MSU Team 1 - Culture Perspective on Schools

8/2/2019 MSU Team 1 - Culture Perspective on Schools

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Running Head: CULTURE PERSPECTIVE SCHOOL NURSING 1

Public Health Nursing in School Setting

Culture Perspective Paper

MSU Team 1- Holly Atterberry, Karen Gaddy, Angie Shaw, & Loridan Moore


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CULTURE PRESPECTIVE SCHOOL NURSING 2

School Nursing in Missouri and Arkansas

Working in the school setting as a public health professional, there are

concerns for health promotion, prevention of disease, and rehabilitation for

students if needed. According to the National Association of School Nurses, the

definition of school nursing is, a specialized practice of professional nursing that

advances the wellbeing, academic success, and life-long achievement of students.

(National Association of School Nurses, 2012). Working in the school setting, the

focus of public health nursing is prevention and implementation of the referral

process for families to receive appropriate resources to help maintain health in the

children. Being in an educational setting, initiative needs to be taken by school

nurses to begin the process of educating students on good health. To maintain good

health, one must understand what health is. The World Health Organization

defined health as, a state of complete physical, mental, and social well-being, and

not merely the absence of disease. (World Health Organization, 2012). A school

nurse must understand the different age groups and developmental stages that are

in the school setting, as well as the external factors that affect the health of students.

Once these factors have been determined, it is necessary to assess the communitys

needs and implement resources that are available to help students reach their

maximum potential in health and education. To better understand the needs of the

children in the schools, community assessments were completed of three schools in

Missouri, Houston, Lebanon, and West Plains, and one school located in Berryville,

Arkansas to determine resources available. A review of these areas and resources


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available will bring insight to the culture and issues school nurses overcome to help

their students have a state of complete physical, mental, and social wellbeing.

To play a critical role as a school nurse, one must understand the age groups

and developmental stages of children from the preschool ages, four to five year olds,

school ages, six to twelve year olds, and up to the young adult ages, thirteen to

eighteen years old, which presents a wide range of developmental stages. It is

important to understand the challenges that children have to overcome in order to

develop adequately, and better understand how to care for them. For children to do

their best throughout school, it is important they understand what health is and

learn how to maintain it. In the school setting, different aspects of health need to be

addressed throughoutthe years of development. According to Eriksons

Developmental Stages, in the elementary years, children are faced with gaining a

sense of purpose and developing a sense of industry (Harder, 2011). At this young

age, teaching health promotion and prevention begins with simple ideas, such as

hand washing, healthy foods, dental hygiene, and germ prevention. Once children

reach the adolescence stage, ages twelve to eighteen, these young adults have to

develop self-identity (Harder, 2011). Health promotion, prevention of disease, and

rehabilitation is concerning related to the different influences students face by

peers, parents, media, and other role models. While the physical health is still

important, there is large concern of mental and social health in this age group.

Education regarding outside influences that affect health need to be addressed, such

as body image, sex education, alcohol and drug abuse, drop-out rates, sleep habits,

and many other issues, to maintain good health. Once these factors are determined


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related to the age groups, it is significant to understand the community resources

around the school district.

Upon assessment of communities surrounding the school districts, there

were multiple programs, government funded and non-government funded, available

that school nurses could take advantage of to help students. The issues that were

noted were mostly related to a poor socioeconomic status, such as nutrition,

medication availability, education, clothing and school supply availability. To

combat these issues, the school nurses uses the available resources to help students

maintain a stress free, healthy environment related to physical, mental, and social

wellbeing. For example, to maintain physical health a school nurse can help students

and their families to obtain prescription medications through government entities

or ensure that children are eating adequate meals for supper. A school nurse may

act as a counselor or refer a student to appropriate mental health services if needed

to maintain appropriate mental health. By encouraging healthy relationships, the

nurse will ensure her students have social wellbeing.

Assessment of the Lebanon School District revealed several agencies and

programs that were available to assist in food, clothing, shelter, and health

promotion to ensure adequate health. The Lebanon School District includes 8

schools that serve 4,643 students preschool through twelfth grade. The dropout rate

in 2008 was recorded at 4% compared to the national rate of 4.4%. The district

spends $7,067 per pupil in current expenditures (Lebanon R-III School District,

2012). It was astonishing to see the roles the Lebanon School District nurse played,

even though there were so many resources were available, such as nurse, doctor,


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counselor, mother, clothes closet, food pantry, and friend. When the nurse see the

need of students outreach her abilities within the school, the referral process begins.

One of the resources available in Lebanon, Missouri is Missouri Ozarks Community

Action, which is a non-profit community action agency. Through this service, low-

income families are able to find head start for children ages three to five years old,

apply for a housing choice voucher program to acquire safe and sanitary housing, or

take life skill classes (Missouri Ozarks Community Action, 2012). The Laclede

County Health Department is also available for multiple services to ensure health of

the students. As a government funded entity, applications for government programs

such as Women, Infants, & Children program are available to ensure there is money

available to buy groceries (Laclede County Health Department, 2012). The health

department can even act as a physicians clinic for families without health insurance

twice a week. Statistics show that there are currently 7,353 food stamp recipients

monthly, 255 families receiving temporary assistance, and 98 children receiving

subsidized child care in Laclede County (Missouri Department of Social Services,

2012). These statistics show that these referral services are being used in families

in this school district, but in some cases the assistance is not enough causing the

multiple roles of the school nurse.

