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The challenges in child health


Why a school nurse is needed in every school


Yinglen Butt


The Covid-19 pandemic has been particularly tough on children and young people.

With many children not attending school – although attending lessons online from home – their routine was disrupted and they were isolated from their usual social circle.

It’s been tough for school nurses, who play a key part in supporting children with physical or mental health issues, inspiring them to living a healthy life and protecting them through safeguarding processes.

Child mental health issues are also on the rise. In 2017, one in nine children aged between five to 16-year-olds identified as having a probable mental health disorder; in 2020, this was one in six. As a specialist in public health, the school nurse may spot the symptoms of mental ill health – such as moodiness or anger – which may be otherwise dismissed as ‘just being a teenager’.

Take the experience of one nurse – usually part of a team working face-to-face with children, she was caring for a child around whom there were allegations of physical abuse at home. When angry the child would lash out.

The nurse decided to do a home visit with the child to speak face-to-face; this later led to the visits taking place in an outdoor area, due to Covid-19. Through talking and listening the nurse was able to find out that the child felt that school was an escape from their home environment and was struggling being only in her home environment. Giving the child time out away from home with a trusted professional helped them to find some peace and a space to consider solutions.

Without the face-to-face visits of the school nurse, that child’s personal issues would have escalated.

This is just one example of why the Royal College of Nursing recently reignited the call for more school nurses, saying that every school should have a nurse.

School nurses support the children and young people in their care in many ways, whether that is support with an ongoing condition or providing advice about healthy eating, drug use or stopping smoking. Even more importantly, in the currently climate of a pandemic, they support young people with mental health issues and promote wellbeing. In fact, they support the whole family, providing advice and support to parents and carers. The example above shows school nurses have to be flexible and find a way around problems to ensure that the child is at the centre of care. As we can see, they have proved their ability to be flexible and find a way around problems to ensure that the child is at the centre of care.

The number of school nurses has decreased by 29% since 2009 (NHS England data) and this cannot be allowed to continue. In a recent report by the Centre for Social Justice, there is a call for the number of school nurses to be returned to the levels pre-2010. Funding must be made available for this as it is clearly a priority service.

If we want children to reach their full potential, then they need access to public health practitioners who are specialists in early intervention and prevention. School nurses are specialist community public health nurses who have been trained to understand how to work with children, young people, parents or carers and other key stakeholders and provide the support they need.

If you want children to meet their educational attainment, their physical needs must also be met. It’s important that they have enough nutritious food, exercise and sleep. A school nurse will be able to spot the signs of a child who maybe looks malnourished or alternatively struggling with their weight or who seems constantly tired. There could be a problem at home or an underlying health condition and the school nurse can provide help for the family in a place that’s easy for them to access.

At a time like this, we should be prioritising children’s health and wellbeing and helping them to develop healthy lifestyle choices that will have longer term benefits in their health outcomes. The health of our children should be seen as an asset to be cherished. School nurses will play an essential part and funding must be available for that.