NASN school nurse (Print)最新文献

Dissociation is a well-established outcome of early life trauma, but school nurses may not be aware of resources and recommendations available to support students who experience it. If dissociation or behaviors consistent with dissociation are present, trauma-informed care (TIC) principles can guide individualized care of the student. Part I of this two-part article provided a pertinent background on dissociation, dissociative identity disorder (DID), the effects of social media, and TIC. Part II offers specific recommendations for implementing these principles in school nursing practice and follows the student vignette through the school year. Due to their holistic approach to care and long-standing leadership in providing TIC, nurses can significantly affect health, safety, and access to learning for students expressing dissociative experiences at school.

Human health is being impacted by anthropogenic (human-made) climate change. This article describes four ways that climate change may affect mental well-being in school-age children. First, natural disasters-such as more frequent and intense tornadoes and flash floods-may have a direct influence on mental well-being by contributing to acute anxiety and distress. Second, indirect effects of severe weather-including changes in social support systems-may affect mental well-being by increasing isolation. Third, children may suffer feelings of anxiety or depression if they perceive a sense of powerlessness to solve the challenges of a changing climate. Finally, school nurses need to be aware of the emergence of correlations-such as data that suggest increases in temperature may influence the use of inpatient mental health services and suicidal ideations-that require further scientific exploration. This article aims to increase school nurses' understanding of how climate changes may impact the mental well-being of school-age children and to provide strategies for creating a safe, healthy learning environment. This article is the fourth in a series aimed at raising awareness among school nurses about climate-associated illnesses and equipping them with the resources they need to protect school-age children's health.

Mental health needs in school are increasing and can affect every student. School nurses are in a perfect position to support social-emotional learning and implement coping strategies to aid in student success. This article features the implementation of social-emotional interventions in the school health office for all students using the multitiered systems of support (MTSS) framework. MTSS is an evidence-based framework that integrates prevention and tiered intervention with data-based problem-solving to meet the academic and behavioral needs of students. Through a tiered approach, all students receive the support they need to understand their emotions, recognize how strong emotions affect physical health, and how to cope. Because maladaptive coping can have an adverse effect on academics, social-emotional wellness is essential for students to be healthy, safe, and ready to learn.

Dissociation is a normal life adaptation that can become pronounced and disruptive in the setting of repeated or extreme exposure to trauma. Children and adolescents may experience dissociation due to a trauma or stressor-related disorder, anxiety, or depressive disorders. Children and adolescents also may mimic behavior they see online as a way of expressing internally painful and intolerable experiences. Myth and misinformation surround the diagnosis of dissociative identity disorder (DID), formerly multiple personality disorder. The purpose of this article is to provide school nurses with evidence-based information on DID and resources for practice regarding how to provide a secure, consistent approach to students who are being traumatized, misunderstood, or excluded at home or at school. Part 1 of this two-part series describes DID foundations and DID in school-aged children, reviews controversy spurred by social media representation, and presents the Trauma-Informed Care (TIC) model. TIC offers useful perspectives regardless of a student's presentation or diagnostic status. Part 2 will discuss recommendations for managing dissociative presentations using a team-based approach, focusing on the school nurse's roles and responsibilities.

Students with intellectual and developmental disabilities (IDD) are likely to experience psychiatric symptoms, like depression, anxiety, and distress, throughout their lifetime. Due to communication differences and minimal use of specialized diagnostic assessments for anxiety and depression, emotional pain can often be overlooked or underestimated in students with IDD. This is often complicated by atypical presentations of anxiety and depression, such as externalized aggression, self-injurious behaviors, or other behavioral dysregulation, that can indicate emotional distress, physical pain, or other medical complications. School nurses play an important role in assessing for emotional and physical pain in students with IDD using assessment tools currently available and clinical judgment. Tools that have been created for use in this population may account for the diversity of communication, sensory, and developmental differences in students with IDD. Through leading education and advocacy for the interprofessional school team, school nurses can increase the access that students with IDD have to equitable emotional health evaluations and services. School nurses can also promote emotional wellness for students with IDD through the incorporation of mindful and community activities in the care plan.

School nurses are members of the school-based mental and behavioral health support team. This consensus document was developed by school nurses and school nurse leaders in collaboration with leaders from national associations and organizations with a vested interest in K-12 mental and behavioral health. The document is also publicly available on the National Association of School Nurses website.

This article shares an updated structure for school nurse evaluation using the School Nursing Practice Framework and the fourth edition of the School Nursing: Scope and Standards of Practice. This evaluation structure is modeled on work originally published in the January 2020 issue of NASN School Nurse. The original linking of the Framework for 21st Century School Nursing Practice and the 3rd edition of the School Nursing: Scope and Standards of Practice allowed the school nurse and their evaluators to understand the complex roles and responsibilities of the school nurse. This updated version incorporates the growing understanding of social issues and complex health concerns impacting school nursing practice. The School Nursing: Scope and Standards of Practice (4th ed.) competencies recognize issues including emerging technologies, structural barriers to health, and the complex health needs of students in an environment of inequities, violence, and underfunding, as well as the impact of natural disasters, public health crises, human migration, and social media on students. The updated School Nursing Practice Framework (Framework) likewise incorporates an understanding of the foundational aspect of the standards and the interconnectedness of the key principles. Our revised evaluation tool accomplishes the integration of the revised Framework with the updated standards of school nursing practice.