In the current discussion on bullying and its tragic consequences, the strategic role that school nurses can play is overlooked. Research has shown that students who are bullied are likely to present to the school nurse with multiple health symptoms–difficulty sleeping, wetting, headaches, stomach aches, nervousness, and depression to name a few. In a 28-country study, the health symptoms from being bullied were universal.

What little research has been done about school nurses and their perceptions of bullying has shown that they have not been educated about their role and don’t quite know what it is. In some schools, the nurse is not even a member of the Violence Prevention Task force.

I have presented the Bully Victim Identification and Intervention Program for School Nurses in Western Massachusetts schools, most recently, South Hadley. It educates the nurses about what to look for as signs and symptoms of bullying. It raises awareness about three particularly high risk students-those who are overweight, gay/lesbian/bisexual/transexual, or special needs. It helps to explore their role and the actions they can take. The nurses who have attended the program have been passionate about expanding their role in preventing bullying.

Not including school nurses in bullying prevention efforts speaks to a lack of recognition of their worth. They are mandated to screen students for potential vision, hearing, posture and weight problems. They monitor and prevent the spread of communicable diseases, and administer medications for students with prescriptions.

They are also the growth and development educators for the school, the wellness coordinators, the nutrition consultants, the emergency medical and triage nurses, the mental health pointguards, dental care assistants, health policy administrators and a member of the assessment team for children with learning difficulties. The extent to which they involve themselves in wider issues depends on school administrators and parents recognizing the valuable role they can play.

In order for school nurses to fulfill the depth of their roles in dealing with bullying, they need three things:

  • An efficient health record keeping system.
  • Inclusion on critical committees.
  • A nurse leader.

One of the primary tactics for dealing with bullying is recording the “who, what, where, when and why” of it. Keeping and reporting data is a powerful tool for schools. Many school nurses still use a record-keeping system that is a paper format, while some have a software program that is part of the school’s administrative software and which often does not capture the nuances of medical record-keeping.

All schools have a School Council. They should also have a Violence Prevention Task Force and school nurses should be included on committees such as these. They provide a dimension to the discussion that no one else can.

Finally, a nurse leader provides the glue for a coordinated program of nursing from preschool through high school graduation. She advocates for the equipment and support the nurses need to do their jobs efficiently and effectively. She reduces the administrative strain on them which frees them to embrace other responsibilities like assisting someone who is being bullied.

The Bully Victim Identification and Intervention Program for School Nurses emphasizes that a comprenhensive bullying prevention program requires the 4 P’s: people, policies, programs and persistence. It’s time for the school nurse to be included in the 4 P’s.

Nora Zinan, DNP, MSPH, RN is currently Adjunct Faculty at Elms College in Chicopee, Mass. She lives in Sunderland, Mass.

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