During a global pandemic, the school nurse is essential and relevant, even when there are no students in school buildings. As we continue to perform essential duties, we also have an incredible opportunity!
NASN created the Framework for 21st Century School Nurse Practice to outline the various aspects of our role. The framework outlines 5 major components, or domains, of the work we do: Community/Public Health, Care Coordination, Leadership, Quality of Care, and Standards of practice, We can use this Framework to ensure we are practicing to the limits of our licenses AND to educate the educators about what it is we do (beyond what they see in the health rooms). Corinna Brower, State School Nurse Consultant, has created some guidance which will inform your conversations with district administrators and your communities. Some examples of the work we can do in the midst of this pandemic (and about which we can share) include, but are certainly not limited to, the following...
Distance learning necessitates essential, regular communication with students and their families. In many districts, teachers will touch base with every one of their families at least twice each week. As nurses, we can add another layer to this communication by reaching out to families of students with chronic health conditions to ensure they are connected to the care their children need and understand risk factors associated with COVID and to answer questions, within our scope. We can be resources for teachers when they come across a family which needs support relating to physical and/or behavioral health. (Care Coordination and Community/Public Health domains)
In addition, we can help advocate for staff as decisions are made about who must work in buildings, facilitating districts’/ESDs’ compliance with evidence based public health guidance and reducing staff’s risk of exposure to the COVID virus. (Community/Public Health, Leadership, and Quality Improvement domains).
We can support the childcare programs mandated by the Governor, ensuring that the policy and protocols in place reduce the risk of exposure of both staff and students to the COVID virus (Community/Public Health, Leadership, and Quality Improvement domains).
We can continue with year end care planning and preparation for care coordination when students return to buildings, as well. (Care Coordination), In addition, as staff have more time, we will continue to deliver the medical trainings they need (virtually). (Care Coordination and Quality Control domains).
One silver lining of this pandemic is that we can use non-student time (which we almost never have) to improve our practices. Without the need to provide direct care to students, we can focus on developing system solutions to improve the efficiency and quality of the care we provide and to facilitate closer adherence to the laws and standards which govern our practices (Standards of Practice domain).
Around this last work, we have a HUGE opportunity. School nurses, so often overwhelmed by enormous caseloads, typically do not have time to connect with one another as we develop systems solutions. With time to focus on the foundations of our practice, I propose that we collaborate on projects which will markedly improve the efficiency and effectiveness of school nursing in Oregon. The following projects come to my mind (but I am open to other projects if you have suggestions):
The Template Committee has begun a process of creating care planning tools (action plan templates), for which we are extremely grateful. I recommend that we renew their efforts in two ways. We should collaborate to create templates for several more conditions AND refine existing tools which can accompany those templates (e.g. tool kits).
To support evidence based practice, I suggest that a group of us research and collect the most up-to-date resources which inform decisions we make every day. For example, in places the Communicable Disease Guidance from ODE/OHA, states, “may attend with licensed health provider/school nurse permission…” When school nurses make decisions about medical conditions, we should be well versed in the current information about those conditions.
In addition, as we coordinate care for student conditions, it is important that we have access to resources about medical conditions. I envision folders on our website which offer “one stop shopping,” providing templates for action plans along with other care coordination tools such as links to medical basics (including current data) about a condition, applications to care in the school setting, recommendations for 504 accommodations (when appropriate) and perhaps (eventually) nursing care planning tools .
PLEASE consider joining us by contributing your time and talent toward the advancement of one of these projects. We will use the feedback.osna@gmail.com account to manage these projects, so please send your ideas or offers to help there. Looking forward to collaborating with you all! feedback.osna@gmail.com