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School nurses

To many, the image of the school nurse is that of a stern or matronly nit-checker. But sweeping changes in health education in schools have meant that the role of the school nurse in both primary and secondary schools is now impressively wide-ranging.

School nurses are highly skilled professionals, and are in fact the only trained nurses working between health and education. They provide an essential link between school, home and the community that helps safeguard the well-being of children and young people.

An integral part of the school health team, they have numerous responsibilities, which include:

Supporting children with complex health needs
Running immunisation and vaccination programmes
Running drop-in clinics, parenting programmes and bed-wetting clinics
Assessing the health needs of every five-year-old pupil
Providing health schemes for young people

These last two responsibilities highlight just how important it is for school nurses to provide a smooth transition from primary health care to the teenage years, which can arrive with fairly complex health issues to consider.

Role play
The expansion of the school nurse's role comes in line with the Government's healthcare agenda for the next ten years. A national strategy for schools, 'Making a Difference', recognises that these professionals have a strengthened public health role. School nurses are now becoming team leaders by helping young people to make choices for a healthy lifestyle, working to reduce risk-taking behaviour like substance abuse and focusing on issues like teenage pregnancy.

Here's to your health
Concerns over the well-being of many UK school children have been consistently highlighted by the media. Lack of exercise, excess weight, smoking, and high salt and sugar intakes are just some of the health problems facing young people. The Government has responded by launching initiatives such as Health Improvement Programmes, Health Action Zones and Health Promoting School Schemes and by placing these areas of concern within the remit of the school nurse.

Working partners
School nurses work not just within schools, but also with individuals and communities as a whole. It's this expansive public health role that has resulted in partnerships with organisations like the National Healthy School Standard (NHSS). Jointly funded by the DCSF and the Department of Health (DoH), the NHSS has an overall aim to help schools become healthier. A free advice and support network for teachers and lecturers, this organisation has established around 150 nationally accredited education and health partnerships across the UK. These are between local education authorities and primary care trusts, who in turn provide support to schools. Working together, the NHSS and school nurses can offer a range of benefits to healthy schools programmes, such as:

Confidential, one-to-one advice for young people that encourages them to manage their own health needs
Unique insights into the health needs of the school community
Clinical expertise and local knowledge to support school staff across themes and through the whole-school approach
Support for linking schools with primary care, and for helping primary care trusts to gain a better understanding of the priorities and language of the education sector
Additional resources for all schools, including independent schools

Location, location
The amount of involvement school nurses have within healthy schools programmes varies from area to area. Some nurses will find that under NHSS guidelines they have quite a conspicuous role in coordinating local healthy schools programmes, while others might be working on the sidelines. This could be due to anything from a general reluctance on the part of schools to involve school nurses in the bigger health picture to a lack of resources for specific projects or the already heavy workloads amongst school nurses in general.

On the case
Case studies from around the UK reflect simple but innovative ways for school nurses to inject a bit of creativity into their health schemes for young people.

Cardigan Secondary School in western Wales developed a pilot scheme in which pupils could text their school nurses for health advice between 9a.m. and 6p.m. from Monday to Friday. This short-term project offered students instant help and provided those who might be wary of approaching adults with their problems face-to-face the chance to do so anonymously. Message topics varied from family planning issues to skin problems.
In a year-long pilot project in the Manchester area, nurses from the Oldham primary care trust gave teachers advice on recognising and treating symptoms of asthma, which has been rising steadily in British children over the last few years. Three primary schools were involved in 'Bronchial Boogie', giving asthmatic children access to after-school instruction that combined learning to play wind and brass instruments with asthma education from a school nurse. Positive results in pupils included increased confidence, improved health and the bonus of learning a new skill.

Getting organised
There are plenty of resources for schools and school nurses for help and advice relating to school health agendas.

The Community Practitioners and Health Visitors Association (CPHVA) is unique in that it is the only nursing organisation that has a dedicated Professional Officer with a school nursing background. The interests of school nurses can be expertly handled through the CPHVA, which champions the causes of community practitioners and makes school nursing a high priority. The annual CPHVA School Nurse Conference at the International Conference Centre in Harrogate on 21-23 October 2004 is a key event for all those in the world of health and education to network, swap ideas and keep up to date with new developments in professional practice.

The Royal College of Nursing (RCN) is hosting the Independent School Nurses Conference and Exhibition, which happens on 25 August 2004 at Imperial College in London. Aimed at independent and boarding-school nurses, who are often seen to be working in quite isolated fields, this event also offers information for updating practices and introducing new ideas.

Further information
For more information relating to school nursing, see the Department of Health's (DoH) website. It offers a downloadable resource pack for school nurses, including a self-evaluation tool to pinpoint strengths and weaknesses in a series of areas needed for a child-centred public health role.

The websites listed below are also excellent resources for information on school nursing, with many of them providing news articles, notices, special publications and links to further health education sites.

Useful websites

Community Practitioners' and Health Visitors' Association (CPHVA)

Department of Health

Health Development Agency

Health Visitor and School Nurse Innovations Network

Independent Schools Council

National Healthy School Standard (NHSS)

Nursing, Midwifery and Allied Health Professions

Royal College of Nursing

SureStart

Teacher Support Network

Wired for Health