School Nurses and Advanced Health Assessment

Today more than ever before, school nurses need advanced assessment skills. While nurses in all settings are more independent and more accountable, school nurses are even more so. Budget cuts have necessitated the elimination of nursing coordinators or school doctors on a full-time basis so very often school nurses are the only medical personnel in their building. This becomes a major responsibility when you’re the one who everyone is turning to for answers on child abuse, substance abuse, blood borne pathogens and asthma just to name a few issues. School nurses must rely on themselves and on their own nursing skills. And one of the most important and sophisticated skills nurses must master is assessment. One of the most challenging issues a school nurse faces is serving children who lack health care. More often than not, the school nurse is the only medical personnel the child has seen in some time. Correct assessment of a child’s complaint and knowing when or when not to refer for medical care becomes extremely important. In today’s economic climate, families are under great pressures of all kinds which affect their children. Lack of jobs, health insurance and money all help to create pressures in families which many times leads to abuse within families. In these situations, school nurses must rely on their assessment skills, very often acting as forensic nurses in investigating a suspected incident of child abuse which has presented itself in her health office. Determining whether an incident should be considered child abuse necessitates the collection of subjective and objective data in a thorough, systemic fashion in order to formulate a diagnostic impression. Whether the issue is a pandemic flu, lack of health care or child abuse, school nurses are expected to know and respond to a host of many complicated issues and advanced health assessment skills is a must for practicing school nurses today.

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