School Nurses are front line, in the trenches, healthcare warriors every day in our nation’s schools. The call from RWJF to “Build a Culture of Health” has given rise to community collaborations that spotlight the impact and importance of School Nursing. The last 15 years of my 31 years in Nursing has been as a School Nurse in Camden, NJ. Camden is usually listed as the #1 or #2 most dangerous city, with more than 50% of the population under age 21. 99% of my students qualify for free breakfast and lunch. Needless to say, my role is often primary care to staff, students and families.
For many years, I struggled to feel supported in my work. The isolation led me to create my own network of like-minded healthcare warriors in other school nurses who were as passionate as I was about caring for our kids. It was not until I was accepted in the Johnson & Johnson School Health Leadership Program in the cohort of 2015 that I found the tools I was so desperately seeking.
As part of the J&J Fellowship, you form a team attend and one week summer Institute in New Brunswick, NJ. My team attended this past summer of 2015. During the Institute, we were immersed in leadership training, exposed to current research in School Nursing practice and are supported in exploring what it means to be a Health Leader in your school community. I felt like somehow my passion to be a School Nurse was reignited during that week. My reset button was pushed and our toolbox was restocked.
The initiative that my team chose was based on the Camden County Health Assessment from 2013. It revealed that Camden residents were using the ER as Primary care at an astronomical rate, but at the same time, it showed that there were more Healthcare providers in the city than anywhere else in the County. That was an intriguing comparison; there were more than enough providers but they were not being accessed. Access to care was not the issue; it was accessing the care that was the problem. Our project took shape based on this one question. Why, in a City with more providers than expected, would residents still be using the ER for primary care?
As School Nurses, we could have given you our top 10 reasons, but as newly minted Health Leaders, we knew we had to find out from the perspective of the families. Culturally informed, patient/family centered care was the foundation in which we began our inquiry. We researched an evidence-based tool to collect our data. We chose to use a “Community Café” model in which to host structured conversations with our parents to find out what barriers to care they were experiencing.
Our findings will be on display in June because our initiative has been accepted as a Poster presentation for NASN’s National Conference in Indiana. Beyond that wonderful privilege the scope of our project is expanding to include the other Nurses in my district. My team collaborated with the Camden Coalition of Healthcare Providers to share our Café findings the themes identified to improve relationships with primary care providers so that our students will have improved health outcomes and improved school attendance. Closing the achievement gap is directly related to school attendance and School Nurses have an important role in supporting school attendance through school health services.
By stepping outside of the Health Office and seeking a collaborative relationship, we were able to partner with the Camden Coalition on a larger pilot project that will share access to health records and school forms with School Nurses and Primary Care Providers. Coordinating care and ensuring continuity of care is a key component in providing the best outcomes for our students. Beth Mattey, President of NASN has been generous in her support of our pilot project along with the Camden Coalition of Healthcare Providers. A similar initiative was successfully implemented with DE School Nurses and Nemours Hospital for Children. The outreach from NASN and J&J School Health Leadership Program has enabled our initial initiative to move to a larger scale pilot project that we hope to begin in the Fall of 2016.