Preparation to Promote Student Health and Wellness
The program prepares candidates to integrate health and wellness concepts in the educational setting to allow students to be in school, healthy, and ready to learn.
The program prepares candidates to integrate health and wellness concepts in the educational setting to allow students to be in school, healthy, and ready to learn. Candidates are knowledgeable about primary (disease prevention and health promotion), secondary (health screening, emergency, and acute care) and tertiary (rehabilitative or palliative care) levels of health care intervention as these relate to students and their families. In order for students to be optimally ready to learn, the program ensures that the candidate understands and can effectively apply the critical concepts of health and wellness within the school setting. These include, but are not limited to:
- promoting school safety, including disaster preparedness;
- delivering first aid and emergency care
- identifying and accessing local community and public health resources;
- addressing public health issues in the community that may affect schools;
- addressing student, family and community mental health and wellness;
- promoting nutrition and fitness;
- addressing specialized healthcare needs of students, including special education students;
- understanding child and adolescent growth and development;
- promoting staff wellness;
- addressing issues of community and family violence and substance abuse;
- addressing acute and chronic diseases or conditions within the student population
Criterion 1: Candidates recognize the need to integrate health and wellness concepts in the educational setting in the area of health education and health promotion in order to bring about positive behavioral changes among school age children and adolescents, as well as role models in faculty and staff.
Once candidates enter the core school nurse courses (NURS 184, 185, 186, & 187) they
demonstrate knowledge of NASN standards of nursing practice and are able to apply
the Nursing Process in the school setting in meeting the healthcare needs of individual
school age children and in development of various screening and health education programs
to maximize health and wellness through health promotion and health education (Standard
5b). Candidates also quote relevant sections of the CA Education Code that relate
to school nursing practice. Candidates research imperatives for health education,
including Healthy People 2010 goals, which include focus areas with goals and selected school-related objectives
which they can use as a guide in developing realistic health education offerings.
Candidates also define the responsibility for health promotion and health education
needs to be a collaborative effort and is best accomplished through partnering with
teachers and/or through participating in the development of coordinated school health
programs that involve a joint effort with teachers, families, and community. In preparing
candidates as health educators, candidates are required to take NURS 137, Teaching
Perspectives for the Healthcare Client, in which they gain insight into learning theories,
lesson planning, and curriculum development. In NURS 184, Introduction to School Nursing,
candidates are expected to familiarize themselves with a conceptual model, the constructionist
approach (Danielson & McGreal, 2002), for effectively teaching of school age children
and adolescents in the school setting which they can use in developing a health lesson
plan to teach in NURS 186, School Nurse Practicum I (elementary) or NURS 187, School
Nurse Practicum II (secondary). In NURS 185, candidates gain insight into the Group
Process and the art of facilitating a small group, which they can then use in facilitating
small group discussion on an adolescent health issues at the secondary level in NURS
187, School Nurse Practicum II. Candidates follow guidelines for grade/age appropriate
health education and learner readiness found in the CDE (2003) Health Framework for California Public Schools: Kindergarten through Grade Twelve and CDE (2010) California Health Education Content Standards: Kindergarten through Grade twelve in developing relevant and appropriate health curriculum and teaching plans.
With regard to faculty and staff health promotion, through Healthy People 2010 candidates research the essential components of a comprehensive worksite health promotion
program, i.e., health education that focuses on skill development and lifestyle behavior
changes in addition to information dissemination and awareness building, preferably
tailored to employees’ interest and needs, supportive social and physical environments,
integration into the organization’s structure, screening programs, etc. In didactic
coursework candidates learn about the importance of including faculty and staff in
health education and health promotion programs, recognizing the health adults are
role models for youth, and that healthy teachers mean continuity of education for
students and fewer sick days for employees. Candidates incorporate the Coordinated
School Health Program Model which outlines a nine-step process for developing a school-site
health promotion program in meeting the needs on a campus. Candidates must only use
evidence-based resources such as the CDC School Health Policies and Programs Study
for specific recommendations for school staff health promotion (CDC, 2001) and the
purpose of the CDC School Health Index that related to school site self-assessment
in order to plan health promotion programs and address other health related needs
in the school community. (See NURS 184, Introduction to School Nursing, weeks 7 and
10).
Criterion 2: Candidates are knowledgeable about primary (disease prevention and health promotion), secondary (health screening, emergency, and acute care) and tertiary (rehabilitative or palliative care) levels of health care intervention as these relate to students and their families:
While candidates are registered nurses who are aware of the levels of prevention and
care, this subject matter is covered throughout the core school nurse courses and
specifically addressed in NURS 184, Introduction to School Nursing, in Wk 4 as it
relates to the role of the school nurse.
