U.S. School Nursing Job Analysis

Reported Impact of COVID-19 Workload and Stressors on School Nurses' Provision of Care During the 2021-2022 School Year: A Secondary Analysis of U.S. School Nurse Survey Data

Many school nurses experienced increased work burden and stress during the COVID-19 pandemic. This analysis examined data from a Centers for Disease Control and Prevention cross-sectional, nationwide survey of school nurses in March 2022 to examine associations between school nurses' ability to conduct their core responsibilities and selected nurse and school factors among school nurses during the 2021-2022 school year and COVID-19 pandemic. Perceived adequate staffing and financial compensation reduced the odds of reported difficulties across all core school nursing tasks. Nurses without a registered nurse license and with higher caseloads were more likely to report difficulty in implementing specific tasks. The impact of these factors varied, with inadequate financial compensation having the largest association with school nurses' difficulty implementing all the core responsibilities. The study results improve our understanding of school nurses' challenges in implementing core school nursing responsibilities during the COVID-19 pandemic in the 2021-2022 school year.

The History of US Menstrual Health, School Nurses, and the Future of Menstrual Health Equity

In the United States, adolescents suffer from inadequate menstrual health, meaning that adolescents are unprepared for menarche, lack the practical resources they need to comfortably and confidently manage menstruation, and receive inadequate health education and care for menstrual pain and disorders. In this article, we provide a historical analysis of the role of school nurses in addressing menstruation from the early 20th century up to the present day. We contextualize the current realities of school nursing and menstrual health education and clinical support. We argue that the decentralized US school system, a cultural aversion to open discussion about menstruation, and the outsized influence of commercial menstrual product manufacturers have hampered the ability of school nurses to deliver menstrual health education along with menstrual health support. Finally, we discuss implications for today's schooling experiences as well as recommendations for how to support school nurses in aligning our national approach to menstrual health toward the public health perspective of menstrual equity. (Am J Public Health. 2024;114(9):903-908. https://doi.org/10.2105/AJPH.2024.307705).

A job analysis of mental health nursing in a school for students with intellectual and developmental disabilities

While schools have become settings for the delivery of mental health supports to students, mental health nursing has not yet described its practice in schools. In the absence of this mental health nursing literature, a quantitative self-reporting job analysis methodology was used to describe the tasks of mental health nursing in a specialist school as an observant-participator in a single-case holistic case study. Additional aims were to compare the results with the general school nursing and the disability nursing literatures and interpret these findings for mental health nursing. Categories of tasks from general school nursing were used to deductively interpret the results. Tasks were recorded across all categories of school nursing. The greatest number of tasks were recorded in the professional performance category, followed by planning, then personnel. The least number of tasks were recorded in the health education and promotion category, followed by practice and treatments, assessment and diagnosis, and management. These results differ from tasks in general school nursing but share similarities with intellectual and developmental disability nursing, particularly related to relationships and communication. Practising effectively as a mental health nurse in a specialist school requires capabilities for working with people with disability, particularly communicating and establishing relationships, in addition to clinical mental health skills. Mental health nursing in schools is an area of practice that requires further exploration to capitalise on emerging policy developments to support student mental health.

Factors associated with continuing education needs in medication administration among school nurses

AIM

To investigate the continuing education requirements and factors influencing school nurses' needs in relation to medication administration on school campuses.

DESIGN

A total of 391 school nurses working in K-12 schools in Taiwan were invited to participate in an online questionnaire survey.

METHODS

This cross-sectional study employed a probability proportionate to size technique along with a random sampling method. Data were collected from February to April 2023.

RESULTS

School nurses reported a significant demand for continuing education and perceived moderate levels of stress and government support related to medication administration. Among the various dimensions, the highest demand was observed for 'definition of campus medication errors' and 'regulations for campus medical orders.' Moreover, the 'identifying drug interactions' and 'adverse drug effects and referrals' dimensions were identified as the most stressful aspects. Notably, perceived stress emerged as the sole predictive factor for continuing education demand, accounting for 16.1% of the variance.

CONCLUSIONS

The study found that there was a significant demand for and moderate stress related to continuing education among school nurses. Therefore, it is crucial for the government and school nursing organizations to develop targeted programs focusing on medication administration. These initiatives should be designed to enhance nurses' capabilities and reduce their stress, thereby ensuring safe medication administration on campuses.

IMPACT

Continuing education enables school nurses to acquire up-to-date knowledge and improve the workflow in their practice. This study highlights a strong need for education in medication administration with a focus on 'campus medication error definitions' and 'campus medical order regulations.' The government and relevant school nursing organizations should prioritize the development and implementation of continuing education programs to decrease the school nurses' stress related to medication administration.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

REPORTING METHOD

This study adhered to the relevant cross-sectional EQUATOR STROBE guidelines.

