The Journal of School Nursing
2021, Vol. 37(5) 321–322© The Author(s) 2021Article reuse guidelines:sagepub.com/journals-permissionsDOI: 10.1177/10598405211036948journals.sagepub.com/home/jsn
The 2010 Future of Nursing report, Leading Change, Advancing Health was the second most downloaded document ever published by the Institute of Medicine (IOM, 2011), now the National Academy of Engineering, Science, and Medicine (NAESM). The report’s recommendations spurred policy and leadership initiatives that advanced nursing. The 2010 Future of Nursing report challenged nurses and health care systems to pivot from their narrow focus on sick care to a broader goal of improving the health of populations. Nurses and institutions were urged to concentrate on preventing illness and creating environments and policies that promote health. Nurses were challenged to advance their education and accept leadership roles in their place of work, in their profession, in board rooms and in their communities. Systems of care were advised to maximize the return on investment in nursing by enabling nurses to expand their practice to the full scope of the registered nurse license. The impact of the report was immediate, and nursing has used the report to bring about changes in hospitals, communities, and in higher education to reach those goals.
Ten years later, school nurses have advanced their education (Mangena & Maughan, 2015; Willgerodt et al., 2018) and there is anecdotal evidence that more school nurses accepted leadership roles on boards and in professional associations. Yet, at the end of the past decade, empirical studies still fall short on describing the impact of school nurse workloads, educational preparation, or work environments on the quality of school health care. We lack rigorous studies about interventions and leadership characteristics at the local and state levels that accelerate the adoption of evidence-based practices or clinical practice guidelines. Unlike our acute care colleagues, we do not have evidence that school districts that involve nurses in decision making or have adequate school nurse staffing have better student health and learning outcomes. Research has not grown at the pace necessary to advance the science of school nursing. The newly released report, The Future of Nursing 2020–2030: Charting a path to achieve health equity (NASEM, 2021), calls for increased research and evidence on effective interventions and on measuring nurses’ ability to address complex issues. The report asserts that social justice and health equity are top priorities. The report specifically calls out school nurses, who live and work with school children and families in their communities, as crucial to addressing and diminishing health inequities and addressing the social determinants of health (NASEM, 2021).
As a subspecialty, in 2030, 10 years from now, we do not want to find ourselves without the evidence to demonstrate the impact of nurses on the health of children in schools across the nation. It is essential to increase the number of nurses with research doctorates who will investigate the impact of school nurses intervening early to address social determinants of health. School nurse scientists with practice doctorates must advance implementation science for rapid adoption of evidence in real-world practice and in community settings. Nurse scientists must partner with nurses in schools to select and collect data to support informed clinical decision making and interventions at the individual and population level. In partnership, school nurses with research and practice doctorates must advance school nursing science with more rigorous, well-designed studies that demonstrate the value of school nursing. This means expanding training and using research methods that better suit population-based studies.
The National Association of School Nurses (NASN) Research Priorities 2021–2022 (2021) outlines the agenda for advancing the science. We challenge school nurse researchers to justify the confidence that The Future of Nursing 2020–2030 report has placed in the subspecialty and build the evidence that school nurses improve the health and health equity of school-aged children.
Martha Dewey Bergren https://orcid.org/0000-0002-7924-4694
Institute of Medicine. (2011). The future of nursing: Leading change, advancing health. The National Academies Press. https://doi.org/10.17226/12956
Mangena, A. S., & Maughan, E. (2015). The 2015 NASN school nurse survey: Developing and providing leadership to advance school nursing practice. NASN School Nurse, 30(6), 328–335. https://doi.org/10.1177/1942602X15608183
National Academies of Sciences, Engineering, and Medicine (NASEM). (2021). The future of nursing 2020–2030: Charting a path to achieve health equity. The National Academies Press. https://doi.org/10.17226/25982
National Association of School Nurses. (2021). NASN research priorities 2021–2022. https://www.nasn.org/research/research-priorities
Willgerodt, M. A., Brock, D. M., & Maughan, E. D. (2018). Public school nursing practice in the United States. Journal of School Nursing, 34(4), 232–244. https://doi.org/10.1177/1059840517752456