Primary prevention (promoting health and preventing disease among school age children and adolescents
susceptible to disease with no known pathology) is covered in seminar courses for
examples, in NURS 184 (elementary seminar), candidates learn about coordinated school
health programs related to health promotion and disease prevention (Wk 2); prevention
through immunization requirements and other programs (Wk 5); health promotion and
the role of the school nurse as health educator (Wk 10). In NURS 185 (secondary seminar),
candidates relate primary prevention to coordinated school health programs at the
secondary level (Wk 2); adolescent preventive services and health promotion (Wk 3);
the school nurse as health educator at the secondary level, The Group Process, and
facilitating small groups on topics related to prevention (Wk 4); adolescent fitness
(Wk 5); health promotion and education related to substance abuse prevention (Wk 6);
health promotion and education related to sexually transmitted disease prevention
(Wk 7); health education as it related to healthy teen pregnancy (Wk 8); and mental
health issues (Wk 9). In Practicum courses (NURS 186 and NURS 187), candidates strengthen
their ability as health educators in the school setting, in health promotion through
counseling with individual children and adolescents, facilitating discussion with
small groups on various health related topics, through presentations to faculty, staff,
and community groups, and through presenting health lessons in the classroom. Candidate
competency in these areas is determined by qualified school nurse preceptors and clinical
instructors.
See Sec. 3 (p. 396 and p. 401): NURS 186 and NURS 187 Preceptor Syllabus checklists - E1 through E19 and S1 through S18 for candidate competencies and skills in the
area of Primary Prevention.
Secondary prevention (detecting disease in early stages in order to reverse or decrease the severity of
the disease outcome, which includes persons who may not exhibit clinical signs) is
addressed throughout the core school nurse coursework. Candidates demonstrate understanding
the importance of screening to detect health related problems that may impact learning,
they also understand the importance of health teaching and health promotion as it
relates to helping school age children, adolescents, and families adapt and care for
adjustments, such as corrective tools and equipment, that may be necessary following
referral and evaluation. In prerequisites to core school nurse courses candidates
are required to take Audiometry for School Nurses (3U), Health Assessment for School Nurses (3U), Introduction to Counseling (3U), as well as Vision and Scoliosis Screening in the School Setting (1U) or equivalent coursework approved by the program coordinator prior to entering
core school nurse courses. These prerequisite courses give candidates the necessary
tools needed to screen, interview, and assess those who may have unsuspected health
conditions and those with suspected health conditions that impact the child’s or adolescent’s
ability to learn. In core school nurse courses candidates learn about the various
sections of the California Education Codes that relate to mandated screening requirements
and guidelines, i.e. vision, hearing and scoliosis. Screening programs, as well as
planning strategies and tools for conducting classroom/school wide screening, are
addressed in different aspects of the core school nurse courses. For example in seminar
courses are as follows: NURS 184, Introduction to School Nursing (elementary) – Role
of the school nurse in Child Health and Disability programs (Wk 5); screening programs
related to BMI (body mass index), nutritional needs, normal growth and development,
identifying barriers to learning through assessment (Wk 6); use of the School Health Index in schools, cultural/ethnic backgrounds and tendency toward related health issues,
health concerns among migrant and homeless, dental screening programs (Wk 7). Examples
in NURS 185, School Nurse Seminar (secondary), School nurse responsibility as it relates
to understanding adolescent growth and development, helping teachers deal with stress
(Wk 1); understanding adolescent behavioral issues (Wk 2); adolescent preventive services
(Wk 3); nutrition and weight control among adolescents, female athlete health issues
(WK 5); adolescent addiction and substance abuse identification and intervention (Wk
6); counseling and referral for suspected sexually transmitted diseases (Wk 7); pregnancy
counseling, referral, and follow-up (Wk 8); assessment and counseling related to various
suspected mental health disorders, anxiety, self mutilation (Wk 9); counseling and
referral for suspected depression, threat of suicide (Wk 10); use of school bases
health clinics for screening and treatment of adolescent (Wk 11). In Practicum courses
(NURS 186 and NURS 187), candidates participate in screening and assessment individual
school age children and adolescents, as well as to participate in various screening
teams where they gain insight into screening techniques and develop their case findings
and assessment skills. This includes, but is not limited to screening school age adolescents
for vision, hearing, scoliosis, dental problems, BMI, nutrition, as well as communicable
diseases, acute and chronic health problems, mental health issues and various other
conditions that have the potential to limit a student’s ability to learn. Candidate
competency in these areas is determined by qualified school nurse preceptors and clinical
instructors.
