Giving Voice to School Nursing as a Primary Health Care Specialty

Abstract

The purpose of this thesis is to give voice to school nursing as a primary health care specialty, and to promote the development of school nursing in New Zealand. School nursing is an invisible practice specialty that is largely funded from within the education sector, to address the health needs of student clients. School nursing is a significant primary health care initiative that can positively influence student health outcomes. My school nursing practice experience and philosophy is presented prior to reflecting upon the history of school nursing, and the health concerns present within the student population. The work then moves to review and critique school nursing literature from New Zealand, Australia, the United Kingdom, and the United States. This thesis highlights the need for collaborative policy and practice development initiatives including a legislative requirement for school nurses, school nursing competencies and standards, school nurse to student ratios, postgraduate training, professional liaison, practice funding, and research. A discourse on the reflective topical autobiographical method introduces autobiographical poetry from school nursing practice and reflective inquiry, as the central research endeavour of this thesis. Autobiographical poetry is offered as a window to this specialty practice, and accompanying reflections allow access to a further layer of practice knowledge. Student health needs, the scope of nursing intewentions, and the essences of school nursing practice have been distilled from the poetry. Poetic representation and subsequent reflection has facilitated the development of a school nursing framework for use within the New Zealand context, entitled Health Mediation in School Nursing. School nursing is presented throughout this thesis as an important child and adolescent primary health care initiative, which has the potential to reduce health barriers to learning, improve student health outcomes, and build student success in the social, emotional, and educational domains.