Since the 1980s, the number of school-based health centers has increased due to funding that lead to recognition by policy makers and health organizations. The mission was to provide comprehensive pediatric health care to children with limited access to health care and the uninsured. The goal was to decrease school absenteeism and missed work days by providing convenient primary and acute care while children are in school. For sponsoring organizations managing school-based clinics, allowing parents to be absent during clinic visits met its mission. However, the ease of young children receiving health care in the school setting without being accompanied by their parents has positioned nurse practitioners in an ethical and legal dilemma. Asking a young child significant health history during a physical examination or having them describe their chief complaints during an acute visit may not be the best way to provide good care to our young patients. Additionally, what are the legal responsibilities of a nurse practitioner when caring for a child without active participation of the parent? Little has been documented in the past about the dilemmas nurse practitioners face in school clinic settings. With increasing use and recognition of school-based health centers in the United States, the need for more discussion is required to explore solutions to provide quality comprehensive care for patients and their families.
The Essential Elements of Adolescent-Friendly Care in School-Based Health Centers: A Mixed Methods Study of the Perspectives of Nurse Practitioners and Adolescents