The next school district assessed was in West Plains, Missouri home to

elementary, middle, and high school campuses, as well as a community college, a

distance campus for Missouri State University. There are three full-time nurses and

one part-time nurse to provided care to almost 1,900 students and staff. In this

school district, it was evident that the school nurses are not only serving their


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students, but the families involved with the students care. The school nurses in this

district are active in finding programs they feel will benefit their students and

families to encourage the best health possible. The multitude of resources available

in this area are listed on the school districts website. There is everything from

transportation services to recreational activities to healthcare clinics to domestic

violence resources (Community Resource and Services, 2011). Due to the open

communication between needs of the students and nurses, the appropriate

resources are found and utilized. The county health department is also available as a

referral service, but the West Plains school district has numerous direct programs

and contacts to refer families and students too.

The one school district that was assessed in a different state was the

Berryville, Arkansas School District. This school district has approximately 1,795

students currently enrolled with four different campuses, elementary, intermediate,

middle, and high school. This school district is located in a rural area, which lacks in

general hygiene care and nutrition due to poor socioeconomic status. While the

socioeconomic status may not be the greatest, there are multiple resources,

government funded and non-government funded, available to assist students and

families in needs. This community has several churches that provide items, such as

hygiene products and food. Some of the government programs consist of a nutrition

assessment programs and ARkids insurance for healthcare. The one drawback is

that both charity and government funded programs have income guidelines that

must be met to acquire benefits. For instance, the maximum gross income for a

family of four can be on greater than $2,400 per month, which would allow up to a


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maximum benefit of $668 per month from the nutrition assessment program

(Berryville School District). In a different case, the school offers a program to any

student who wants to participate to take home a backpack filled with food to take

home on Friday to provide food over the weekend, or even every night to ensure

they have a nutritious meal every night. This programs helps students and families

have nutritious food and ensure appropriate diet at home. The community

surrounding the school district offers parks and outdoor space for families and

children to exercise. These services help students maintain adequate health

throughout their time at school.

The last school district to discuss is the Houston R-1 School District. This

school is located in Texas County, which is the largest county in the state of

Missouri. Houston has three different schools, elementary, middle, and high school,

and has approximately 1,000 students. There are two full-time nurses, one for the

elementary building and one that covers both the middle school and high school.

This school district is similar to others regarding the poverty that surrounds the

community. It was found that approximately 50% of students were eligible and

enrolled for free or reduced lunches in 2009, unemployment rate was 9.3% for

adults, and over 30% was receiving food stamp benefits (Kids Count, 2009). To

ensure families are receiving adequate food at home for their children, programs

such as Women, Infant, and Children can be referred or assistance from the local

food pantry can be used. The county health department is located in Houston, which

allows children to receive their immunization or vaccinations for free (Texas County

Health Department, 2011). Referral services in Texas County are mostly


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government-funded programs. There are a limited number of private resources the

nurse can utilize in this area. At times, local churches or organizations may have

programs, which improve the health of the students, otherwise places like the Texas

County Health Department, Texas County Food Pantry, Division of Family Services,

and others can be utilized.

Through assessment of these communities that surround the school districts

that are used for clinical sites bring insight to different resources related to

nutrition, health care, and other aspects of health for students. It is important to

understand the areas that were assessed consist of a majority of low-income

families. This creates a challenge for school nurses because students and families

expect her to play a multifaceted role in their lives. It is evident school nurses have a

wide variety of roles to encourage appropriate health of the students so they can

achieve their maximum potential. Due to the poor socioeconomic status of these

areas, there are a limited number of private resources related to the government

resources. It can be noted that the school district with a better socioeconomic status,

West Plains R-7 School District, had a complete list of community resources on their

own website that parents can access directly. Even though majority of families in

these communities have a poor socioeconomic status, there are resources available

to maintain good health of the students. As a school nurse, there is a responsibility

that lies in picking up on the students who may need more attention to obtain the

level of health they need. Being aware of the issues that are affecting the students

within the school will help the school nurse assist children and their families in

maintaining a state of complete physical, mental, and social wellbeing.


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References

Berryville School District(n.d.). Retrieved from http://www.trulia.com/school-

District/AR-Carroll_County/Berryville_School_School_District_27/

Harder, A. (2011). Erik Eriksons stages psychosocial development. Enrich your life

and your relationships. Retrieved from http://www.support4change.com

/index.php?option=com_content&view=article&id=47&Itemid=108

Laclede County Health Department (2012). Listing of services. Retrieved from

http://laclede.lphamo.org/ListingofServices/ListingofServices.html

Missouri Department ofSocial Services (2012). Childrens division. Retrieved from

http://dss.mo.gov/cd/office/laclede.htm

Missouri Ozarks Community Action (2012). Head start. Retrieved from

http://www.mocaonline.org/headstart.php

National Association of School Nurses (2012). Planning a career in school nursing.

Retrieved from www.nasn.org/RoleCareer/PlanningaCareerinSchoolNursing

Texas County Health Department (2011). Child health. Retrieved from

http://www.texascountyhealth.org/Child%20Health.aspx

Unknown (2011). Community resources and services. Retrieved from http://wpr7.

schoolwires.net/cms/lib2/MO01001590/Centricity/Domain/52/

Community%20Resources%20and%20Services%20current%20as%20of%2

09%206%2011.pdf

Unknown (n.d.) Berryville School District. Berryville School. Retrieved from

http://bobcat.k12.ar.us/

Unknown (2010). Food for kids. Rice Depot. Retrieved from http://www.ricedepot.


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org/ffk.asp?t=Food%20For%20Kids.

Unknown (2012). Lebanon R-III School District. Retrieved from http://www

.education.com/schoolfinder/us/missouri/district/lebanon-r-iii-school

district/#learn-more

World Health Organization (2012). Frequently asked questions. Retrieved from

http://www.who.int/suggestions/faq/en/index.html

Documents

MSU Team 1 - Culture Perspective on Schools