The role of the school nurse in state primary schools.

Abstract

This research study intended to describe the present role of the school nurse emerging from official records, and the perceptions of it as reported by students, parents and teachers in a self-administered questionnaire. School nurses' views were also gathered during a focus group interview where factors enhancing or hindering their work were identified. Existing literature was reviewed through which the role of the school nurse emerged as an extended one including aspects of health promotion, health education, disease prevention, screening, administering first aid and case management. This was used as a basis for the design of the questionnaire. Results emerging from official records and corroborated by the findings from the focus group interview, indicate that the role of the school nurse is still primarily based on preset objectives of screening and vaccination. According to school nurses psychological and behavioural issues are treated in the presence of the doctor and upon referral by teachers or parents .. Health education and health promotion are only carried out by the school nurse if the opportunity arises and on the individual school nurse's initiative, time and organization permitting: The very small number of school nurses compared with the large number of schools at which they are expected to attend renders the presence of school nurses per school to a very minimal one, based on tasks and school populations·. Children in this study perceived the school nurse's role mainly as a health promoter and as a person who can intervene in actual and potential problems. For children, the role of checking for normal development was of less importance while they do not perceive the school nurse as a provider of long-term care in schools. Teachers in this study viewed the school nurse mainly as an assessor of normal development. Health and safety promotion including health education were perceived as forming parts of the school nurse's role together with intervening with actual and potential problems. Teachers did not agree that child case management forms part of the school nurse's role.

Parents in this study perceived the school nurse as an agent of health in school. They agreed with a fairly extended role as a person who intervenes with actual and potential problems, assesses normal development and promoting child health and safety. Parents agreed least with the role of the nurse as provider of child case management but this was still relatively higher than for the two other sample populations.

Qualitative findings from the focus group interview supported the quantitative findings emerging from the official records. School nurses reported that most of the time they assisted the doctor. School nurses said that they would like to extend their present role if there is enough time and if they were given specific education, which they felt they needed. They felt that being accepted in schools, where they form part of the staff, was very important for their work to be a success. A set of recommendations for further research, nursing education, nursing management and the School Medical Service concludes this work. Keywords: School nurse, primary school, role, perceptions.