The school environment is usually expected to be a safe and conducive space for learners to maximize their educational outcomes. However, school environments are sometimes prone to risky behaviors that can lead to health risks. Incidences of students engaging in physical violence, bullying, and abuse are common occurrences. Environments with risky behaviors can facilitate more risky behaviors, especially for children undergoing certain mental health issues. To ensure school safety and health of learners, school nurses must work with staff to identify areas of riks and develop safety plans.
Part 1
The cut in the case of the 10 th -grade girl is a physical injury. The injury can be due to physical violence and abuse. One of the first possible cause of the cut in the forearm of the girl is school violence. Students are at higher chances of engaging in risky behaviors that could lead to physical injury. Examples of school violence behaviors include bullying, fighting, and the use of weapons. Such acts can lead to serious physical injuries, such as cuts to the victims ( CDC, 2020 ). Violence within the school environment, therefore, remains a crucial reason for the possible cause of the cut. Another reason for the cut could be due to domestic violence. Children continue to remain the victims of domestic violence, which can lead to physical injury. Also, sexual abuse where the abuser uses physical force can be a possible cause of the cut in the forearm.
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The school nurse requires collaboration with the school counselor to help the 10 th -grade child improve her health. Both the school counselor and nurse can work to provide the students with the skills for success in school areas, including academics, social and emotional domains, as well as remaining healthy. The collaboration between the two professionals will ensure that the right strategy is developed to help the child improve her health outcome ( Selekman, 2013 ). The interprofessional collaboration has been found to play a significant role in supporting a positive health outcome of the children ("American Academy of Pediatrics," 2017). As a school nurse, I will work with both the parents and the pediatricians to help the child. Reaching out to the parent will help in the identification of other risk factors, and the best way to help the child. The parent has to be involved in the treatment of the child because it enhances understanding of more risk factors a child may not identify. As a school nurse, I will also engage the pediatrician into this problem to help the girl. Working with the pediatricians, we will be able to interpret and reinforce the right medical recommendations within the educational environment.
The “Family Educational Rights Privacy Act” (FERPA) guides the personal information and confidentiality of the personal health information of the children. Under this federal law, the school nurse is not allowed to share such information without the consent of the parents. The school environment is usually subjected to FERPA, which regulates the information that can be shared ( Selekman, 2013 ). However, the teachers and other school officials who directly work with the students are being exempted. They can get access to the personal information of the students without the consent of the parents. As a school nurse, I will, therefore, share the health information of the girl with the teacher. The teacher is allowed to access such information under FERPA law.
Part 2
Suicide occurs due to certain mental health issues that act as risk factors. Teens undergo a lot of mental health issues before reaching a point where they decide to commit suicide. Understanding these issues and taking into account the risk factors and signs is a sure way to help the teens live a healthy life ( Terzian, Andrews& Moore, 2011 ). The major factors that can lead to suicide crisis amongst the adolescence are the psychological and mental disturbances. Depression is the leading cause of suicide among teens. Depression comes from several factors and can lead to distress, irritability, and inability to control emotions. The feeling of hopelessness usually accompanies depression and can make a teen more likely to commit suicide. Besides, the presence of previous traumatic events, sexual abuse, poor relationship with parents, and hostile school environment are all possible risk factors that could lead to depression.
As a school nurse, understanding the risk factors in which the students are exposed to is a crucial step providing lasting help. Students who are at risk of suicide tend to display certain signs which can be identified early enough before the crisis occurs. Some of the warning signs to pay attention to are social isolation, sleeplessness, changes in appetite, and preoccupation with deaths. Before a teen commits suicide, they are more likely to be first be exposed to at least certain risks and then display certain warning signs. School nurses can prevent this crisis by doing risk assessments to identify those at risk. The assessment also helps in the identification of the warning signs early enough before the crisis occurs ("National Association of School Nurses," 2015). It allows for the right intervention to be undertaken to prevent suicide from taking place.
The role of the school nurse in such a situation is to work with the school staff and parents to identify the risk factors and warning signs of mental issues in children. Working with the teachers, the school nurse needs to identify any student who is at risk of suicidal thoughts. Proactive communication can best help identify any social problems that the children are undergoing ("American Academy of Pediatrics," 2017). In response to the suicide crisis, the school nurse can introduce a counseling session of all the students to reduce trauma and promote positive mental thinking. The counseling programs should focus on identifying and reducing any risky behavior that the children could be exposed to due to their environment. The school nurse must also work in the front lines with the school staff to recognize any warning signs such as "changes in school performance, mood changes, complaints of illness before or during the school day, problems at home, self-harm, and suicidality" ("American Academy of Pediatrics," 2017). Dealing with the behavioral health crisis also requires that the school nurse provide regular educational programs, which include behavioral health screening and education on mental health. Coordination, which involves working with the school staff, parents, and the community to identify risk factors, is an essential step to dealing with mental health issues of teens.
Part 3
The obligations of a school nurse in the emergency preparedness for learners with chronic conditions is to provide case management. The school nurse remains a crucial part of the educational staff and is obliged to assess, plan, implement, and monitor the individual health “plans for students with chronic conditions.” The school nurse works with the teachers to assess the health condition of the students and the development of the appropriate care plan. The nurse thus provides the emergency preparedness team with a full assessment report of the chronic conditions of children. The nurse also gives details of care plans for each patient to ensure success. Because they provide direct care to the student, the school nurses are the first to identify the health conditions of all students ( Selekman, 2013 ). The nurse then records the data of the number of learners with chronic diseases and the kind of care they currently receive ( CDC, 2020 ). This data is crucial in the disaster preparedness plan. The school nurse's role is also to “monitor individual health plans and emergency care plans for students with chronic health conditions” (CDC, 2020). This role places the nurses in a position to understand the progress of each patient, and information that is vital in the disaster preparedness plan. Based on the condition of each patient, the emergency preparedness team can develop the right program to increase care.
Conclusion
Nursing schools play a significant role in promoting the positive health and safety of learners. By working with the school staff, the school nurse is central to better health and wellbeing of the students. They identify any health risks and work with other professionals to find a lasting solution. Also, the school prepares future nurses who can handle patients with required standards hence deliver quality services.
References
American Academy of Pediatrics. (2017). Promoting children’s mental health. Retrieved from https://www.aap.org/en-us/advocacy-and-policy/federal-advocacy/pages/mentalhealth.aspx
CDC. (2020). Preventing School Violence |Violence Prevention|Injury Center. Retrieved 9 May 2020, from https://www.cdc.gov/violenceprevention/youthviolence/schoolviolence/fastfact.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fviolenceprevention%2Fyouthviolence%2Fschoolviolence%2Findex.html
CDC. (2020). Retrieved 9 May 2020, from https://www.cdc.gov/healthyschools/chronic_conditions/pdfs/2017_02_15-FactSheet-RoleOfSchoolNurses_FINAL_508.pdf
National Association of School Nurses. (2015). Framework for 21st-century school nursing practice. NASN School Nurse, 130(4), 219-231. Doi: 10.1177/1942602X15589559
Selekman, J. (2013). School nursing: A comprehensive text (2nd). Newark, DE: F.A. Davis Company. Chapters 28, 34, 35, and 37.
Terzian, M. A., Andrews, K. M., & Moore, K. A. (2011). Preventing multiple risky behaviors among adolescents: Seven strategies. Res Results Brief , 24 , 2013.
