The Journal of School Nursing2023, Vol. 39(1) 3–5© The Author(s) 2022Article reuse guidelines:sagepub.com/journals-permissionsDOI: 10.1177/10598405221143495journals.sagepub.com/home/jsn
The editorial “School nursing research and research implementation priorities,” highlights how the National Association of School Nurses (NASN) research priorities are crucial to moving school nursing and school health research forward. In this editorial we echo the importance of school nurses reading and understanding published articles in The Journal of School Nursing and contributing to research that informs school nursing practice. Each of the NASNs research priorities is vital to the science supporting school nursing practice. We encourage school nurses and researchers, and implementation scientists to partner to contribute school nursing evidence that guides the specialties’ practice and informs policy to positively impact student health and education outcomes.
Keywordsschool nurse, research, editorial, school nurse practice
Tanner and Stanislo’s (2022) editorial “School nursing research and research implementation priorities,” highlights how the National Association of School Nurses (NASN) research priorities are crucial to moving school nursing and school health research forward. The authors share the importance of school nurses reading and understanding published articles in The Journal of School Nursing and contributing to research that informs school nursing practice. They clarified NASN’s process to determine research priorities and how the priorities guide research and evidence-based practice.
Historically, school nursing has faced challenges. We encourage school nurses and school health researchers to move beyond the challenges, highlight the profession, value the discipline, and share their impact on student outcomes. School nurses were and continue to be front-line nurses during the COVID-19 pandemic. Almost three years into this public health emergency, many physical, behavioral, and emotional health issues have been emphasized, but still need further research and guidance for school nurses. There is a great need to explore and share with stakeholders school nurse health and educational outcomes, the perspective of families and students, and front-line nurses’ lived experiences.
Addressing health equity and social determinants of health (SDOH). This research priority is achieved when everyone has the opportunity to be as healthy as possible. There is a natural connection between school nurses and how they can address SDOH and improve health equity for their students. The work of Schroder et al. (2018) highlights evidence for addressing the SDOH when caring for children with asthma, obesity, and insufficient sleep (three common childhood conditions). We must also answer the call Willgerodt et al. (2021) proposed to focus efforts on examining population-level structural inequities, school policies and procedures that perpetuate systemic inequities, and our behaviors that contribute to inequities.
Disaster preparedness and public health emergency response. The school nurse must be involved in safe school planning, including public health crises, disaster preparation and simulated exercises, as well as crisis management. Hoke et al. (2021) surveyed school nurses during the COVID-19 pandemic and shared the critical role of the school nurse as an expert in infection control, disaster preparedness, and population health.
Funding for school health. This research priority is key to investigating the cost-benefit of alternative funding models. For example, the cost of obtaining school nurse outcomes and the processes to achieve them (Wang et al., 2014), the role and value of school nurses in under-resourced rural and urban school settings, and the impact of state legislation, policies, and Medicaid funding on school nursing services and student health and academic outcomes (Lerner & Edward, 2016).
Implementation science. Implementation science promotes the uptake of research and evidence-based practice into daily use. Researchers must evaluate strategies to increase and accelerate the adoption of evidence-based clinical guidelines (e.g., medication administration in schools, type 1 diabetes management) and NASN toolkits (NASN, n.d.). To move research forward, findings must be integrated into health and education policy.
School nursing practice. School nurses are aware of the importance of improving all students’ health and welfare, particularly advocating for those with chronic health conditions. School health policies that require standards for the structure and processes of care reinforce the commitment to equity, non-discrimination, and inclusivity for all students. McCabe et al. (2022) found that US school districts with policies on school nurse employment were more likely to have policies on chronic health condition management. This work stresses the practicing school nurse is essential to developing school-based health policies and monitoring the implementation of such policies.
School nursing workforce. All students deserve daily access to a registered nurse during school hours, but this is often not the case (Best et al., 2021). Research on workforce factors such as turnover, intention to stay, recruitment and retention of a diverse workforce that mirrors the student enrollments (Willgerodt et al., 2018), effects of COVID-19, and COVID-19-related policies continues to be needed. Jameson and Bowen (2020) studied school nurse workloads and found heavier workloads lead to higher nurse stress levels, which may impact student care. They also make the connection between the workplace environment and burnout, an area that will need continued exploration post-COVID-19.
School nursing well-being. The COVID-19 pandemic brought to light the immense pressures school nurses face while trying to protect students, families, and school communities. The well-being of school nurses must be explored using measures such as stress, burnout, moral distress, and anxiety. Using different methodological approaches, Lee et al. (2021) and Merkle et al. (2022) explored school nurses’ experiences and examined symptoms such as depression, anxiety, and suicidal ideation among school nurses during the pandemic. These studies underscore the mental health challenges many school nurses experienced and must inform supportive policies, practices, and future studies to reduce workplace stressors and increase workplace support for school nurses.
