School Nurse Director’s Guidebook: Supporting Staff in Managing Students’ Physical, Mental, and Behavioral Health

Establishing a Supportive Framework for School Nurses

As a nurse director, you are the bridge between the school nurses who spend their days serving students and the administrators who care about students’ health, but don’t have the same insight into what it takes to manage a clinic.

We’ve discussed the kindness in clarity before, and you have an opportunity to provide clear guidance to school administrators, stakeholders, and school nurses. As you work to align policies with local and national guidelines, you may also consult nurses to ensure that any procedures prioritize the diverse needs of students.

With the turnover that schools often see with school nurses, having a strong professional development and training program can go a long way toward setting new nurses up for success and retaining your existing nurses. Traditionally, professional development can feel like a one-size-fits-all approach, so prioritize tailoring your PD offerings to your community’s needs, emerging health issues, and advancements in healthcare.

With so much on their plates, nurses rarely have extra time to dedicate toward in-depth professional development. And while you might not have unlimited time either, you could consider forwarding on helpful articles or on demand webinars that they might not have time to seek out.

More often than not, the best learnings can come from peers. Creating opportunities to collaborate whether in regular meetings, workshops, or in online communities can go a long way.

It might feel like you have little control over whether or not a nurse stays in the profession, and so many articles detail the ongoing nurse shortage. But that makes it even more important to focus on what you can control.

Empowering School Nurses in Physical Health Management

Every day, nurses encounter an incredibly diverse array of situations alongside the more basic day-to-day band-aids and headaches. Depending on your school community, you might have higher instances of chronic conditions like diabetes. When you add all of these elements up, the result is a potential for a lot of surprises. Making sure everyone has the resources they need to handle whatever situation comes their way can help in reducing stress.

Beyond having access to resources, make sure you’re communicating how to access those resources. This might entail maintaining a repository of reference materials like local healthcare contacts, community resources, guidelines for chronic condition management, and medication administration protocols.

An electronic health records (EHR) system can make this kind of repository easier to keep track of, and can provide guidance to nurses in real-time for things like documentation. If we consider the example of having a school with many students who have an individualized health plan (IHP) for a chronic condition like diabetes, an EHR can send notifications for medications, track prescription inventory, and make clear the fields that are required for thorough documentation.

Confidentiality and Privacy

Data security should be a priority for anyone who consistently works with student data, and student health records are some of the most sensitive data that a school has in their possession.

Gone are the days of keeping sensitive information on post-it notes in the nurse’s office. But you should also check in with your vendors to ensure that they’re properly protecting students’ data.

Having role-based processes (EHRs build this in to the system) can make data more secure while maintaining accessibility. And of course parents should have access to their student’s information. Some EHRs have parent portals where guardians can sign and upload required forms and view student health information.

With FERPA, security isn’t simply a nice-to-have; it’s required by law.

The Importance of an EHR System

Some administrators think that a SIS is sufficient to support the physical, mental, and behavioral health needs for every student in the district.

Here’s where your SIS is likely falling short:

• Prescription scheduling, administration, and inventory tracking
• State reporting for health records
• Secure collaboration with parents for health needs
• Individual health care plans and chronic condition management
• Communicable disease case management

That’s only five things, but there are plenty more. Like all of the reporting capabilities that come with an EHR that can offer you as detailed or broad a view as you’d like. Or a way to see trends or identify students at risk of mental health crises.

An EHR can handle the day-to-day operations in your district, but where it really excels is in the grey area of all of your what-if’s.

What if we have a strep outbreak?

What if we have an influx of students with chronic conditions?

What if we have a break-in to our district pharmacy and need to know what was taken?

What if a student threatens to harm themself or others…how do we proceed?