See Sec. 3 (p. 396 and p. 401): NURS 186 and NURS 187 Preceptor Syllabus checklists - E1 through E19 and S1 through S18 for candidate competencies and skills in the
area of Secondary Prevention.
Tertiary prevention/intervention (includes ameliorating the course of disease, reducing disability, including rehabilitation
involving persons with clinical manifestations of disease). Candidates define the
purpose of tertiary prevention which is to interrupt the progression of a condition
in order to decrease the amount of morbidity or complications that are possible. Candidates
demonstrate the importance of sound health teaching and health promotion, as well
as case management of school age children and adolescents who have been identified
as having chronic health conditions that significantly impact their lives and frequently
their ability to reach optimal levels of ability to learn. Prerequisite to core school
nurse courses prepare candidates to work effectively to help these children and adolescents.
These courses are COUN 174 (or 200), Introduction to Counseling, in which the candidate
gains insight into effective counseling techniques that aid the candidate in interviewing
clients and families; SPED 120, Mainstreaming Exceptional Students, that gives the
candidate insight into programs and rights of individuals with disabilities; and NURS
136, Health Appraisal, which gives candidates insight into appropriate health assessment
techniques in determining deviations from the norm. In NURS 184, Introduction to School
Nursing (seminar), subject matter related to tertiary prevention/intervention is addressed.
For example: The role of the school nurse in caring for children and adolescents with
chronic conditions such as asthma, attention deficit disorders, diabetes, seizure
conditions, Cystic Fibrosis, severe allergies, Sickle Cell disease, and mental health
issues are covered in Wks 8, 9, & 11; health teaching techniques in Wk 11; Individuals
with disabilities in Wk 12; the IEP process, mainstreaming, and advocacy for children
and families in Wk 13; and care of the medically fragile and those with special health
care needs, and supervision and training of unlicensed personnel to care for children
with special needs is covered in Wk 15. In practicum courses (NURS 186 and NURS 187),
candidates participate in case management of students with complex health related
issues; learn to develop individual health care plans and emergency action plans for
those with special needs; participate in supporting, counseling, and teaching children,
adolescents, and families about their health conditions and assist clients in taking
responsibility for self care, offering students and families support and directing
them to appropriate resources; as a member of the education team at school sites candidates
participate in the planning process specific to the school nurse role in finding appropriate
educational placement of students needing special education programs or 504 plans
to accommodate their learning needs in the classroom.
See Sec. 3 (p. 396 and p. 401): NURS 186 and NURS 187 Preceptor Syllabus checklists – E20 through E30 and S19 through S30 for candidate competencies and skills in the
area of Tertiary Prevention/intervention.
Criterion 3: In order for students to be optimally ready to learn, the program ensures the candidate understands and can effectively apply the critical concepts of health and wellness within the school setting. These include, but are not limited to:
Promoting school safety, including disaster preparedness:
Candidates respond to a research question in NURS 184, Introduction to School Nursing,
in week 5 requiring the candidate to discuss the role of the school nurse in evaluating
playground safety at an elementary school and to include in their response what should
be included in a playground injury prevention plan. In week 7, one of the questions
requires the candidate to discuss the role of the school nurse in participating in
a school wide program to address individual safety relate to bullying. In NURS 185,
School Nurse Seminar, Week 11 is entirely devoted to school safety issues such as
the role of the school nurse in promoting safety and involvement in school wide disaster
planning, crisis intervention and post-vention, emergency action plans, collaboration
in school safety, identifying gangs and gang related violence, hate motivated behavior
and anger management. In practicum courses, students are expected to become familiar
with the school wide emergency plans at the school sites at which they are assigned,
understand the role of the school nurse in the event of a disaster or crisis incident,
to participate in planning an emergency action plan if the opportunity arises, to
be area of potential dangers in the neighborhood, to become familiar with signs of
gang activity in their area, to be aware of threats to individual students such as
bullying, and to be prepared for the role of the school nurse in a disaster, i.e.
as first responder, triaging, counseling, etc. Candidates are knowledgeable about
potential environmental health hazards such as mold, and playground safety issues.
See Sec. 3 (p. 396 and p. 401): NURS 186 and NURS 187 Preceptor Syllabus checklists – E8, E9, E22, E30 and S6, S7, S30 for candidate competencies and skills in the area
of school safety promotion and school wide disaster preparedness.
Delivering first aid and emergency care:
A requirement for all candidates entering the program is a current First Aid and CPR
certificate which needs to be kept current throughout the program. Prior to entering
core school nurse courses, candidates must also take NURS 136, Health Appraisal with
gives them the skills necessary to assess various health concerns and complaints.
