Working to keep school children healthy: the complementary roles of school staff and school nurses

BACKGROUND: Against a background of future uncertainty for school nursing and little previous research, this study aimed to identify and describe the distinctive role of the school nurse in working to keep school children healthy. Particular attention was paid to the 'interface' between nursing and the health-related work of teachers. The research was carried out in four health authority areas in England. METHODS: Seventy-eight semi-structured interviews were carried out with a range of respondents: school nurses, school Heads and teachers, health authority purchasers and NHS Trust managers. Seven focus group discussions were held with parents and eight with young people of secondary school age. RESULTS: Four key elements of the school nurse role were identified: safeguarding the health and welfare of children; health promotion; a pupils' confidante; and family support. In each of these aspects of work, nurses and teachers had shared or complementary roles. An over-arching role for the school nurse as 'health adviser' to pupils, parents and teachers was also identified. Despite these common elements, emphasis in the practice of individual school nurses varied widely. Difficulties for school nurses in developing their role were identified. Parents and young people saw school as an appropriate setting for health-related work. CONCLUSION: The research identified key components of the school nursing role and the complementary roles of nurses and school staff. To optimize school nurses' contribution to child health, a more strategic approach is required, in partnership with education, along with research into the effectiveness of school nursing interventions.