COMMUNITY SETTING Forensic Nursing

Choose the following Community Health settings, and describe what you have learned about the setting and the role(s) of the nurse in that setting (see Nies & McEwen, 2019, Chapters 30-34). Do not choose home health nursing

• Forensic Nursing

Next study levels of prevention in this week’s lesson (primary, secondary, and tertiary). Note that the term primary is used differently than in normal conversation.

• Describe one of the levels of prevention, and discuss how a community health nurse (CHN) in the setting you discussed can implement this level of prevention

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CHAPTER 30- SCHOOL HEALTH (PAGES 613-627)

According to the Centers for Disease Control and Prevention (CDC) (2016), the healthy development of children and adolescents is influenced by many societal institutions, and after the family, the school is the primary institution responsible for the development of young people in the United States. The school environment is also a key setting in which students’ behaviors and ideas are shaped. Just as schools are critical to preparing students academically and socially, they are also vital partners in helping young people take responsibility for their health and adopting health-enhancing attitudes and behaviors that can last a lifetime (CDC, 2017).COMMUNITY SETTING Forensic Nursing

BOX 30.1 Youth at Risk

· • Every day nearly 3200 young people start smoking (CDC, 2015).

· • Daily participation in high school physical education classes dropped from 42% in 1991 to 27.1% in 2013 (CDC, 2017).

· • Seventy-five percent of young people do not eat the recommended number of servings of fruits and vegetables.

· • Marijuana use among young people increased from 15% in 1991 to 46% in 2015.

From National Institute on Drug Abuse: National survey of drug use and health, 2015. https://www.drugabuse.gov/national-survey-drug-use-health

Academic success and healthy children and youth are closely intertwined. It is impossible to achieve success in school without maximizing the health of the students. School-age children and adolescents face increasingly difficult challenges related to health. Many of today’s health challenges are different from those of the past and include behaviors and risks linked to the leading causes of death such as heart disease, injuries, and cancer. Examples of behaviors that often begin during youth and increase the risk for serious health problems are the use of tobacco, alcohol, and drugs; poor nutritional habits; inadequate physical activity; irresponsible sexual behavior; violence; suicide; and reckless driving (Box 30.1).

In the United States, approximately 55.6 million children attend school every day (National Center for Educational Statistics, 2016). Their presence creates a unique opportunity for school nurses to have a positive impact on the nation’s youth. The primary providers of health services in schools are school nurses, and there are approximately 73,000 registered nurses working in schools in the United States (U.S. Department of Health and Human Services [USDHHS], Health Services and Resources Administration, 2010).

School nursing is a specialized practice of professional nursing that advances the well-being, academic success, and lifelong achievement and health of students. To that end, school nurses facilitate positive student responses to normal development; promote health and safety, including a healthy environment; intervene with actual and potential health problems; provide case management services; and actively collaborate with others to build student and family capacity for adaptation, self-management, self-advocacy, and learning (NASN, 2017). The National Association of School Nurses (NASN) recommends one school nurse for every 750 students in the general population, one for every 225 students in mainstreamed special education populations, and one for every 125 severely chronically ill or developmentally disabled students; however, caseloads vary widely, depending on mandated functions, socioeconomic status of the community, and service delivery model (NASN, 2015).

More than 21% of the nation’s children live in poverty (National Center for Children in Poverty, 2017). Poverty is defined as an annual income below $24,339 for a family of four (U.S. Census Bureau, 2017). Decreased or inferior health care has been linked to serious health problems, resulting in an increase in absenteeism that may be correlated with failure in school. The school nurse can effectively manage many complaints and illnesses, allowing these children to return to or remain in class.

TABLE 30.1

Racial and Ethnic Breakdown of Uninsured Children in the United States in the Year 2012

Race	Number	Percentage
White	2.9 million	38.8
Hispanic	2.7million	38.1
Black	1.0 million	14.2
Asian and Pacific Islander	306,000	4.3