In seminar courses (NURS 186 and NURS 187) first aid and emergency care is addressed;
in NURS 184, Introduction to School Nursing, Wk 8, a weekly question requires the
candidate to outline the assessment and first aid steps in managing various injuries
and other types of complaints. In NURS 185, School Nurse Seminar, Wk 5, questions
relate to the role of the school nurse in managing common sports injuries and emergency
first aid. In practicum courses at the elementary and secondary levels (NURS 186 and
NURS 187), candidates spend time working under the direct supervision of a qualified
school nurse at a school site assessing student complaints of illness or injury who
come into the health office, those injured on the playground or in P.E., and those
who require emergency care in the classroom, i.e., seizures.
See Sec. 3 (p. 396 and p. 401): NURS 186 and NURS 187 Preceptor Syllabus checklists - E20, E21, E22, E23 and S19, S29 for candidate competencies and skills in delivering
first aid and emergency care to students, faculty and staff at the elementary and
secondary levels.
Identifying and accessing local community and public health resources:
Community health coursework is required as a prerequisite to entering the program.
It is the strong belief of program faculty that the school nurse must have a global
understanding for community health issues and knowledge of relevant resources in the
community in order to meet the needs of the school age children, adolescents, and
families they serve. Most candidates enter the program having completed a BSN program
that includes community health coursework leading to a PHN. Candidates entering the
program having completed a bachelor’s degree in another field are required to complete
community health coursework, both didactic and field experience, at the university.
Though a PHN is not required, importance is placed on the need for candidates to know
and understand community health needs, issues, and resources. California State University,
Fresno offers community health coursework through the RN to BSN program, NURS 141,
Concepts in community Health (3U), and NURS 141L, Practicum in Community Health Nursing
(3U) in which application of primary, secondary, and tertiary prevention in the community
with individuals, families, and groups is addressed. The importance of community involvement
is stressed in core school nurse courses. In NURS 184, Introduction to School Nursing,
community outreach is covered in the following areas: Coordinated school health programs
which includes community outreach (Wk 2); community collaboration (Wk 7). In NURS
185, School Nurse Seminar, community outreach is covered in the following areas: Coordinated
school health programs, adolescent and family involvement (Wk 2); disease prevention
for adolescents through coordinated programs (Wk 3); accessing community resources
as they relate to primary, secondary, and tertiary prevention and intervention regarding
adolescent involvement with substance abuse, unsafe sexual behavior and sexually transmitted
diseases, pregnancy, and mental health issues (Wks 6, 7, 8, and 9); school based clinics,
community partnerships (Wk 12). In both practicum courses, NURS 186 and NURS 187 (elementary
and secondary respectively), candidates are required to spend 8 to 10 hours each semester
becoming acquainted with community resources relevant to each of these educational
levels through actually visiting community agencies and programs and being involved
in other community activities such as participating in community health fairs or planning
a health fair where agencies are invited to a school site.
See Sec. 3 (p. 396): NURS 186 Preceptor Syllabus checklists – E6 and S4 for candidate competency in identifying and accessing local community
and public health resources.
Addressing public health issues in the community that may affect schools:
Program faculty realizes that the school nurse cannot remain isolated in the school
building without knowledge of what is taking place in the community. As noted above,
Community health coursework is required as a prerequisite to entering the program.
Candidates incorporate a global understanding for community health issues and knowledge
of relevant resources in the community in order to meet the needs of the school age
children, adolescents, and families they serve. Most candidates enter the program
having completed a BSN program that includes community health coursework leading to
a PHN. Candidates entering the program having completed a bachelor’s degree in another
field are required to complete community health coursework, both didactic and field
experience, at the university. Though a PHN is not required, importance is placed
on the need for candidates to know and understand community health needs, issues,
and resources. California State University, Fresno offers community health coursework
through the RN to BSN program, NURS 141, Concepts in community Health (3U), and NURS
141L, Practicum in Community Health Nursing (3U) in which application of primary,
secondary, and tertiary prevention in the community with individuals, families, and
groups is addressed. In practicum courses (NURS 186 and NURS 187) candidates spend
8-10 hours visiting and becoming acquainted with community resources and gaining insight
into health issues in the community; they also spend 10-12 hours each semester during
their practicum experiences attending community meetings where health issues are discussed,
i.e., school nurse meetings and conferences, meeting for health care providers put
on by local health departments, and community forums addressing health issues. Candidates
participate in community screening programs, i.e. tuberculosis case follow-up, meningitis,
flu, etc. that may occur during their practicum experience. Working under the supervision
of a qualified school nurse preceptor, candidates gain insight into steps that are
necessary to prepare the school community to meet the challenges of public health
threats such as the HINI flu, i.e. notification if school community and families,
health education (effective hand washing techniques and coughing techniques) in and
outside of the classroom, use of other recommended precautions, establishment of guidelines
for exclusion and readmission to school, and staying informed themselves through communication
with the local public health department and CDE advisories.
