I am grateful to OHA for inviting OSNA to participate in the hiring process for the new State School Nurse Consultant. Since her hiring, I have had the opportunity to work with our new State School Nurse Consultant, Corinna Brower, and we agreed that one way to introduce her to school nurses in Oregon would be to share a Q&A session. This is long, but I wanted to make the whole discussion available!
Q: What is your background? Why did you apply to the State School Nurse Consultant position?
A: I am quite frankly thrilled to be joining the Oregon Health Authority as the State School Nurse Consultant. I’ve been working toward this type of job for over a decade. I grew up in Oregon, I developed a passion for health promotion as a Peace Corps Health volunteer in Morocco and then as a nurse and health advocate in Arizona. It is great to finally be on home turf again.
While I’ve been in schools and partnering with school nurses for many years, my primary employment has been as an acute care RN with chemotherapy certification. I’ve also worked as a clinical instructor, challenging new nursing students to think critically about best practice. In addition to direct care and nurse education, I’ve spent over a decade volunteering in health-promoting efforts at K-12 schools.
My school-based health promotion efforts have included providing classroom health lessons, conducting needs-assessment surveys with school health staff, and interning with the Coordinated School Health Program serving Wellness Coordinators in schools across Pima county. In 2015 I began working towards my Master’s in Public Health, in the “Health Behavior and Health Promotion” track. Through the years, I have taken every opportunity to learn about what goes on in schools.
Q: During your past experiences, what have you learned about what goes on in schools?
A: Even educated members of the public have a lot to learn about what school nurses do. As a nurse myself, after years seeing hospital patients and volunteering with K-12 students, I entered the Masters program thinking I knew what should be happening in schools. How naïve I was. I was one of those people who thought the Coordinated School Health/Whole School, Whole Child, Whole Community (CSH/WSCC) models would be great, if only school nurses would try to implement them. I still think the WSCC model is great, but nurses are already doing pretty intense work. During the first months of my studies, I sought out school nurses for health promotion projects. As I listened to their stories, my eyes were opened to the real challenges school nurses face.
I heard…
…a nurse who started in schools after years in the ER, seeing students day after day with critical needs, saying, “Some days it feels just like working in the ER, without any of the equipment or support.”
…a school nurse assisting a classroom teacher who had students with seizure disorder, diabetes, and asthma, the teacher telling the nurse, “I don’t feel qualified to know what to do.”
…school nurses serving 2, 3, 4 different schools, with catchment areas across the county.
…school administration challenges from a school nurse with low-income and diabetic students, wanting to provide healthy snacks, allowed to have “share tables” at one school but not at another due to differences in the principals’ interpretation of infection prevention standards.
…care coordination challenges from an experienced school nurse, using as an example a student whose headaches seemed beyond the norm; the nurse had to argue with teachers and parents that this was more than attention-seeking, who ultimately referred the child for evaluation and the child ended up having surgery for a brain tumor.
…stories from schools where nurses who are not even employed because “anyone can give a kid a band-aid.”
As a nurse who volunteered in schools, I was remarkably uninformed about what school nurses do, and what they need to do their jobs better. I worked hard to change that. For years now I’ve worked to educate myself about what is really going on in the world of school health. That experience gives me motivation to communicate even more clearly with decision makers about how truly necessary school nurses are to the health and wellbeing of student populations.
Q: What sort of work have you done in schools related to school nursing or school health promotion?
A: School health issues I’ve addressed range from school nurse challenges and school community issues, to state legislation and infrastructure considerations. I’ve worked directly with K-12 students in multiple health-related roles, including: as a guest speaker presenting health lessons tailored to specific class needs; as an Open Airways for Schools facilitator helping 3rd-5th graders manage their asthma; as an educator for the Skin Cancer Institute’s “Students are Sun Safe” program for 6th-8th graders; and multiple years at one high school helping develop wellness programs. The final years with the high school included forming the school’s first Student Wellness Advocacy Team, and two years facilitating meetings and supporting their Coordinated School Health efforts.
My work at the high school led to an internship at the county level, where I helped create a sustainable way to improve school health and wellness programs at the county’s Coordinated School Health program -- a program serving 80-100 schools each year. In support of that program, I conducted needs-assessment with school nurses and school wellness coordinators. The results helped guide changes in the way the program is run. My efforts helped establish an ongoing partnership between the University of Arizona and the Pima County Health Department.
In addition to working directly with students and schools, I’ve participated in efforts to pass health-promoting legislation: attending town hall meetings, developing infographics and social media messaging, and meeting with local legislators. All these efforts were conducted simultaneously with my work in the hospital. In many hospital patients, I saw the worst-case scenarios that result from lack of knowledge, lack of access to resources, and lack of support. Those direct-care experiences provided strong motivation to continue my efforts in schools and communities.
Q: Not having worked as a school nurse, what other strengths do you bring to your role as a state school nurse consultant?
A: While I have not worked in a school health office, all of the activities I’m performing as the State School Nurse Consultant are closely linked to work I’ve been doing – either for pay or as a volunteer – for many years. Here are a few examples of what that has looked like in my first month.
This role includes finding answers to day-to-day questions posed by school nurses across the state. I’ve worked hard to develop a network of resources, and have already been able to provide evidence-based answers to questions posed at the start of the school year. Some questions are related to issues of legality or liability, such as scope of practice and delegation; for these I refer to written laws at the state and national level as well as seeking input from contacts at ODE and OSBN. Some questions are about best practice for a specific clinical issues; for these I draw on my own experiences as well as seeking expert input from NASN and OSNA sources. Some questions are about challenging situations given limits of local resources. These may best be answered by experienced, local school nurse colleagues, so -- with permission -- I refer these types of questions to the OSNA discussion group, or to nurses practicing in schools with similar demographics to that of the questioner.
The State School Nurse Consultant role includes supporting the continuing education of school nurses. School nurses are not only care providers, but health educators for their communities. It is vital that they have up-to-date information on managing health issues. Many health issues I know well, but my role is not be to educate individual nurses. My role is to look at how nurses are educated across the state, and work to ensure every school nurse has access to the continuing education they need. In the past month, this part of my role has included delivery of up-to-date information through School Nurse Orientations, and working with OSNA on conference planning. In the coming months, as I develop closer relationships with the many players impacting school nursing, I hope to advocate for the continuing education of school nurses in other ways as well. This may mean working with ODE to develop new standards and funding options to support continuing education, for example.
The State School Nurse Consultant position includes supporting school nurses in their unique and vital role, and advocating for them when they face challenges. One challenge I’ve discussed with school nurses this month is that most school nurses in Oregon are evaluated by non-nurse personnel, such as the principal or special education coordinators. As someone with over a decade in direct care, I might be more qualified to evaluate what successful nursing practice means, compared to some non-nurse administrators. But as the State School Nurse Consultant, it is not my role to evaluate individual nurses. It is my role to evaluate how nurses are evaluated, and strive to find tools and policies that more fully recognize the role nurses play in the school setting. This includes working closely with ODE and OSNA to develop policies that will positively impact school nurses, and the communities they serve.
As passionate as I am about school-based health promotion, I respect that there are other individuals who could be more effective running a school health room. But the position of State School Nurse Consultant isn’t about one health room, or one district. It’s about supporting all school nurses, across all the districts in Oregon. This position offers me the opportunity to use all my knowledge and my passion for health promotion to support school nurses in my home state. I feel truly fortunate to have this opportunity, and will do everything I can to ensure school nurses across the state are getting the support they need.