School Nurses' Roles in Promoting Population Level Health in an Urban School District

Evaluations of the role of school nurses often do not address their role in promoting a Coordinated School Health Program (CSHP), which has more potential for changing the culture of health within their schools. These studies may not adequately capture the contribution of school nurses because of the multi-layered nature of their work and their invisibility within schools. While school nurses are often viewed as providing only individual care for students, they often play a primary role in promoting the overall health of their schools. This study was conducted to determine the role that school nurses play in promoting the CSHP model and population level health services within their schools. Data from interviews with 18 nurses in a large, urban school district that serves a predominately low-income student population were evaluated qualitatively according to the components of the CDC's Coordinated School Health Program and population-level interventions included in the Wheel of Public Health Interventions. Results indicated that through collaboration with school staff and community resources, school nurses are engaged in provision of health services/health education for their school communities, strengthening the relationships between students, parents/guardians, and school staff. While the school nurse plays a role in the coordination of the eight components of their school's CSHP, they support each component to varying degrees through both individual and population-level interventions in their schools. This study provides evidence of the leadership role that school nurses provide for a coordinated school health teams in their school communities.