See Sec. 3 (p. 396 and p. 401): NURS 186 and NURS 187 Preceptor Syllabus checklists – E6, E9 and S4, S7 for candidate competency in addressing public health issues in
the community that may affect schools.
Addresses student, family and community mental health and wellness:
Candidates who enter the program have a background of understanding for mental health
and wellness issues. These were addressed in undergraduate nursing programs through
sociology and psychology courses, psychiatric affiliation, and in their community
health nursing experiences. In the program, candidates learn about the value of coordinated
school health programs, use of the School Health Index, and value of surveys in determining
health education needs in the school community. As a prerequisite to practicum courses
(NURS 186 and NURS 187) candidates are required to take an introduction to counseling
course, COUN 174 or COUN 200, which prepares them to use effective counseling techniques
and interviewing techniques with both students and families in discussing student
and family concerns. Mental health and wellness addressed in NURS 184, Introduction
to School Nursing, examples: Employee job satisfaction, Wk 4; identifying barriers
to healthy lifestyle for children (Wk 6); helping students and families cope with
stress (Wk 7); anxiety disorders and behavioral issues (Wk 11); acting out behaviors,
school phobia, children of dysfunctional families (Wk 12); supporting parents of special
needs children (Wk 13). In NURS 185, School Nurse Seminar, examples: Adolescent behavior
and impact on health and learning, teacher stress (Wk 1); coordinated school health
programs and adolescent health issues (Wk 2); adolescent preventive services, health
education, school nurse as health educator (Wk 3, 4); adolescent activity and fitness
(Wk 5); health promotion and education as it relates to substance abuse, unsafe sexual
activity, pregnancy (Wks 6, 7, 8); psychiatric disorders, behavioral and emotional
issues, depression and suicide, stress and self injury, eating disorders, date rape,
hate motivated behavior and anger management, role of the school nurse in counseling
and psychosocial interviews (Wks 9, 10, 11). Under the supervision of a qualified
school nurse preceptor in practicum courses (NURS 186 and NURS 187), candidates have
the opportunity to interview and teach school age children, adolescents, and families
regarding a variety of health related issues. At the secondary level, candidates practice
health promotion and to teach, interview and counsel adolescents working through personal
crises in their lives, i.e. substance abuse issues, suspected sexually transmitted
diseases, pregnancy, emotional issues, depression, and possible threatened suicide.
See Sec. 3 (p. 396 and p. 401): NURS 186 and NURS 187 Preceptor Syllabus checklists – E4, E5, E11, E12, E18, E31, E34, and S2, S3, S10, S11, S13, S15, S21-26, S31, 232
for candidate competency in addressing student, family and community mental health
and wellness issues.
Promoting nutrition and fitness:
In core school nurse courses, candidates study the importance of growth and development
and age appropriate nutritional needs and physical fitness needs of school age children
and adolescents, as well as the additional nutritional needs of athletes. In NURS
184, Introduction to School Nursing, subject matter is addressed: The school nurse
role in keeping children with food allergies safe at school through educating and
working with teacher, families, and students (Wk 5); assessment of growth and development
of the school age child, calculating body mass index, promoting a healthy lifestyle
among school age children (Wk 6); promoting healthy eating in school, assessing school
nutrition services (Wk 7); intervention in the cycle of childhood obesity (Wk 9).
In NURS 185, School nurse seminar, examples where subject matter is addressed: The
role of the school nurse in understanding adolescent growth and development (Wk 1);
adolescent physical activities and fitness, nutritional needs of the young athlete;
and identification, counseling, and referral of students with eating disorders (Wk
9). In practicum courses (NURS 186 and NURS 187) candidates perform health assessments
on school age students and adolescents during their clinical experience with a qualified
school nurse preceptor. In NURS 186, candidates are asked to complete a case study
on a school age child which includes a nutritional assessment, giving the candidates
the opportunity to do some teaching and health promotion with the family. Candidates
frequently choose nutrition as a topic to teach as a lesson in the classroom at the
elementary level or individually with students with special needs such as students
with diabetes, and/or facilitating discussion among small groups at the secondary
level, i.e. pregnant teens, athletes, others.
