NR 443 Week 4 Assignment – Community Settings and Community Health Nursing Roles

For this week’s topic of discussion, I chose to talk about the setting and role of the Community Health Nurse in the school health setting, as well as an objective from Healthy People 2020 regarding that bullying among adolescents. At-risk health behaviors typical for teens among the school-aged group tend toward things like Violence, irresponsible sexual activity, poor dietary intake, suicide, inadequate physical activity, reckless driving, and the use/abuse of drugs, alcohol, and tobacco (Nies & McEwan, 2019). Community Health Nurses who specifically care for this aggregate population see students for everything from simple medical complaints to immunizations, mental health, health education, to learning disability screening (Nies & McEwan, 2019). Nurses, in this setting, function as a bridge between the home and their health care provider (Nies & McEwan, 2019). School Nurses can also administer daily medications, perform vision tests and hearing tests, provide first aid, and provide parents with resources within their community (Nies & McEwan, 2019). NASN (2011) defines the role of the school nurse as “a specialized practice of professional nursing that advances the well-being, academic success, and lifelong achievement and health of students.” School Nurses also “facilitate positive student responses to normal development; promote health and safety, including a healthy environment; intervene with actual and potential health problems; provide case management services; and actively collaborate with others to build student and family capacity for adaptation, self-management, self-advocacy, and learning” (Nies & McEwan, 2019).

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One of the most common issues related to a school-aged adolescent is stress. Stress can lead to more serious symptoms such as eating disorders, substance abuse, anger issues, class absenteeism, problems sleeping, physical exacerbations, sexual promiscuity, depression, and even suicidal ideations (Nies & McEwan, 2019). Depressive disorders usually begin in school-age years and have a direct correlation with the risk of suicidal behaviors (Nies & McEwan, 2019). As a School Nurse, it is especially imperative to be fully aware of typical warning signs and students in need of a mental health referral to a professional (Nies & McEwan, 2019). One such cause of depression can be related to Violence, which is a significant risk factor affecting a student’s physical and psychological health (Nies & McEwan, 2019). Warning signs of Violence come in many forms indicating neglect or abuse (e.g., physical, emotional, or sexual) and can ultimately lead to criminal behaviors in some (Nies & McEwan, 2019). In the past decade, many of us have seen the effects of Violence among adolescents in the form of school shootings.

A specific issue of interest that I keep hearing about in recent years, but has always been a problem, is bullying and its more recent partner-in-crime trend, cyberbullying. The healthy objective topic I chose to address this issue as a community health nurse relates to Violence Prevention – IVP-35 Reduce bullying among adolescents (USDHH, 2016). According to this data, nearly 20% of all high-school-aged adolescents reported they were bullied at school in 2009 (USDHH, 2016). While some studies suggest that bullying may stem from abuse during an adolescent’s past childhood, one study collected data to find the correlation between bullying behavior and abuse from current adult family members (Fujikawa et al., 2016). According to this study, more students identified themselves as victims of abuse from current adult family members than students who were not exposed to abuse from current adult family members (Fujiwaka et al., 2016). Additionally, the study also revealed there was an increase in suicidal ideations among adolescents dealing with abuse at home (Fujiwaka et al., 2016).