The Evolution of the Role of U.S. School Nurses in Adolescent Mental Health at the Individual, Community, and Systems Level: An Integrative Review

School nurses are crucial to addressing adolescent mental health, yet evidence concerning their evolving role has not been synthesized to understand interventions across levels of practice (i.e., individual, community, systems). We conducted an integrative review of school nurse roles in mental health in the U.S. related to depressive symptoms, anxiety, and stress. Only 18 articles were identified, published from 1970 to 2019, and primarily described school nurses practicing interventions at the individual level, yet it was unclear whether they were always evidence-based. Although mental health concerns have increased over the years, the dearth of rigorous studies made it difficult to determine the impact of school nurse interventions on student mental health outcomes and school nurses continue to feel unprepared and under supported in this area. More research is needed to establish best practices and systems to support school nursing practice in addressing mental health at all levels of practice.

Parents perceptions of school nurses roles: The impact of communication on students with autism spectrum disorder

This qualitative study used the nursing grounding theory to describe parents' experiences working with school nurses to elevate their child’s healthcare. Seventeen interviews were conducted with parents/primary caregivers (P/PCG) who had children with autism spectrum disorder (ASD; ages six to ten). Through centering parents’ voices, the investigators were able to identify gaps in P/CG understanding of their school nurses’ roles through thematic analyses. We found that P/CG lacked the understanding of school nurses' roles and how school nurses could aid their child’s healthcare. The oversight of school nurses contributed to miscommunication, which constrained the relationship between the parent and the school nurse. These findings provide insight into the importance of enhancing communication between the parents of children with ASD and school nurses and was the catalyst to why this article was written. When healthcare professionals provide clarity and expertise to parents as to their respective roles, incorporate perspective-taking, and tailor their approaches based on their concerns, it may enhance parents’ experiences with their school nurses. In addition, school nurses should consider various routes of engaging parents so they have a deeper understanding of their responsibilities in enhancing the healthcare of children with ASD.

Key Challenges and Opportunities for Implementing School Located Vaccination Clinics for COVID-19 and Influenza: Roundtables With School Nurses and Immunization Programs

School-located vaccination clinics (SLVs) are an established strategy to offer influenza and routine vaccinations and improve student and community health. The COVID-19 pandemic has led many communities to expand SLVs to include COVID-19 vaccines. However, these SLVs are less documented than in the past due to the fast-paced nature of the pandemic and the additional pressures put on schools and public health organizations. We conducted five virtual roundtables with 30 school nurses and state immunization program managers from across the United States to gain insight into SLVs occurring during the COVID-19 pandemic. Roundtables explored participants’ experiences planning and implementing SLVs, including factors influencing success and available resources. Findings highlighted SLVs as an opportunity to increase access and equity for vaccines. Participants shared strategies for School-located vaccination (SLV) funding, partnership building, vaccine storage and management, consent, data sharing, messaging, and promotion. These shared experiences offer useful insights for those interested in future and sustained SLV implementation.

The Landscape of State and Local School-Located Vaccination Clinics: Practices, Policies, and Lessons Learned for Providing COVID-19 and Routine Vaccinations

For decades, school-located vaccinations clinics (SLVs) have successfully offered influenza and routine childhood immunizations that have contributed to lowering the morbidity and mortality of vaccine-preventable diseases. These SLVs laid the foundation for state and local health departments and school districts to quickly implement SLVs in response to COVID-19. To support school nurses and immunization programs in implementing future SLVs during the COVID-19 pandemic, we explored the landscape of SLVs between August 2019 and late summer 2021 using publicly available information from school and health department websites, news articles reporting on SLVs, and internal documents provided by school nurses and immunization programs who hosted SLVs. Our scan identified variability in the reach, scope, and approach to SLVs, but consistent themes persist such as the importance of partnerships and SLVs as an opportunity to promote equitable access to vaccinations. Useful documents and resources for planning and hosting SLV clinics were compiled into a table. With COVID-19 vaccines now available to all school-age children, SLVs provide an even greater opportunity to improve school and community health. The included resources are designed to provide support for those interested in SLV implementation.

School Nurses Practices Promoting Self-Management and Healthcare Transition Skills for Adolescents with Chronic Conditions in Urban Public Schools: A Mixed Methods Study

Background: Adolescents and young adults (AYA) with chronic conditions should acquire self-management skills as part of their healthcare transition (HCT) from pediatric to adult-focused care. HCT/self-management skills have the potential to help mitigate health disparities among minority AYA with chronic conditions. This study investigated school nurses’ practices promoting HCT/self-management skills in urban public schools. Methods: Seventy-nine nurses from three urban school districts in Massachusetts completed a survey of 32 Likert-type questions on HCT/self-management skills, eight demographic questions, and five open-ended practice questions assessing how often they have asked students with chronic conditions about HCT/self-management skills, based on the UNC TRxANSITION IndexTM. Results: Among the 79 school nurses who participated (response rate 76%), 67% never or rarely assessed students’ knowledge of HCT/self-management, and 90% would use a tool that promotes/measures HCT/self-management skills. Conclusion: In our study sample, most school nurses acknowledged the importance of assessing HCT/self-management skills. The majority favored using a tool to promote these skills.

A Systematic Scoping Review of Psychological Capital Related to Mental Health in Youth

Psychological capital (PsyCap) is a term coined in organizational psychology and refers to a person’s development of states that motivate behavior. Also known in the literature as PsyCap, this construct typically refers to positive states of hope, self-efficacy, resilience, and optimism that are amenable to intervention and that are related to subjective well-being and life satisfaction. The aims of this systematic scoping review were to explore how PsyCap is described in youth mental health literature and how PsyCap and mental health are related. Results from four databases were reported following PRISMA guidelines. A total of 772 studies were identified and 16 studies were fully reviewed, including an overall sample of 6,772 youth from six countries. PsyCap has a positive relationship with mental health in youth. Future studies should involve school nurses to validate the constructs that characterize PsyCap and validate an instrument for measuring PsyCap in youth mental health in English.

School Garden Benefits: Health Promotion and Environmental Conservation

Garden-based learning promotes environmental awareness, health, and wellness across the school community and beyond. In this article, we review the literature on the benefits of school gardening and describe firsthand experiences for garden success. By sharing lessons learned, our aim is to inspire school nurses to join forces with like-minded teachers and staff or take the lead to build capacity in their school for gardening and a green culture dedicated to the conservation of natural resources.

Long COVID—The New “Invisible” Illness: How School Nurses Can Support the Nursing and Educational Teams for Student Success

School-age children are not immune to COVID-19 or the pronounced and persistent symptoms associated with a long-COVID diagnosis. Students may present with a variety of symptoms affecting their physical, cognitive, and mental health. The school community should be educated on the school-based interventions and recommendations for creating an individualized safe and successful return to school plan. As we await approval for vaccinations in school-age children younger than 12 years and continue to reposition ourselves to the waves of this pandemic and new variants of the virus, understanding the medical and educational long-term effects on our students may be a long-term need.

Preparing for the Impact of COVID-19 on the Mental Health of Youth

The COVID-19 pandemic is continuing to have long-term and global effects that the vaccine may not ease. Children and adolescents endured unprecedented periods of loneliness, social isolation, financial stressors, in-home conflicts, changes in living circumstances, and variable access to healthcare, resulting in increased mental health sequelae. Timely recognition of students’ anxiety, depression, and disruptive behaviors will allow appropriate interventions to de-escalate these feelings and prevent suicidal ideations and attempts. As youth return to school, their mental health needs will not subside. School nurses and the multidisciplinary team have a vital role in impacting this population’s already surging increase of mental and behavioral health disorders.