See Sec. 3 (p. 396 and p. 401): NURS 186 and NURS 187 Preceptor Syllabus checklists – E13, E31, and S11, S22, S24 for candidate competency in promoting nutrition and
fitness among school age children and adolescents.
Addressing specialized healthcare needs of students, including special ed. students:
Throughout the core school nurse coursework candidates study the care of students
with special needs, including those in special education programs and the medically
fragile. The care of students with special needs is addressed in seminar courses and
candidates are exposed to caring for these students in the school setting in practicum
courses at the elementary and secondary levels. Candidates demonstrate that an important
school nurse function is to develop healthcare plans for individual school age children
with special needs in regular education and in special education programs, and for
families with a child in an early intervention program. These include Individualized
Health Care Plans, i.e. for students with diabetes, Sickle Cell Disease, Cystic Fibrosis,
etc.; Individualized Family Service Plans related to early childhood; 504 Plans for
students who need special accommodations or nursing services in a regular classroom;
and Emergency Action Plans for students with conditions that can become life threatening.
Candidates also define the role of the school nurse as a member of the IEP (Individualized
Education Program) team. Candidates understand that the plan must be specific to the
client or family and must be developmentally, culturally, and environmentally appropriate,
seeking to safeguard the student and promote health and prevent disease. To prepare
candidates to understand the laws and basic issues relevant to students placed in
special education in the least restrictive environment, candidates are required to
take SPED 120, Mainstreaming the Special Needs Child (3U), (or Psych 168) as a prerequisite
to core school nurse courses. Candidates learn about the law that authorizes special
education, federal Public Law 94-142 of 1975, now known as IDEA (the Individual with
Disabilities Education Act). In NURS 184, Introduction to School Nursing, specialized
healthcare needs of students, including those in special education programs are addresses:
Care of students with chronic health problems, development of Individual Healthcare
Plans and Emergency Action Plans (Wks 8 & 9); Special education, the IEP Process,
interdisciplinary collaboration, role of the SEPA (Special Education Local Planning
Area); IFSPs (Individual Family Service Plan), special programs/placement (Wks 13
& 14); medically fragile students, developing special healthcare plans, supervision
and training unlicensed assistive personnel to assist in caring for students with
special needs; infection control in the medically fragile population, understanding
and advocating for parents of children with disabilities (Wk 15). In NURS 185, School
Nurse Seminar, special education at the secondary level is addresses (Wk 1). Candidates
also spend time shadowing three other members of the education team to gain insight
into their roles and how they work with students and families, and how they interact
as a member of the education team. In NURS 186, School Nurse Practicum I, candidates
learn first-hand about the role of the school nurse as a member of the IEP team. Candidates
gain insight into the IEP process through completing a required case study, on a school
age child of a different cultural other than their own, who has been referred for
evaluation for possible placement in a special education program. Candidates participate
in the entire process beginning with the Developmental History, the school nurse assessment
of the child, participation in the initial Student Study Team meeting, and ending
with the placement of the student into the appropriate program. Candidates spend quality
time in their practicum experience developing care plans for students with special
needs and gaining first-hand experience in caring for the medically fragile. In practicum
courses candidates are also encouraged to actually spend time observing in special
education classrooms to gain insight into teacher-student interaction and classroom
issues. In NURS 187, School Nurse Practicum II, candidates have the opportunity work
with adolescent with special needs either through developing care plans, emergency
action plans and/or participating in the IEP process. At the secondary level, candidates
also must use demonstrate their counseling and assessment skills in meeting the healthcare
needs of student who are suspected of substance addiction, have pregnancy related
issues, and various other conditions of a physical or mental health nature, i.e. eating
disorders, depression, such as eating have become addicted to substances.
See Sec. 3 (p. 396 and p. 401): NURS 186 and NURS 187 Preceptor Syllabus checklists – E20, E27, E22, E24, E25, E27, E28, and S9, S10, S22, S23, S24, S27, S29 for candidate
competency in addressing specialized healthcare needs of students, including special
education students.
Understanding child and adolescent growth and development:
Candidates enter the program with a background of understanding for growth and development
obtained from their basic under graduate nursing programs. Candidates in core school
nurse courses understand growth and development and, in practicum course (NURS 186
and NURS 187) incorporate guidelines for growth and development when assessing client
health status; and in planning and development age/grade level appropriate health
education materials, lesson plans, and classroom teaching which needs to be based
on student readiness to learn. Candidates also gain insight into the nutritional needs
of children and adolescents based on age and level of activity. Sources used by candidates
in the program that gives them the necessary insight into growth and development and
nutritional needs for age and level of physical activity are the required course
readings: Selekman (2006) School Nursing: A Comprehensive Text, chapter 16, Growth
and Development: Preschool through Adolescence; California Department of Education
(2003) Health Framework for California Public Schools; Kindergarten through Grade
Twelve; California Department of Education (2010) Health Education Content Standards
for California Public Schools: Kindergarten through Grade Twelve; and recommended
text practicum courses, Lewis, K. D. & Bear, B. J (2008) Manual of School Health (3rd
Ed.), as well as other reference materials. In seminar courses, growth and development
is addressed in NURS 184, Introduction to School Nursing, assessment of growth and
development and body mass index (Wk 6); and in NURS 185, School Nurse Seminar, adolescent
growth and development (Wk 1).
