School nurses – Transitioning to practice

By Deborah Kerz, APNA Project Officer 

Source: APNA Primary Times Winter 2023 (Volume 23 Issue 1)

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Health assessments, vision and hearing tests, ice packs, Panadol and bandages: Decades ago, this described the very limited scope of practice many school nurses experienced when treating their student patients. Today, things are very different. School nurses are fast becoming a vital conduit between students, teachers, parents, schools, and the health system.^{1, 4} However, it can be hard for nurses to move from more traditional primary health care (PHC) backgrounds into school nursing as there are few traditional pathways to follow. APNA’s Transition to Practice Program (TPP) is one important way nurses can find their feet in this growing sector. 

School nurses work in both public and private schools. They are an integral part of school wellbeing programs and other school teams, and they liaise with educators, families, and PHC providers to improve health outcomes for students.^2–3 They require a broad knowledge and skill base, including child and adolescent health and development, case management, trauma/emergency care, counselling, and education.^1,4  

APNA has offered its TPP since 2015. The program supports nurses transitioning into PHC. Traditionally, participation has been mostly general practice nurses; however, it has recently expanded to support nurses in all PHC settings, including aged care, correctional services, Aboriginal Community Controlled Health Organisations and school-based nursing.⁵ 

The TPP offers transitioning nurses online education activities that provide foundational knowledge, the opportunity for skill development, and most importantly access to a clinical and professional mentor matched to their location and PHC setting.  

‘The TPP has been an amazing support. Creating those professional relationships is invaluable.’ School nurse Belinda Lesh 

Kelli Radford and Belinda Lesh were involved in APNA’s TPP class of 2022–2023 as mentor and mentee, respectively. Here, they describe their roles as school nurses and share how their experience with the TPP has helped to shape their careers and their attitudes towards nursing. 

Why school-based nursing? What appealed or drew you to the role? 

Kelli: Initially, the hours and family-life balance, as I had a baby at home. I had school holidays off, so this worked well with my own child’s school holiday breaks. Once getting into the position, I enjoyed that no 2 days were the same. I had to use my skills of observation and decision-making without a doctor present on the ward.  

Belinda: I was drawn to school nursing as it combines both of my passions – children/families and nursing. I see so much potential for health care in the school setting, including the chance to educate and shape the health of our future generation, and the opportunity to find the children that are vulnerable and struggling and link them with other community services or provide tools and strategies to assist them in the hard spaces.  

 

Describe an average day/week as a school-based nurse? 

Kelli: My day starts with dispensing the morning medications, assessing any boarders who are unwell and organising their care in the clinic for the school day, arranging medical appointments and liaising with parents. In amongst the routine activities, we set up first-aid kits for excursions and support the school with first-aid at events (sporting events), and so on.  

Belinda: Our week starts with assessing any boarders who are unwell or have had injuries over the weekend. We make appointments for the boarders that require them – dentist, physio, GP etc. We have two registered nurses that work each day. One will accompany the boarders to their appointments while the other covers the clinic. We liaise with parents, heads of departments in the school and boarding staff, ensure we are onsite at sporting events, such as athletic carnivals and cross country, and order stock for all first-aid kits required and for the clinic and ensure that all the boarders have the medication they require. 

 

What are some of the challenges you have overcome? 

Kelli: Since starting in school nursing, we have evolved from being the ‘band-aid station’ to developing protocols and procedures through the help of School Nurses Association Guidelines, as there was nothing, and we didn’t fit into the traditional hospital setting. We also don’t fit into the typical medical practice setting either. School nurses for a long time have been a forgotten arm of health care.  

Belinda: Coming into this position felt very isolating. Were there other school nurses out there? How did they do things? Where were the rules and how did you find them? The range of knowledge required was also overwhelming. Once I had reflected on one situation and determined how to do better, the next time it would present again, yet completely different. I also found that many of the existing protocols and procedures were no longer working as our college had doubled its number of students. Revising these protocols and procedures as well as developing ones that address current issues is ongoing.  

 

How has being involved in APNA’s TPP impacted your personal and professional development?   

Kelli: It’s been a great opportunity to build a relationship with another school nurse. We swap ideas and problem solve using each other’s experiences in our respective schools, which are very similar in student day/boarding numbers.  

Belinda: The TPP has been an amazing support. Firstly, having access to Kelli as a mentor. Being able to phone and say, ‘this is happening, what do I do?’ Often Kelli would respond with ‘us too!’ Knowing the hurdles and challenges we face are happening in other schools helps to put everything in perspective. Being able to visit Kelli at Kinross Wolaroi School and see how another school clinic was set up and how it ran was immensely helpful. I also attended the APNA Roadshow in Sydney in December and was able to meet other school nurses there. Creating those professional relationships is invaluable.  

The amount of education we have access to is also wonderful. Being able to choose a module that relates to what I need in the moment and increase my knowledge base in that area has been extremely helpful. 

 

For more information about the Transition to Practice Program or school nurses, contact the TPP team, transitiontopractice@apna.asn.au, or got to https://www.apna.asn.au/education/transitiontopracticeprogram. 

 

Kelli Radford, TPP Mentor 

Kelli graduated from Charles Sturt University, Bathurst, NSW, then spent the following 4 years at the Calvary Hospital in Cairns, QLD, in the Orthopaedic/Children’s Ward (Ward Registered Nurse). She then spent time working in aged care and then hospital-based surgical and children’s care. After a break to have a family, Kelli became a school nurse at Kinross Wolaroi School (KWS) in Orange, NSW. She is now KWS Nursing Unit Manager. 

 

Belinda Lesh, TPP Mentee 

Belinda completed a double nursing/early childhood education degree at Charles Sturt University, Bathurst, NSW, before working in the NICU, community child and family health and paediatric wards at Canberra Hospital. After moving back to Bathurst, Belinda started as a school nurse at The Scots School. She is currently Senior Nurse at Scots All Saints College, Bathurst. 

 

 

Transition to Practice is part of the Nursing in Primary Health Care Program, supported by funding from the Australian Government Department of Health and Aged Care.

References 

1 Australian Nursing and Midwifery Federation (ANMF), National school nursing standards for practice: registered nurse, ANMF website, 2019, accessed February 2023. http://anmf.org.au 

2 Department of Education, State Government of Queensland, State schools nursing service practice guideline, Department of Education website, 2021, accessed 5 April 2023. https://education.qld.gov.au 

3 Department of Education and Training (DET), State Government of Victoria, Victorian school nursing program guidelines, DET website, 2019., accessed 28 March 2023. www.education.vic.gov.au 

4 Department of Health, State Government of New South Wales, Wellbeing and health in-reach nurse coordinator program operational guidelines, Department of Health website, December 2022, accessed 27 March 2023. www.health.nsw.gov.au 

5 APNA, Transition to Practice Programs, APNA website, January 2023, accessed 27 March 2023. www.apna.asn.au