a three-year Athletic Health Care and Training Program involving coaches, school nurses, and student trainers. The injury-recognition rate in the experimental group compared favorably to athletic trainers, and satisfactory injury management increased significantly with this training compared with control groups in the study.

School nurses also assume some athletic care responsibility. However, the athletic day often extends beyond the time when school nurses are available. Consequently, nurses frequently see an injury or health problem sustained during a practice or game from the preceding day. Carey questioned the appropriate role of school nurses in athletic injury care. He doubted school nurses and school boards would be anxious to extend their responsibilities to include primary care to athletes during after-school hours. [5]

Several sources have recommended extending the role of school nurses to meet the special needs of athletes. [5,7,8] Some Iowa communities require a nurse to be present at athletic events. Nursing education provides a background in anatomy, physiology, and awareness of physical and emotional needs of young people. [7] In Wisconsin, school nurses spent 120 hours learning appropriate care for athletes and their injuries. Instruction included evaluation, treatment, and follow-up for health injuries, as well as liability issues and use of office staff. The program [7] attempted to prevent injuries, seek changes where safety could be enhanced, recognize injuries as quickly as possible, institute appropriate treatment, and rehabilitate after injury. Alt [7] attributed success of this program to good planning, communication, and ongoing evaluation.

Thorne [8] described a Connecticut high school where school nurses were involved in preventing athletic injuries. …

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