The Evolution of the Role of U.S. School Nurses in Adolescent Mental Health at the Individual, Community, and Systems Level: An Integrative Review

School nurses are crucial to addressing adolescent mental health, yet evidence concerning their evolving role has not been synthesized to understand interventions across levels of practice (i.e., individual, community, systems). We conducted an integrative review of school nurse roles in mental health in the U.S. related to depressive symptoms, anxiety, and stress. Only 18 articles were identified, published from 1970 to 2019, and primarily described school nurses practicing interventions at the individual level, yet it was unclear whether they were always evidence-based. Although mental health concerns have increased over the years, the dearth of rigorous studies made it difficult to determine the impact of school nurse interventions on student mental health outcomes and school nurses continue to feel unprepared and under supported in this area. More research is needed to establish best practices and systems to support school nursing practice in addressing mental health at all levels of practice.

School Nursing for the Novice: How Do I Begin?

Obtaining a position as a school nurse is an exciting career opportunity, but the reality of a new position in a new specialty area can quickly lead to anxiety and feeling overwhelmed. Your first thoughts might be “Can I really do this job?” and “Where and how do I begin?” The answer to these questions will depend on your situation—are you a nurse hired for a previously established school nurse position or are you the first nurse at your school, charged with initiating a school health program? The purpose of this article is to offer guidance for the novice school nurse in establishing a school health program and school nurse office, as well as to encourage and provide direction for the development of your school nursing practice.

A Qualitative Exploration of School Nurse Continuing Education Needs

Continuing education (CE) can help school nurses achieve the unique competencies required for the challenges of an academic health setting. A comprehensive understanding of school nurse learning needs is necessary to guide CE development. The purpose of this study was to describe school nurse perceptions of their learning needs according to the Framework for 21st Century School Nursing Practice ™. The researchers analyzed data from 24 interviews with practicing school nurses using descriptive coding to identify perceived learning needs. Learning needs relevant to all areas of the framework were identified, with clinical judgment and team development emerging as priority areas for CE. These results illuminate school nurse perceptions of their own learning needs and can help guide the development of meaningful CE opportunities.

School Nurses’ Reports on Reopening Roles, Practices, and Concerns During the COVID-19 Pandemic at the Start of the 2020–2021 School Year

The COVID-19 pandemic has caused major disruptions to U.S. school systems since March 2020. To facilitate our understanding of how school nurses participated in school reopening and what support school nurses needed beginning the 2020–2021 school year during the COVID-19 pandemic, we conducted a national survey in late summer 2020. A sample of 747 school nurses from 43 states responded to an online survey about roles, practices, and concerns. Over one-third (36.9%) reported not being included in school reopening planning. Mitigation practices reported by respondents primarily included measuring temperatures of students before school (21.3%), mask wearing by students (79.9%), and 6 feet social distancing (76.7%). The respondents’ greatest concerns were the educational impact on students with individualized education plans, parents sending children to school with COVID-19 symptoms, and the economic impact on families. Our results point to opportunities for greater school nurse involvement, improvements in practices, and measures to address school nurses’ concerns.

Using the Strengths and Difficulties Questionnaire in practice

This article is intended to draw the attention of any practitioners who are unaware of the Strengths and Difficulties Questionnaire (SDQ) to this excellent and accessible resource. It is an instrument that lends itself to the evaluation of practice by any qualified practitioner, health visitor, teacher, social worker, community nurse, school nurse or researcher who wishes, with the parents' permission, to understand whether their work with a child's family or teachers is having the desired impact. It is brief and straightforward to administer and is readily accessible online. This article explores the SDQ and its usefulness.

The Impact of Distress, Personal Meaning & Training on the Delivery of Support to Grieving Students by School Nurses

Supporting grieving students is part of a school nurse’s role which can provide meaning or special purpose in their career. This was verified by an online survey completed by 648 school nurse members of the National Association of School Nurses (NASN). A majority of respondents felt personal distress as a result of their work with grieving students which was predicted by a lack of access to work/community resources available and a lower level of educational background of the school nurse. Training to support grieving students and a higher level of educational background of the school nurse, however, appeared to predict a greater level of personal meaning found in school nurses’ support of grieving students. Level of support by school leadership provided to school nurses in their support of grieving students was also found to be related to both the personal distress experienced and the personal meaning derived by school nurses.

The Vital Role of the School Nurse in Managing Asthma

Since asthma is the most common noncommunicable chronic childhood disease in the United States, school nurses will encounter students with this health condition. The purpose of this article is to present the school nurse as the leader in directing the management of a student’s chronic health condition at school. This article provides a table of resources and discusses many aspects of asthma management, including utilization of the student’s asthma action plan, student-specific school accommodation needs, the importance of developing individualized healthcare plans, providing education to school staff related to asthma management and determining of the family and student knowledge level, as well as strategies to minimize exacerbations. The article also explores school nurse opportunity to advocate for emergency asthma medication access as a part of emergency preparedness. School-based asthma management can be complex and school nurses have a pivotal role in asthma management in a school.