9.13: Health Services
School nurses respond to emergencies, acute health needs, manage chronic health conditions, and provide referrals and support for primary care for both students and often staff as well. School nurses are also an integral part of the health team in that they can help identify physical hazards, provide individual and small group counseling and education for health issues, and support school-wide community health measures such as preventing the spread of infectious diseases. They may also play a role in ensuring quality health education curriculum, monitoring the availability of healthy foods (through the cafeteria, vending machines, etc.), and working with psychological counselors and social workers to support students' social and emotional well-being (National Association of School Nurses, 2017). The role of the school nurse is so integral to the WSCC model, that were it not for the heavy workload assigned to school nurses they would be an obvious choice to lead a school health advisory council (Seabert et al. 2021).
Since the 1960’s, schools have been recognized as a potential hub to offer increased access to healthcare in the communities that they serve. School-based health centers (SBHC) expand on the services offered by the school nurse to provide physical, mental, vision, and dental health services within the school setting. Schools that serve low-income communities, those with many uninsured or underinsured students, and those with limited access to healthcare (rural or urban), benefit highly from SBHCs. An SBHC may include pediatricians, physician’s assistants, nurse practitioners, dentists, mental health and substance abuse counselors and other healthcare providers. Some may even become Federally Qualified Health Centers and expand their services to student families, employees, and the community at large. Since most SBHCs are located on school property, they can make doctor’s appointments easier for parents and kids to get to. SBHCs can help address inequities in healthcare access and improve health outcomes for students experiencing poverty, adverse childhood experiences, and those at higher risk for health-risk behaviors. There is evidence that SBHCs are financially sustainable with a variety of grant funding sources, and can improve physical health outcomes, as well as the potential for positively influencing mental health outcomes and educational attainment. Although the role of SBHCs in sexual and reproductive health is controversial for some, they can also help to prevent teen pregnancies and STIs, as well as providing prenatal care for teens who do become pregnant (Arenson et al., 2019).