School Health Nursing Research

This assignment delves into various research articles focusing on crucial aspects of school health nursing. The papers explore school asthma screening and its impact on attendance and learning, the experiences of transgender individuals in healthcare settings, and the challenges faced by school nurses in managing mental health issues among students. Additionally, the assignment examines school nurses' roles in promoting health within the school environment and their experiences caring for students with diabetes.

Types of health services provided by the practice setting
This part focuses on the different health care facilities that Melbourne high school
provides to the students. It is one of the selective state schools for boys of 9-12 years. Academic
excellence and health are interrelated and hence this school helps to cater to the physical as well
as mental well being of the students (Engelke, Swanson &Guttu, 2014). This part focuses on the
range of health care services provided by the setting and the type of population receiving the
service.
Apart from academic help, The Melbourne high school provides a wide range of facilities for the
well being of the students. Provision of self-discipline, conflict management by expert faculties,
management of the health issues under the supervision of the well qualified nurses are some of
the advantageous features of this school (Reuterswärd&Lagerström, 2012). This school has
always earned reputation in terms of the ambience, academics and well being of the students.
The health care section of this school provides prompt assessment and action against any medical
issues faced by any child (Haddad, Butler &Tylee, 2012). The nursing facilities in the Melbourne
high school involves first aid, management of pain, sports injuries, chronic health problems,
communicable and non communicable diseases, primary assessment of the possible health
ailments, psychosocial care and managing LGBTI students (Engelke, Swanson &Guttu, 2014).
The healthcare system of the school mainly monitors the health education of the students, the
physical education and activity, the health policies, the prevention of the tobacco use and
nutrition. This school has an excellent service team for the students, which consist of student
learning coordinator, a well-being coordinator, a nurse serving all the time, counselor for career,
and psychologists.("Melbourne High School", 2017)

The nursing facilities involve special school nurses for the management of chronic diseases
which the parents might or might not be aware off (Haddad, Butler &Tylee, 2012).There are
specific preventive and screening services provided by the school nurses for managing both the
communicable and the non-communicable diseases (Reuterswärd&Lagerström, 2012). The
school nurse generally provides care for the students with injuries and illness for all the students.
Also provides a long-term care for the student who needs special attention by communicating
with the parents along with the reference with the doctors. An individualized plan for providing
health care is developed in the context of the students suffering from the chronic disease, and
when needed a plan for the emergency is being developed for managing the potential events in
the premises of school (Refer to photos 3,4,& 5). ("Melbourne High School", 2017)
The nursing facility in this school also provides interventions regarding the management of the
sexually transmitted diseases. Special diet plans are provided for managing the problems related
to obesity (Moricca et al., 2013).The school nurses are qualified enough and are well acquainted
with the skills of first aid and general medicines. The nurses are also skilled in providing
emotional support to the student. There are lots of boys who come running to the school nurse
just to have a chat. Sometimes they share the personal things with their school nurses whom they
are unable to share with their parents (Engelke, Swanson &Guttu, 2014). The school nurses often
have to do a bit of counseling in case of students facing psychosocial issues.
Melbourne high school strives for the betterment of the student education and health. Due to its
allied education and health services provided by the proficient school nurses, this educational
institution has earned a good reputation.

Roles and the responsibilities of the nurses
Nursing is a noble profession and every nursing organization should comply with the
national standards of the nursing practice. The standards of practice are the framework for
improving the safety and the quality of care in the patients (Haddad, Butler &Tylee, 2012). This
part of the paper focuses on the roles and the responsibilities of a school nurse in a practice
setting. It will also compare and contrast the roles of the nurse in the practice setting with the
ideal standards of nursing.
A school nurse should be able to maintain all the domains of the nursing standards that can help
a nurse to improve her professional service (DeSocio&Hootman, 2004). A school nurse’s unique
role lies on the assessing the health status of the patient and providing appropriate care. The
school nurse plays a crucial role in the provision of comprehensive health care services to the
students (Selekman, 2012). Reports say that many students enter the school with several chronic
conditions that require management throughout the day. For providing an optimal care to the
students, preparation, education and staffing levels the school nurses are the important
requirements of success (Wang & Volker, 2013). The main role of the secondary school nurses is
to support health promotion and prevention of ill health in school settings. A nurse can devote
itself into the school community development activity. School nurses can promote health in
schools by taking up small group work focusing on important health related information and
advising the young people to make healthy life style choices. A school nurse is entitled with the
duty to attend each and every child. A school nursing service refers to a socialized practice of
professional nursing that progress with the well being, academic success and lifelong
achievement of the student (Gereige et al., 2017). The nurse in the school provides the resources
that are needed for the health services. Being an expert of health care of the school, the nurse

