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Fay W. Whitney School of Nursing

College of Health Sciences

Leadership in Nursing Series:
Nurse Leader in Mental Health Education & Practice

Leadership in Nursing Series: Christina Bartholomew, Nurse Leader in School Nursing

NOTE: On September 15 each fall, the University of Wyoming Fay W. Whitney School of Nursing mails out the school's annual Alumni Newsletter magazine/publication. The theme of the 2016 issue: Leadership in Nursing. The following spotlight is taken from that publication, where the goal is to recognize nurse leaders in diverse roles. Return to the web weekly for spotlights on other nurse leaders in their respective roles.

Christina Bartholomew, RN, MS, NCSN

Nurse Leader in School Nursing:

Christina Bartholomew starts off her description of leadership in school nursing with a quote from the National Association of School Nurses:

“School nursing is a specialized practice of professional nursing that advances the well-being, academic success, and life-long achievement and health of students. To that end, school nurses 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.” (NASN, 2010c).

We would like to quote Bartholomew, summing up what she believes about leadership in school nursing:

"School nurse leaders are the voice for students with healthcare needs; they are the translators of health care to the education administrative and teaching staffs."

Following are Bartholomew's expanded views on the importance of leadership in school nursing:

School nurse leaders...imperative to transition from hospital to school nursing

Bartholomew elaborates on the mission of a school nurse: "When a Registered Nurse enters the realm of school nursing, a new world unfolds. Nurses step into the realm of education in a public school setting. The laws that govern how we educate students become the focus. The unique vocabulary, regulations and obligations change from the health care setting to a school setting. HIPPA is overshadowed by FERPA, from a caseload of 10 or fewer patients to schools with sometimes <100 or as high as 1600 students. Acronyms abound: IDEA, FAPE, 504, IEP, MDT, CMDA, and the list continues. What language are they speaking? How do I proceed? How do I move from hospital to school successfully? A strong leader in school nursing is imperative to this transition."

School nurse leaders...essential to success of health care programs in schools

Bartholomew strongly states that leadership in school nursing is essential to the success of a health care program in schools. She says, "School nurse leaders are the translators of health care to the education administrative and teaching staffs. Often, school nurses are the sole person in a school with any healthcare background. IDEA (Individual with Disabilities Educations Act) guarantees, at a federal level, that no student with disabilities is prevented from getting a public education. Under IDEA, each student is guaranteed a Free and Appropriate Public Educations (FAPE)."

School nurse leaders: they are the bridge

Bartholomew continues, "School nursing leaders are the bridge from the school nurses in the buildings to the administrative staff of the district. To this end, the leader must be in tune with what’s happening in the schools (including maintaining clinical skills) and also with what’s happening at the district level. The leader must constantly be asking whether any issues at the district level will affect school nurses and the care that is required for students. This requires a high level of collaborative and communication skills. To do this, the school nursing leader must be involved in committees, both at the district and community level. Contacts at the local public health departments, local health care providers, community agencies and the WY Departments of Education and Health are vital to the ability of school nurses to meet the health care needs of students."

School nurse leaders provide consistent, evidence-based care

"School nursing leaders must evaluate the medical needs of students in the school setting," says Bartholomew, "and set standards so that each child with similar disabilities receives the highest level of care so the child can learn at his fullest potential. Identification of new issues and implications for school nursing are vital to keeping up to date in clinical practice. With this comes the territory of policy and guideline development. As a leader it is essential all school nurses give consistent, evidence-based care."

Bartholomew continues to stress the need for evidence-based practice: "School nursing leaders must support evidence-based practice in this time of stagnation/reduction in budgets. Decisions sometime have to be made that are not supported by all principals and even, some school nurses. With the rising rate of students with insulin dependent diabetes, care needs to be shifted to those students. Sometimes, school nursing time is lowered at another building where student acuity isn’t as high. No longer can leaders say 'that’s the way it has always been done.'"

School nurse leaders adjust leadership styles

Bartholomew stresses that school nurse leaders must support the school nurses in their district, but acknowledges that leadership styles should be flexible: "Leadership styles might range from the autocratic (where there is no choice or opportunity for discussion) to consensus building (where discussion and decision-making requires collaboration). The school nurse leader must be comfortable moving from one style to another. Change is never easy, but with mentoring, modeling, collaboration, evidence based decision making, and sound management techniques, change can happen."

School nurse leaders must prepare for change

"Leadership in school nursing is evolving at a rapid pace," notes Bartholomew.  "As school nursing changes continuously, so must the leader. Challenges abound in the education world, and sometimes the health needs of children become displaced. Research shows that healthy students learn better. School nurse leaders are the voice for students with healthcare needs."


Story posted 9/01/2016


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