Innovation and effectiveness: changing the scope of school nurses in New Zealand secondary schools

Abstract

Objective: To describe the changing role of school nurses in eight New Zealand (NZ) secondary schools from low socio‐economic areas with high Pacific Island and Māori rolls. Methods: An evaluation of a pilot addressing under‐achievement in low‐decile schools in Auckland, NZ (2002‐05). Annual semi‐structured school nurse interviews and analysis of routinely collected school health service data were undertaken. Results: Two patterns of school nurse operation were identified: an embracing pattern, where nurses embraced the concept of providing school‐based health services; and a Band‐Aid pattern, where only the basics for student health care were provided by school nurses. Conclusions and Implications: School nurses with an embracing pattern of practice provided more effective school‐based health services. School health services are better served by nurses with structured postgraduate education that fosters the development of a nurse‐practitioner role. Co‐ordination of school nurses either at a regional or national level is required.

Determinants of the intention of elementary school nurses to adopt a redefined role in health promotion at school

“…Resha [58] reported that a limited understanding of schools as an organisation was a barrier to school nurses' ability to exercise leadership in a health-promotion role. In New Zealand, Kool and colleagues [4] found that school nurses who chose to adopt a role redefined in health-promotion terms instead of their actual traditional role believed this option helped them to gain more knowledge and a better understanding of school needs. Thus, it seems that better knowledge of school needs, leadership, and feelings of worth are linked.…”

“…The latter seems to rely more on individual resources, while the former tends to rely more on organisational resources [4]. …”

Sustaining secondary school nursing practice in Australia: A qualitative study

“…Kool et al . () found that nurses, whose role was predominantly to engage in the provision of first aid, lacked motivation, were isolated from school management, and did not function as part of the health team. The majority of nurses in our study described a positive working relationship with staff who had a student welfare role.…”

“…A formal system of debriefing, or clinical supervision, was suggested as a support strategy to overcome professional isolation of secondary school nurses in Queensland, Australia (Barnes et al, 2004a). Engaging in regular meetings with other nurses undertaking secondary school nursing roles and supervision and support provided externally to the school were factors that supported the most effective and motivated approach to secondary school nursing in NZ (Kool et al, 2008).…”

“…Postgraduate qualifications in a range of areas have been identified as required by secondary school nursing, including adolescent health and development, adolescent mental health, family planning and sexual health, psychosocial health, primary health care, and health promotion (Barnes et al, 2004a, Department of Human Services, 2006aBuckley et al, 2009;KPMG, 2009). Keller and Ryberg (2004) argued that school nurses require a master degree level of education; others advocate that this is a nurse practitioner role (Kool et al, 2008).…”