The Role of the School Nurse in the United States, United Kingdom, and Italy During the COVID-19 Pandemic: A Scoping Review

The school nurse has a crucial role in the United States and the United Kingdom and has their own expertise dedicated to school assistance for children, families, school staff, and the community. This study aims to identify the role and skills of the school nurse and understand the effects of COVID-19 on nursing skills in the following countries: The United States, the United Kingdom, and Italy. A Scoping Review was conducted following the JBI methodology for scoping reviews, following the PRISMA-ScR guidelines. Three databases were consulted: PubMed, Cinahl, and Scopus. In all, 58 studies met the eligibility criteria and were included. 93.1% of the studies were carried out in the United States, 5.2% in the United Kingdom, and 1.7% in Italy. 34.5% of the articles were published in 2020, 15.5% in 2021, 31% in 2022, and 19% in 2023. 22.4% of the studies included in the review concerned health promotion and education. Regarding the methodology of the studies, 41.5% of the studies were commentary papers, 15.5% were observational studies, and 12% were cross-sectional studies. Considering the effects of the school nurse in the United States and the United Kingdom, it is possible to reflect on how the systematic presence of a nurse could also have benefits in Italy.

Doctor of Nursing Practice and Its Application to School Nursing

School nurses who are considering a terminal degree in nursing have two options, a Doctor of Nursing Practice (DNP) or a Doctor of Philosophy in Nursing (PhD). There are several factors for school nurses to consider when determining which terminal degree is best suited for them. This article focuses on the relevance of a DNP degree to school nursing, by first reviewing the evolution of DNP programs and then pivoting to discussions by three school nurses on why they chose this terminal degree and the projects completed during their courses of study. A main focus of a DNP project is to gather, analyze, synthesize, and translate research into practice, often operationalized as quality improvement (QI) in clinical settings. School nurses, practicing independently from other healthcare professionals while often managing large workloads, stand to benefit from obtaining or working with a nurse prepared at this level.

Nursing Practice and Telehealth in School Health Services: A Scoping Review

BACKGROUND

The COVID-19 pandemic has propelled the adoption of telehealth in school settings, emphasising the pivotal role of nurses. This review explores the last decade's evidence on telehealth interventions in school nursing practice; Methods: Following Joanna Briggs Institute guidelines, we conducted a systematic search in PubMed, CINHAL, and Web of Science in March 2023. Out of 518 articles across 21 journals, 32 satisfied the review criteria. The selection process rigorously adhered to PRISMA-ScR guidelines for scoping reviews; Results: The results were categorised into three main areas: (a) the purpose of telehealth and intervention strategies, (b) the role of nursing in school-based telehealth practice, and (c) perceived benefits and limitations of school-based telehealth studies. Telehealth interventions encompass health promotion, mental health management, and early diagnosis. School nurses play a multifaceted role, including management, education, and remote monitoring. While telehealth offers advantages like improved health and cost savings, challenges include digital literacy, device access, and costs; Conclusion: This review underscores the crucial role of telehealth in schools for enhancing healthcare delivery in educational settings. However, more empirical evidence is required to specify nurses' contributions to school-based telehealth interventions. Promoting their leadership through stakeholder collaboration is essential. Further research should address challenges and opportunities in school nursing practice, enriching healthcare in educational settings.

What school nurses receive for themselves that influences their remaining in practice: A qualitative study

BACKGROUND

Previous research indicates a link between what nurses receive for themselves and their remaining in practice. In Norway, school nurses tend to remain in practice, but what it is they receive for themselves has been scarcely studied. The aim of this study, therefore, was to describe and interpret what it is school nurses receive for themselves that influences their remaining in practice.

METHOD

The study has a qualitative design with a hermeneutic approach. Data were collected through individual interviews on two separate occasions with 15 Norwegian school nurses. The data were analysed using a phenomenological hermeneutic method.

RESULTS

Two themes demonstrate what it is the school nurses receive for themselves: (1) 'Gaining interesting workdays for yourself' and (2) 'Attaining pleasure for yourself'. Each theme has two sub-themes. The first theme involved the school nurses 'having an attractive scope of practice' and 'having varied tasks'. The second theme involved 'being trusted' and 'being given a response'. The study themes can be comprehensively understood as an expression of what the school nurses identify as the main locus of the good work-life. The school nurses' remaining seems to revolve around what it is they receive on their own behalf: an affirmation for their ordinary life and what they do as a nurse.

CONCLUSION

This study highlights that what school nurses receive on their own behalf may influence their remaining in practice. It adds to previous research with a more specific understanding of nurses remaining in practice by stating that in identifying the main locus of the good work-life, the school nurses received affirmation for their ordinary life and what they do as a nurse. Thus, it is important that nurses identify the main locus of a good work-life for themselves, as receiving affirmation for what they do in their ordinary workdays may influence their remaining in practice. REGISTRATION OF CLINICAL TRIAL AND REGISTRATION IDENTIFICATION NUMBER: The study was approved by the Norwegian Centre for Research Data (project 59195). National Research Ethics Committee approval was not required, as the study only involved health professionals and did not ask for sensitive information.