assesses the complete care system and then develops some plan to ensure the health care needs
are met (Appendix items 6 & 7). Responsibilities include development of plans for responding to
emergencies and disasters and confidential communication and documentation of student health
information ("Melbourne High School", 2017)
It is rightly said the school is the second home for a child. As a result the school environment
greatly influences a student’s mind. Many children enter the schools with several physical and
mental ailments (Pryjmachuk et al., 2012). A doctor cannot be available all the time and
therefore a school nurse is the sole representative of health care in a school scenario. In order to
understand the roles and the responsibilities of a school nurse, it is important to understand the
relation between health and education (Haddad, Butler &Tylee, 2012). The role of a school nurse
should encompass both educational and the health care goals. Responsibilities of the school
nurses involve assessment and treatment within the professional nursing communication with the
parents and making of suitable referrals to the doctors (Wang & Volker, 2013). In this practice
setting student centered health care plans are developed in order to provide a student specific
care. According to the federal laws the students with special health care needs are included in the
regular health care settings. The nurses in the Melbourne High School practice pay attention to
these students individually (Poteat, German & Kerrigan, 2013).
As said by Lim& Bernstein (2012)some sentinel events or illnesses can impose permanent scars
in the child’s brain. A school nurse should be able to provide a healthy school environment that
should be emotionally safe for the students (Kosciw, Palmer & Kull, 2015). The nursing
facilities of the Melbourne high school are able to provide a physical and emotionally safe

environment to the students.A safer school environment involves monitoring of immunizations,
ensuring eradication of contagious illnesses and reporting of infectious diseases as required by
the federal laws. School nurses have to encounter situations such as ankle sprain, anaphylaxis,
and general pain(Wang & Volker, 2013). In such cases it is required that the nurse should have
an expanded knowledge about regarding the application of first aid and anaphylaxis
management. The nurses in charge of the school practiceshould be up to date with the basic skills
of nursing, policies and the federal laws(Moricca et al., 2013).
The nursing facility in this school is also efficient in dealing with students and the families with
special needs (Kosciw, Palmer & Kull, 2015). There are a few students in this school with
autistic spectrum. Family meetings are arranged as a collaborative care can bring about better
outcomes in the students and also help to work out the best way to address their needs (Moricca
et al., 2013). A school nurse plays a key role in reducing the negative outcomes and risk taking
attitudes among the young students. It can be accomplished by counseling the older students and
interacting with them in a friendly manner, which helps the teenagers to open up and share their
problems which they cannot discuss with their parents. Hence forth school nurses support the
school community in addressing the social and the health issues faced by the young people
(Kosciw, Palmer & Kull, 2015). According to Engelke, Swanson &Guttu, (2014), evidence
based research increases the horizon of knowledge in nursing. For example, as per the
Medication Administration policy, a student can only be given Panadol, but the nurse in charge
was capable of changing the policy and was also able to introduce eight other standard
medications other than Panadol. It proves that the health facility of the school is always striving
for the safety and the well being of the patient.

Hence, it can be said that although most nurses comply with all the rules and regulations, they
need to be more holistic towards the children and should practice evidences based research for
addressing the complex health and mental problems of the students.
Managing the LGBTI population
Every person, including the students regardless of their sexual orientation is entitled to
receive a safe and supportive school environment (Coleman et al., 2013). The school nurses are
the vital members of the school to support the health and the well being of the students and
advocate practices and policies that would provide psychological, physical and social safety to
all the students (Carabez et al., 2015). This portion of the paper discusses the policies and the
steps taken by the Melbourne High School health service for managing the LGBTI persons.
LGBTQ may be described as those who can be identified as lesbian, gay, bisexual, questioning
and transgender. As per reports many adolescents do not determine with any sexual group may
have had sexual intimacy with the same sex or both the sexes and those people who have
confusion regarding their sexual identity can be considered as questioning (Coleman et al.,
2013).
Sometimes other students don’t know the sexual orientation of the patient. Only a limited
amount of information is available regarding the health risks of the LGBTI persons (Heck,
Flentje& Cochran, 2013). Fear of stigmatization prevents the student from coming to the school
nurses for the check up. Many students also do not receive health care due to the negative
experiences of the past (Kosciw, Palmer & Kull, 2015). School nurses can collaborate with the
community health care providers, school personnel, the teachers and their families to promote

physical and emotionalwell being to the patient (Heck, Flentje & Cochran, 2013). The practice
setting set up workshops with the LGBTI students to support their needs. As per Dorsen, (2012),
school nurses should be able to promote and model respect for diversity, lessen the stigma
related to the LGBT population and provide confidential health care support to the LGBT
students. A school nurse should be able to encourage the students to use the schools forms that
are gender neutral (Obedin-Maliver et al., 2012). Public health experts have urged the school
nurse to support, gay, lesbian, bisexual and Trans young people as the nurse can be pivotal in
helping them with problems like self harm and bullying. School nurses can play the pivotal role
to promote respect for diversity, lessen the stigma and provide confidential health services to the
LGBTQ students (Heck, Flentje & Cochran, 2013). School nurses are one that can foster a
school environment that is supportive for all, irrespective of the gender.
Lack of cultural competency training among the nurses is one of the significant barriers
to the LGBTI students, receiving nursing care (Carabez et al., 2015).LGBT youths are often
stigmatized or humiliated due to their sexual orientation. The ambience of this school is gender
neutral and the nurses can provide a culturally safe ambience for the students. There are certain
risks associated with the LGBTI students (Coleman et al., 2013). The LGBT adolescents can
have a high risk of depression and attempted suicide. The LGBTI adolescents fear of
discrimination in schools and the collages and even in the health settings (Kerr, Santurri& Peters,
2013).Melbourne High School aims to provide a non-threatening environment for the students
such that they can share their concerns. The student’s consent is taken before entering the gender
in the medical recorded (Obedin-Maliver et al., 2012). A nurse should be able to resist any
harassment to the LGBTQ students. There should be safe places such as designated classroom,

