Nurse’s Office

The role of school nurses has been expanding throughout our history, constantly adapting and responding to world events.

Driven by the pandemic and exacerbated by systemic inequity, the need for holistic solutions to support student health has never been greater. As the world responds to the current crisis and future challenges, school nurses will continue to play a critical role as architects and designers create facilities that are resilient and take a comprehensive approach to student health. By using an evidence-based approach to planning, there can provide a student-centered health experience.

Top Health Considerations

01. Chronic Health Conditions

02. Mental Health

03. Social Determinants

N.14

Sound and visual privacy

N.9

Flexible furniture

Chronic Health Conditions

In the US, more than 40% of school-aged children and adolescents have at least one chronic health condition (CHC), ranging from asthma to diabetes to food allergies. (185) School nurses play a pivotal role in the daily management of symptoms for these students, as the only healthcare provider in the building. In 2017, a systematic review assessed the role of school health services in addressing CHCs. (186) The study found that direct access to health services improved health and academic outcomes. This is crucial as chronic absenteeism among youth can be linked to CHC, and ultimately affects academic performance. (187) For a high school in Florida, 92.6% of students indicated health reasons were “sometimes” or “usually” the cause of their absences. (188) Children who are chronically absent for even one year in high school are reportedly seven times less likely to graduate. (189) Nurses can provide direct care and help students with CHC manage their own conditions, thus ensuring attendance. According to the CDC, school nurses often have three main roles in managing chronic health conditions: (190)

• Provide direct care: giving medications

• Provide case management: assess, plan, implement and monitor individual health plans

• Advocate for students and families: provide resources and support needed.

Mental Health

Nationwide, the teenage mental health crisis is rising. Roughly one-third of all visits to school nurses are mental health issues. (191) While nurses do not replace social workers or school psychologists, they still play an important role for the 42% of students experiencing poor mental health. (192) Nurses can identify and respond to mental health concerns and steer students to appropriate services, as a member of the interdisciplinary team addressing students’ mental health. As part of the school mental health team, school nurses can serve as advocates, facilitators, and counselors for the health of the student. (191) As an integral member of the school, nurses are in a unique position to play an active role in mental health. In fact, students felt more comfortable going to the school nurse for mental health concerns. (193) These students felt visiting the school nurse would be less stigmatizing than seeking a behavioral health provider. Due to their regular access to students and ability to notice changes over time, nurses are equipped to assist from a mental health perspective.

Social Determinants

According to the National Association of School Nurses, after a child’s home, school is the second most influential environment in a child’s life. (194) Unfortunately, many students experience family crises, homelessness, immigration, poverty, and violence, all of which can impact physical and mental health needs. These social issues add to the complexity of a child’s health needs. In 2021, the US Census Bureau reported 5% of children under the age of 19 did not have health insurance. (195)As a result, the school nurse is likely to be the first and only consistent source of health services to uninsured children. (199) For students without homes, research shows they are more likely to suffer from chronic diseases, hunger and malnutrition. Children and families in unstable housing have difficulty obtaining affordable, accessible and coordinated healthcare services. In additional to physical health concerns, children who experience homelessness have three times the rate of emotional and behavioral problems. (196) These students are significantly at risk for experience school dropout, mental health problems, illicit drug use, suicidality, and even early mortality. While school nurses cannot cure these problems, knowing what illnesses and health-related problems are common may help a school develop a repertoire of responses to students’ health needs.

$2.20 savings for every $1 spent on school nursing, there is $2.20 savings in the community. Preventive screening, like school nurse visits, helps decrease emergency room visits and reduce the number of hours parents lose when taking care of their children.