See Sec. 3 (p. 396 and p. 401): NURS 186 and NURS 187 Preceptor Syllabus checklists – E2, E5, and S1, S3 for candidate competency in understanding child and adolescent
growth and development as it relates to the health care and health education needs
of school age children and adolescents.
Promoting staff wellness:
Candidates define that “health promotion of staff” is one of the eight components
of a Coordinated School Health Program and that the school nurse has a responsibility
for promoting a healthy lifestyle among this population. Candidates understand that
this means creating an interest among staff member for the purpose of encouraging
them to take personal responsibility for their well-being through taking advantage
of opportunities that the school nurse may provide such as health assessments, i.e.
screening; health education offerings and fitness activities based on staff interest.
Candidates learn that investment in the health of employees benefits both the employees
and employers (Partnership for Prevention, 2001). Candidates learn that staff wellness
results in improved health behavior and health status, reduced healthcare costs, and
lower employee absenteeism as well as higher productivity and moral (Allegrante, 1998).
It is also believed that attention to employee health in the school setting further
leads to a greater commitment of the employee to the school’s health program and increases
numbers of healthy role models for school age children and adults. In NURS 184, Introduction
to School Nursing, health promotion of staff is addressed in the following: Coordinated
school health programs (Wk 2); Cal-Osha guidelines and role of the school nurse in
in-services school faculty/staff on safety measure related to blood borne pathogens,
benefits of worksite health promotion program, school nurse development of surveys
to determine health education and health promotion needs of students and staff, evaluation
of survey data in determining programs (Wk 10). In NURS 185, School Nurse Seminar,
health promotion of staff is addressed in the following: Coordinated school health
programs at the secondary level (Wk 2); and bringing health fairs to campus (Wk 3).
In practicum course (NURS 186 and NURS 187) candidates, under the supervision of a
qualified school nurse preceptor, have opportunities to participate in health promotion
among staff. This may include a screening program, i.e. taking blood pressures, administering
PPD (TB) skin tests, presenting at a faculty meeting on current health concerns, i.e.
HINI flu precautions, assisting in the development of a survey regarding staff interest
in a health education offering or physical activity, or taking on a project such as
a school health fair for students and staff.
See Sec. 3 (p. 396 and p. 401): NURS 186 and NURS 187 Preceptor Syllabus checklists – E12, E13, and S11, S15 for candidate competency in promoting staff wellness.
Addressing issues of community and family violence:
In seminar courses candidates define the impact of violence on the school community
and its effect of student learning; the early warning signs of danger and behavioral
precursors; signs of gang activity and bullying; child abuse and neglect; gender harassment
and abuse; date violence; and other various threats to campus security, i.e., intruders.
Candidates also research school site safety plans that address prevention through
partnering with law enforcement and other community groups and agencies, corporation
among members of the school community, school site security measures; conflict resolution;
and the role of the school nurse. In NURS 184, Introduction to School Nursing, following
are examples where subject matter is addressed: Identifying bullies and the victims,
bullying prevention and the role of the school (Wk 7); Child abuse and neglect, identification
and responsibility for reporting and role of the school nurse. In NURS 185, School
Nurse Seminar, following are examples where subject matter is addressed: Bullying
recognition and prevention at the secondary level, sexual harassment (Wk 10); safe
schools and the role of the school nurse, disaster prevention, intervention, and post-vention,
school wide emergency action plans, collaboration in keeping schools safe, gangs and
violence, hate motivated behavior, racial and ethnic issue, anger management. In NURS
186 and NURS 187, practicum courses, candidates have the opportunity to experience
first-hand the concerns associated with community and family violence.
Regarding community violence: Candidates spending time at school sites become aware
of the potential dangers in the community and threats to schools. Working with a school
nurse preceptor and other members of the education team, candidates begin to identify
signs of gang activity and other potential threats to individuals and the school community.