counselor’s office, where the LGBTQ can get the support for the school staffs, administrators,
teachers and other students.
The school nursing practice also promotes the student led Gay straight alliance and the other
clubs, in collaboration with the faculties, for improving the ambience of the school (Carabez et
al., 2015).
The nurses of the school are mainly qualified to work together with the school personnel, the
healthcare providers of the community, all the families and mainly LGBTI students for
promoting the improved both physical and mental health resources and help in the improvement
in the achievement in academics (Carabez et al., 2015).They also can identify the risks of health
that are higher for the LGBTI students and to provide them a proper care that is culturally
competent and in a safe and confidential place. The nurses Provide referrals for the evidence-
based practice to the professionals for taking proper care and those who are having knowledge
about the needs for the care of health of the LGBTI students. The nurses also provide full support
to their families and provide knowledge about the national and the local organizations, which are
mostly available for them to provide help and to support the LGBTI children (Obedin-Maliver et
al., 2012)
Support for creation and authorization of comprehensive zero resistance of tormenting strategies,
attending and promoting proficient improvement programs for school administration. Appointing
work force to comprehend and address the issues of LGBTI students. Also to advance the
comprehensive wellbeing training and educational modules for all the students and support an
inviting comprehensive condition with safe spaces in the school, i.e. wellbeing office, guide's
office, and classrooms (Coleman et al., 2013). The nurses promote the Gay Straight Alliance led

by students and different clubs that are supported by the faculties and chairmen for enhancing the
school atmosphere for all the students, without paying attention to their sex or gender identity.
They provide support to the students by upholding some practices and approaches that advance
the physical, mental and social wellbeing of all the students regardless of their sexual orientation,
gender identity or expression and encourage the utilization of equal school dress, codes of dress,
changing space and washrooms; utilize the students’ favorite names and to secure the
confidentiality while reaching to others if the student isn't "out/open" to the family or to the other
people at school (Kerr, Santurri & Peters, 2013)
It can be concluded that LGBTI students needs to be addressed with extra care within a
non-hostile environment. Community outreach, research and education are required to attain the
optimum health care for this population of students. Supportive families, non-hostile nursing
rationale can improve the health outcomes of the LGBTQ students and help them to live their life
to the fullest. Melbourne High School addresses these concerns.
Reflection on the community practice
As a student nurse I have come across several cases where I had taken prompt decisions
and actions. In my placement in the Melbourne High School I came across an incident that has
impacted on my professional practice.
Context of the incident
In my nursing practice I came across a student who suddenly had an asthmatic attack. The
student was not carrying the nebulizers and was suffering from a sudden respiratory distress.
Details of the incident

The incident involved a 10 years male student of 8th standard. Suddenly he had an asthmatic
attack and was going through a great deal of respiratory distress.For the first few hours he did not
turn up for the routine diagnosis, as he was too shy to seek help from anybody. I found that the
boy was worried during the checkup. I did not enquire about his problems in front of hisclass
mates but later on called the boy and asked about his concerns. I think that as a nurse I should be
able to provide anenvironment conducive to the boy opening up and sharing his concerns and
grievances. As his classmates informed me that the condition of the boy had worsened, I rushed
to the classroom with the first aid box. I helped the student to sit comfortably in an upright
position. I loosened his tight clothing. I enquired if any of the students was carrying an extra
ventolin.
Thoughts
As a nurse I realized the importance of involving the parents and the faculty in this matter to
ensure proper attention is given to the matter. School nurses should have the knowledge of first
aid and management of emergency conditions. I informed the teacher in charge to look for any
student carrying an extra nebulizer. I was concerned about the fate of the boy and quickly sorted
out the procedures of the treatment regimen that the boy has to undergo. I prepared myself for
interacting with the family. I made a checklist of things that needed to be discussed with the
parents. Furthermore I had to make referrals to the experts, who will be seeing the boy; therefore
I prepared a proper clinical hand over for the boy. I made sure that I complied with the policy
and the guidelines regarding the maintenance of the medical records. I made sure that none of his
medical records were exposed to other students or parents/guardians.

Demands
This kind of incident in my professional practice has helped me to deal with critical situations in
the future. Critical incidents not only helped me to develop confidence for interacting with the
families and also provided a huge scope of research as I have researched a lot regarding the
treatment of Asthma prior to the recommendations.
Impact on career
This whole professional practice was quite important for my career as it is known that good
communication skills are important to the nurses. I feel that I will be more confident in dealing
with the children and their families and would be more efficient in monitoring and assessing the
signs and symptoms of diseases. Accordingly, greater confidence would help in building greater
trust between the nurse and the student. After the incident, I believe that I would be able to
interact in confidence and act appropriately in response to critical situations.

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