Behind Closed Doors: School Nursing and Sexual Education

School nurses are independent health professional that should play a key role in providing education about sexual health, pregnancy and STI prevention in the schools. One potential barrier to expanding school nurse practice in those areas are “Gate Keepers” such as the school administration, school boards and involved parents. Additionally, the school nurses may not have sufficient training to negotiate sexual education and to teach this topic.This study employed the phenomenological qualitative research method to explore the school nurses' experiences with barriers and in negotiating strategies to provide sexual education at the schools. Nurses from purposive sample of Massachusetts high school were interviewed. Context of the town characteristics (statistics of STD and pregnancy) was integrated into the analysis. Preliminary results showed that while school nurses do not provide formal sexual education at their schools, informal sessions do occur between the school nurse and individual students. School nurses feel that their students need more information regarding sexual health, yet there is a lack of collaboration with the schools health teachers who teach formal sexual education. Common barriers encountered include lack of privacy, lack of time, the issue of confidentiality when talking with a minor, fear of conflict with school administration and/or parents and a deficit in knowledge. Nurses operating in communities with high teen pregnancy rates more commonly reported barriers and less collaboration. These findings can inform school nurse training and the development of policies and working practices for school nurses that is vital to ensure adequate sex education in schools.