Candidates have the opportunity to see how schools and partners in the community work
together in a multidisciplinary effort to carry out a school-wide safety plan. Most
importantly, candidates learn that the school nurse is a key person in the school
community, one who is knowledgeable of the physical and emotional needs of the students
and who is known and trusted by parents and staff, that he/she is the only health
professional at the school site and, therefore, needs to be involved in the planning,
implementing, and in the execution of the disaster plan, particularly in the area
of crisis response and as a first responder to the public health crisis.
With regard to family violence: In practicum courses (NURS 186 and NURS 187) working
under the supervision of a qualified school nurse preceptor, candidates use their
assessment skills in identifying signs and symptoms of child abuse and neglect and
to exercise their judgment in appropriate reporting. At the secondary level, candidates
also have knowledge of the existence of date violence and sexual abuse reporting guidelines
and are prepared, with preceptor supervision, to counsel and refer these victims to
the appropriate community resources and file appropriate reports.
See Sec. 3 (p. 396 and p. 401): NURS 186 and NURS 187 Preceptor Syllabus checklists – E8, E15, and S6, S16 for candidate competency in addressing issues related to community
and/or family violence.
Addressing substance abuse:
Candidates research substance abuse in core school nurse course relevant to the secondary
level (middle school and high school). Nursing 185, School Nurse Seminar (secondary
level), week 6 is devoted to the role of the school nurse as it relates to substance
abuse prevention and intervention among pre-adolescents and adolescents. This includes
various types of street drugs and addiction, alcohol abuse, smoking and other inhalants,
ergogenic substances used by athletes, factors leading to substance abuse, assessment
and recognition of substance abuse, health education programs, health promotion and
prevention, cessation programs, and Ed code references to health promotion and education
in the area of substance abuse. In practicum courses, particularly at the secondary
level, candidates may assess, interview, counsel, and refer students who are suspected
of substance abuse. Candidates also gain insight the role of the school nurse with
regard to reporting responsibilities, i.e., school administrator and law enforcement
involvement. In the secondary level practicum, candidates visit community agencies
and programs that treat adolescent substance abuse.
See Sec. 3 (p. 401): NURS 187 Preceptor Syllabus checklist – S17 for candidate competency in addressing substance abuse in the pre-adolescent
and adolescent population.
Addressing acute and chronic diseases or conditions within the student population:
The candidate’s nursing background has prepared them with insight into various acute
and chronic health conditions. Candidates demonstrate a clear understanding for the
Nursing Process (assessment, diagnosis, outcomes identification, planning, implementation,
and evaluation) with regard to problem solving and meeting the healthcare needs of
school age children and adolescent. Prior to entering core school nurse course, candidates
are required to have a current First Aid certificate and to have taken NURS 136, Health
Assessment (or its equivalent), which provides them the knowledge background and skills
necessary to properly assess the various health complaints related to acute and chronic
health condition that students present with on arriving in the school health office.
In NURS 184, Introduction to School Nursing, examples of subject matter addressed:
Assessment as it relates to secondary and tertiary prevention and intervention (Wk
4); keeping children with allergies safe in the school setting (Wk 5); acute complaints,
i.e., “stomachache,” chest pain, complaints of “not feeling well”; chronic health
conditions, i.e., asthma, diabetes I, seizure conditions, Sickle Cell disease, Allergic
Rhinitis, encoprisis, food allergies, Cystic Fibrosis, health issues resulting from
obesity, attention deficit disorder, etc. (Wks 6 and 7). In NURS 185, School Nurse
Seminar, examples of acute and chronic health conditions at the secondary level: Substance
abuse issue, suspected sexually transmitted diseases, pregnancy related problems,
anxiety and stress related self injury, eating disorders (Wks 6-9); and use of school
based clinics (Wk 12). In practicum courses, under the supervision of a qualified
school nurse preceptor, candidates assess students with acute and chronic health conditions
who are seen in the health office, develop Individual Healthcare Plans on those with
chronic health conditions, and Emergency Action Plans for those with conditions that
could result in an emergency. Candidates use their counseling skills in helping these
students, as well as the opportunity to teach and instruct the student regarding their
condition and about self care and personal responsibility. Candidates case manage,
i.e., assist families in obtaining appropriate care, and to partner with care providers
in the community and agencies in meeting the healthcare needs of these students. Further,
candidates strengthen their understanding for confidentiality as it relate to HIPAA
and FERPA laws in sharing information on a need to know basis.
See Sec. 3 (p. 396 and p. 401): NURS 186 and NURS 187 Preceptor Syllabus checklists – E2, E4, E 20 through E25, E27, E29, and S19, S20, S22 through S29 for candidate
competency in addressing acute and chronic disease or conditions within the school
population.