Abroad, the position of a nurse in schools has a long history, while her competences have expanded over time. Currently, nurses in foreign schools supervise the management of chronic diseases and provide continuous health education for students. However, in our current conditions, the job position of a nurse at school is not a common practice, while the project Health worker in kindergarten, primary and secondary school in the years 2022 to 2024 tried to change.
School Nurse
The school nurse in the school environment comes into contact with a large number of students on a daily basis, which creates a space suitable for solving and coordinating the health care of children and adolescents. School nursing is defined as a specialized nursing practice that focuses on the well-being and health of students (Martínez-Riera, 2020). A school nurse is an expert who, on school grounds, has the responsibility of providing care to pupils individually or coordinated within the school team, directly, comprehensively or individually (Martínez-Santos et al., 2019). In Slovakia, nurses are employed at all levels of education, as well as in special schools. The school where she works and which is her employer assumes legal responsibility for the nurse. In addition to nurses, the position of school health worker can also be performed by doctors, public health workers or paramedics with adequate qualifications (Brezovský, 2024).
In our territory in the 1970s, a children's field nurse worked in practice, whose task was to carry out visits to elementary schools. The goal was to implement diagnostics and prevention. Currently, the amendment of the Education Act and Act of the Slovak Republic No. 576/2004 Coll. on health care, services related to the provision of health care and on amendments to certain laws. The starting salary for the given position is €1,100 (Húlková and Kilíková, 2022).
Competencies of the school nurse
The task of the school nurse is to assess the student's health, as well as their physical and psychological development. If necessary, they administer medication to students and assess the epidemiological situation at their school. In the case of pupils with chronic diseases, she is responsible for treating children with diabetes mellitus, epilepsy or disabilities. As part of the screening, it focuses on the identification of children's health problems, while at the same time implementing prevention and health-oriented counseling activities. With its action, it should act preventively also in the area of tooth decay, obesity or oncological diseases. Part of her job is keeping statistics on accidents at schools. The condition for providing care to a child is the written consent of the parent (Húlková and Kilíková, 2022).
As health experts, school nurses have an important role in the education of pupils. In their lectures and discussions, they should focus on an active and healthy lifestyle, while in addition to the need for sports activities, they should focus not only on healthy nutrition, but also on the primary prevention of substance and non-substance addictions (Mori et al., 2018). The nurse thus enables the development of positive attitudes and opinions about a healthy lifestyle, which can have an indisputable impact on adult life as well (Martínez-Santos et al., 2019). At the same time, it also focuses on the issue of reproductive health and sexual education (Pavelová et al., 2018).
In the case of pupils with a medical handicap, the school nurse must assess their health status and administer the necessary medication. At the same time, it implements the management of the disease in such a way that the educational process of the pupil is as little threatened by the disease as possible (Húlková and Kilíková, 2022). If a pupil needs to use medical aids, the school nurse provides him with help (Mazurová, 2024). The mentioned interventions are of great importance, because many children need help, but it is not within the competence of the teacher or the assistant to provide it. However, teaching staff often lack the skills to provide first aid in emergency situations. In contrast, a nurse possesses these skills, while they are at a high professional level (Ceballo Mella et al., 2020).
Observations from practice
Based on the experience of providing health care to children with chronic diseases and educating their families, we perceive the position of the school nurse in relation to these patients in ensuring the continuity of care in the school environment as very beneficial. Children with diagnoses such as diabetes mellitus, epilepsy or asthma require regular monitoring, adequate nursing care and education. In our opinion, the presence of a school nurse in schools can significantly contribute to the early identification of health deterioration, prevention of complications and support of adherence to student treatment.
We see the important role of the school nurse, for example, in the possibility of providing targeted education aimed at managing the disease in the school environment, the correct use of medical aids and the prevention of worsening of the condition. Her professional competences make it possible to effectively convey information about the disease not only to the child himself, but also to his classmates and teachers, which minimizes negative manifestations of stigmatization from the environment.
Recommendations for practice:
- Support for the systematic introduction of the position of school nurses in every school facility in the form of funding and promotion of the job position.
- Financial and personnel provision of professional and continuous education focused on nursing in schools.
- Ensuring care in schools for children with chronic diseases by increasing the number of schools where school nurses work.
- Securing funding for the expansion and maintenance of school nurse positions.
Conclusion
The skills and abilities of a nurse who is present in a school facility often bring peace to parents and teachers. On the one hand, it relieves teachers from carrying out selected health actions, on the other hand, it provides care for healthy children as well as children with chronic diseases. For families, it is a guarantee of care and support for the health of their children, while its presence often reduces school absenteeism, as it addresses health needs during the school day.
Author: Bc. Ivana KOVÁČOVÁ
List of bibliographic references
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