Burnout and Mental Health and Well-Being of School Nurses After the First Wave of the COVID-19 Pandemic: A National Cross-Sectional Survey

The aim of this study was to examine the associations between job stressors, COVID-19-related concerns, burnout, and mental health and well-being among school nurses, and whether any of these associations are mediated by burnout. Based on stratified proportional sampling, data collection was conducted by an online questionnaire distributed to 600 school nurses in Taiwan. A total of 256 participants aged between 27 and 62 years (mean = 47.08; standard deviation = 7.28) returned questionnaires. Results showed that burnout was the main mediating variable that fully mediated the relationship between COVID-19-related concerns and mental health and well-being. The effects of job stressors on mental health and well-being included direct negative effects (β = -.29) and indirect negative effects (β = -.67) through mediating factors. School health managers should be more aware of burnout and mental health and well-being among school nurses under the impact of COVID-19.

The Need for Required Stock Epinephrine in All Schools: A Work Group Report of the AAAAI Adverse Reactions to Foods Committee

Epinephrine is the first line of treatment for anaphylaxis that can occur outside a medical setting in community environments such as schools. Patients with diagnosed IgE-mediated food allergy at risk of anaphylaxis are prescribed self-injectable epinephrine and given an individualized anaphylaxis action plan. As students, such patients/families provide their school with completed medication forms, a copy of their anaphylaxis plan, and additional student-specific epinephrine. However, students approved to self-carry prescribed self-injectable epinephrine may forget to do so or have other reasons for lacking prescribed epinephrine such as familial inability to fill the prescription due to cost or other access barriers. Undiagnosed students lacking prescribed epinephrine may also experience anaphylaxis at school. The presence of non-student-specific school stock epinephrine allows school nurses and other staff the ability to treat anaphylaxis onsite while awaiting Emergency Medical Services. Notably, not all states legally mandate K-12 schools to stock epinephrine. In states with laws only voluntarily allowing schools to stock epinephrine, it provides the ability to opt-out. Herein, we present a comprehensive review of barriers to school stock epinephrine, related improvement strategies, and workgroup recommendations supporting the need for mandated stock epinephrine in all schools in every state. Proposed solutions include ensuring legal immunity from liability for prescribers; advocacy for legislation to stabilize cost of self-injectable epinephrine; educational initiatives to schools promoting merits and safety of epinephrine and related anaphylaxis training; and partnerships between patient advocacy groups, medical and nursing organizations, public health departments and other health professionals to promote laws and district policies addressing need for stock epinephrine and school nurses to train and supervise school staff.

Factors associated with nurses' positive attitudes towards families' involvement in nursing care: A scoping review

AIM

To map the factors associated with nurses' positive attitudes towards families' involvement in nursing care and to identify any existing gaps in knowledge.

BACKGROUND

Several tools have been proposed to assess the attitudes, beliefs and practices of nurses towards families in different care contexts. However, there is a knowledge gap on how the results of these tools can identify the factors that are associated with more positive attitudes of nurses.

DESIGN

A scoping review based on the steps proposed by the Joanna Briggs Institute.

METHODS

Three independent reviewers searched the databases: PUBMED/Medline; LILACS; Virtual Health Library; PsycInfo; Google Scholar; SCOPUS and CINAHL, from 2006 to August 2021, guided by the question: What are the factors associated with nurses' positive attitudes towards families´ involvement in nursing care, in studies that used one or both of the following two scales 'Families' Importance in Nursing Care- Nurses' Attitudes' and 'Family Nursing Practice Scale'? This review was conducted in accordance with PRISMA-ScR.

RESULTS

Twenty-six primary studies were identified, in which 9,620 nurses participated. Positive attitudes were associated with three types of variables: (a) personal-longer working career (42.3%) and older age (26.9%); (b) educational-higher level of academic education (30.8%) and family nursing education (23.0%); and (c) workplace-working in primary health care and/or outpatient clinics (34.6%) or in a unit with philosophy/approach to families (23.0%).

CONCLUSIONS

Personal variables such as age and time of service are non-modifiable aspects, but educational and workplace variables are subject to intervention to improve nurses' attitudes towards families' involvement in nursing care. Continuing development programmes about family care can constitute important strategies to improve positive attitudes of nurses towards families in practice.

RELEVANCE TO CLINICAL PRACTICE

Recognising the characteristics associated with nurses´ positive attitudes towards families may enable the development of tailored interventions that promote family-focused care.

Social Media and Adolescent Mental Health: Sounding the Alarm

Adolescence is a period of emotional and developmental vulnerability in which mental illness can be first detected. This is also a time in which adolescents are introduced to social media and may experience the direct and indirect criticism that accompanies it. School nurses are providers that may be the first to detect signs and symptoms of adolescent mental illness inside and outside of the classroom. In order to decrease the risk of social media's harmful effects, school nurses should consider providing adequate education to school and community members on the signs and symptoms of adolescent mental illness and self-harm. Providing timely health guidance to teenagers by assisting in dealing with negative emotions in positive ways may also decrease the risk of this harmful effect. As technology expands, social media is becoming more easily accessible for younger individuals, creating a heightened need for the role of a school nurse. The purpose of this article is to review current knowledge regarding social media and mental health and provide practical suggestions for school nurses to ameliorate the negative impact of social media on student well-being.