Each of the National Association of School Nurses’ research priorities is vital to the science supporting school nursing practice. We encourage school nurses and researchers, and implementation scientists to partner to contribute school nursing evidence that guides the specialties’ practice and informs policy to positively impact student health and education outcomes.
Nakia C. Best, PhD, RN Assistant Professor, University of California, Irvine, Sue & Bill Gross School of Nursing, Irvine, CA, USA
Ellen M. McCabe, PhD, RN, PNP-BC, FNASNAssistant Clinical Professor, New York University, Rory Meyers College of Nursing, New York, NY, USA
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Nakia C. Best https://orcid.org/0000-0002-4111-0527
Ellen M. McCabe https://orcid.org/0000-0003-2901-1670
Best, N. C., Nichols, A.O., Oppewal, S., Pierre-Louis, B., Waller, A.E., Zomorodi, M., & Travers, D. (2021). The impact of school nurse health services and school nurse-to-student ratios in north Carolina public schools, 2011–2016. Journal of School Health, 91(6), 473–481. https://doi.org/10.1111/josh.13025
Hoke, A.M., Keller, C.M., Calo, W.A., Sekhar, D.L., Lehman, E.B., & Kraschnewski, J.L. (2021). School nurse perspectives on COVID-19. The Journal of School Nursing, 37(4), 292– 297. https://doi.org/10.1177/1059840521992054
Jameson, B.E., & Bowen, F. (2020). Use of the worklife and levels of burnout surveys to assess the school nurse work environment. The Journal of School Nursing, 36(4), 272–282. https://doi.org/10.1177/1059840518813697
Lee, R. L., West, S., Tang, A. C., Cheng, H. Y., Chong, C. Y., Chien, W. T., & Chan, S. W. (2021). A qualitative exploration of the experiences of school nurses during COVID-19 pandemic as the frontline primary health care professionals. Nursing Outlook, 69(3), 399–408. https://doi.org/10.1016/j.outlook.2020.12.003
Lerner, E., & Edwards, A. (2016). The medicaid “free care” policy change: What is it, and what does it mean for school nurses? NASN School Nurse, 31(4), 214–215. https://doi.org/10.1177/1942602X16642521
McCabe, E.M., Jameson, B.E., & Strauss, S.M. (2022). School nurses matter: Relationship between school nurse employment policies and chronic health condition policies in U.S. School districts. The Journal of School Nursing, 38(5), 467–477. https://doi.org/10.1177/1059840520973413
Merkle, S. L., Welton, M., van Zyl, A., Chong, M., Tanner, A., Rose, C. E., … & Thomas, E. S. (2022). Symptoms of depression, anxiety, and post-traumatic stress disorder, and suicidal ideation among school nurses in prekindergarten through grade 12 schools—United States, March 2022. The Journal of School Nursing, 1–11. Advance online publication. https://doi.org/10.1177/10598405221131048
National Association of School Nurses. (n.d.). NASN learning center. https://learn.nasn.org/courses?category_ids%5B%5D=687
Schroeder, K., Malone, S. K., McCabe, E., & Lipman, T. (2018). Addressing the social determinants of health: A call to action for school nurses. The Journal of School Nursing, 34(3), 182– 191. https://doi.org/10.1177/1059840517750733
Tanner, A. L., & Stanislo, K. (2022). School nursing research and research implementation priorities. Journal of School Nursing, 38(6). 500–501. https://doi.org/10.1177/10598405221123231
Wang, L. Y., Vernon-Smiley, M., Gapinski, M. A., Desisto, M., Maughan, E., & Sheetz, A. (2014). Cost-benefit study of school nursing services. JAMA pediatrics, 168(7), 642–648. https://doi.org/10.1001/jamapediatrics.2013.5441
Willgerodt, M. A., Brock, D. M., & Maughan, E. D. (2018). Public school nursing practice in the United States. The Journal of School Nursing, 34(3), 232–244. https://doi.org/10.1177/1059840517752456
Willgerodt, M. A., Maughan, E., Jameson, B., & Johnson, K. H. (2021). Actions speak louder than words: Social justice is integral to school nursing practice. The Journal of School Nursing, 37(4), 226–227. https://doi.org/10.1177/10598405211019228
Nakia C. Best, PhD, RN, is an assistant professor in the Sue & Bill Gross School of Nursing at the University of California, Irvine.
Ellen M. McCabe, PhD, RN, PNP-BC, FNASN, is a clinical assistant professor of nursing at New York University, Rory Meyers College of Nursing.
