Factors Affecting the School Nurse\u27s Role in Effectively Managing the Child with Asthma: A Dissertation

This study uses a descriptive survey design to describe and examine the relationship among school nurses’ level of education, years of experience, knowledge of asthma and identification of the school nurse’s level of proficiency based on Benner’s (1984) model of Novice to Expert. A convenience sample of school nurses employed in public schools within the state of Massachusetts with an RN degree (registered nurse) were sampled. The demographic data revealed that of the 325 participants who participated in the study, the majority of school nurses were female ranging in age from 40 to 50 (M=47.0). The majority of nurses had a bachelor’s degree in nursing and were employed in the nursing profession on an average of twenty-two years and in school nursing for ten years. Since the majority of the school nurses did not have a master’s degree, they were not certified by a national certifying body. The majority of participants indicated that they had received certification through the Board of Education in Massachusetts. Most school nurses worked full time in a public school and were responsible for between six hundred and a thousand students. The majority of nurses indicated that they did not have a school-based clinic on site, nor did they have a school-based health center or clinic to refer students. There was little variability among sample characteristics with school nurses employed in Massachusetts being a fairly homogenous group. Those surveyed were sent a packet containing four questionnaires including one on demographics, as well as an asthma questionnaire, a questionnaire assessing chronic health problems in the schools, and a self-reporting questionnaire based on Benner’s (1984) model. Further results of this study revealed that the majority of the school nurses had an average to above average knowledge of asthma. The three most common interventions performed by school nurses as well as non medical personnel for those students with chronic illness are nebulizations, inhalers, and peak flow meters. Based on the self-report model of Benner’s (1984), these same nurses viewed themselves as expert in their level of practice. Mezirow’s Adult Learning Theory as well as Benner’s (1984) model of Novice to Expert were used to support the nurses level of practice based on experience, intuition and a constellation of meaning schemes developed from previous exemplars. Results of the study indicated that although the nurses surveyed were expert in their knowledge of basic nursing concepts, none had advanced practice level courses in advanced health assessment or clinical decision making in order to effectively manage the complexities of chronic illness such as ADHD, diabetes, and epilepsy, as well as asthma, the most common chronic illness in schools today