Advocacy for School Nurses and Student Health and Safety: Highlighting National and State Efforts.

Annually, the National Association of School Nurses (NASN) sets advocacy goals. The goals include legislative and policy priorities. The COVID-19 pandemic brought attention to the need to heighten advocacy efforts, specifically to provide for additional school nurses and supplies necessary to meet the challenge of safely returning students to school. While advocating at the national level, NASN also encouraged advocacy at the state and local levels. This article provides a brief summary of NASN's advocacy efforts as well as providing examples from two different state associations demonstrating the importance of collaboration in advocacy efforts in areas related to the pandemic and in general areas related to school nursing.

Information Sharing in the School Setting During a Public Health Emergency.

The Family Educational Rights and Privacy Act of 1974 is the federal law that protects the privacy of personally identifiable information from student education records and applies to all education entities that receive funding under any program administered by the U.S. Department of Education. The Health Insurance Portability and Accountability Act of 1996 is the federal law that establishes privacy requirements for patients' protected health information. Together these privacy laws establish rules that guide school nurses in the sharing of student information, even in times of public health emergencies. The U.S. Department of Education and the U.S. Department of Health and Human Services have issued special updates to privacy laws in response to the Novel Coronavirus Disease providing certain waivers of typical privacy requirements and direction to allow the sharing of information during this public health emergency. The purpose of this article is to briefly review the privacy laws as they relate to schools, as well as to provide an overview of the recent waivers to assist school nurses, school administrators, healthcare professionals, and public health agencies in protecting the health and safety of students during this current public health emergency.

Physical Exams: Legal Liability (Versus Professional Norms).

This article summarizes the facts and rulings of a relatively recent and representative federal appellate court decision concerning a parent's civil rights lawsuit in response to a school nurse's visual examination of a child's "private parts." The discussion of the court's rulings extends to a sampling of related case law and, as in a previous NASN School Nurse Zirkel article, the difference between legal and professional boundaries.

School Nurse Advocacy: The Dilemma of Ethical Interpretation Versus Legal Protection.

This article summarizes the facts and rulings of a recent, representative federal court decision concerning the legal claims of a school nurse who had engaged in advocacy for student safety, with particular attention to a student with insulin-dependent diabetes who committed suicide. The discussion of the court's rulings for the school nurse's various legal claims identifies the difference between ethical interpretation in terms of prevailing perceptions among school nurses and legal protection in terms of the current state of the case law specific to such advocacy.

The Role of School Nurses, Challenges, and Reactions to Delegation Legislation: A Qualitative Approach.

Passage of new laws, national standards regarding delegation, and the recommendation for at least one full-time nurse in every school have provided more visibility to the role of school nurses. Recent legislative amendments in Kentucky presented an opportunity to examine how the role of the school nurse is changing. Aims were to describe the (1) role of school nurses in Kentucky, (2) impact of school nurses, (3) challenges faced by school nurses, and (4) impact of budget cuts and legislation. Three focus groups were conducted. School nurses faced challenges of limited time and resources, communication barriers, and multiple documentation requirements. Nurses' greatest impacts were their availability, recognition of psychosocial problems and health concerns, and connection with resources. Nurses had not yet encountered many changes due to new legislation that expanded delegation of diabetes-related tasks to unlicensed school personnel, but some had concerns about possible negative effects while others expressed support.

State-level Collaborations Among School Nurse Organizations: A Year in Review.

The passage of the Every Student Succeeds Act provides an impetus for school nurse organizations to advocate for student health and climate goals at the state level. Collaboration between state agencies and associations is a starting point for advocacy. Advocacy also includes legislative involvement. This article explores state advocacy and collaboration efforts among school nurse organizations over the past year identifying common themes, with a focus on Every Student Succeeds Act involvement, as well as listing unique activities by state.

Historic Leadership.

School nursing practice establishes itself in the midst of both education and nursing philosophies, ethics, standards, laws, and regulations. Treading these two worlds is difficult at times and requires that a school nurse possess a strong foundational knowledge base, seek professional collaboration, and navigate conflicting professional demands in order to promote student and public safety. This article is Part 2 of a four-part series that recounts the inspiring story of a school nurse, Ellen Johnsen, who did just that back in the 1980s in Broken Arrow, Oklahoma. Part 2 describes how Ellen's actions led the Broken Arrow Public Schools to revise its unsafe and illegal medication administration policy, which brought the policy into partial compliance with the nurse practice act but culminated in Ellen losing her job. The purpose of this series is to enhance understanding of the legal parameters governing school nurse practice, provide examples of ethical decision making, and review the challenges associated with serving as a leader.

Cardiac Emergency Response Planning for Schools: A Policy Statement.

A sudden cardiac arrest in school or at a school event is potentially devastating to families and communities. An appropriate response to such an event-as promoted by developing, implementing, and practicing a cardiac emergency response plan (CERP)-can increase survival rates. Understanding that a trained lay-responder team within the school can make a difference in the crucial minutes between the time when the victim collapses and when emergency medical services arrive empowers school staff and can save lives. In 2015, the American Heart Association convened a group of stakeholders to develop tools to assist schools in developing CERPs. This article reviews the critical components of a CERP and a CERP team, the factors that should be taken into account when implementing the CERP, and recommendations for policy makers to support CERPs in schools.

Medicinal Use of Marijuana: What School Nurses Need to Know.

The subject of medical marijuana is complex and currently of interest and concern to patients and health care providers. Legislators throughout the United States have passed state-specific laws and regulations that impact medical practice and the use of marijuana as a therapeutic modality. In November 2015, New Jersey became the first state to specifically allow the administration of medical marijuana for students and persons with developmental disabilities. The purpose of this article is to provide a frame of reference for school nurses and to encourage awareness of the implications for student health and relevant nursing interventions in the school setting.