New Jersey Health Initiatives (NJHI) practices an innovative method of awarding grants to address the challenges that are faced in building a Culture of Health. Instead of assigning missions to organizations and telling them what to do with the funding, NJHI is taking a step back and allowing grantees to come up with their own goals and action plans. NJCCN is currently administering one such grant, which we are using to educate and support school nurses in their uniquely community-oriented work.
The first action under this grant project was to host a retreat on February 4th at the Princeton Marriott. Forty-two school nurses were in attendance.
Bob Atkins of NJHI presents on the role of school nurses within the wider communities, beyond the walls of their schools.

Bob Atkins of NJHI presented on the role of school nurses within the wider communities, beyond the walls of their schools.

The day started with a presentation by Bob Atkins on role of school nurses in the wider community, beyond the walls of their schools. He pointed out that school nurses get an insider’s perspective on the lives of their students. Every Monday morning, students flock to the nurse to be treated for the ailments that cropped up over the weekend, and nurses hear the accompanying stories. In this way, they become involved with every crisis from house fires to new glasses prescriptions. But healthcare shouldn’t be limited to treating problems as they arise, in a “downstream” framework. Instead, healthcare should be addressed “upstream,” addressing the sources of health problems before they become crises.

Jennifer Rosen Valverde presented on the social determinants of health, especially poverty.

Jennifer Rosen Valverde presented on the social determinants of health, especially poverty.

The next presentation by Jennifer Rosen Valverde (Clinical Professor of Law in the Education and Health Law Clinic, and Legal Director of the Health, Education, Advocacy & Law) Collaborative) was on the social determinants of health. She particularly stressed the detrimental effects of poverty, both directly and indirectly. Income level determine’s a family’s diet, their housing, education, and transportation, all of which contribute to the state of their health. These factors (and more) contribute to a collective discrepancy of 15 years in the life expectancy of men in the top 1% and the bottom 1% in the United States. She urged school nurses to advocate for themselves and for their students, stating that her goal is “to have a more empowered and unifying voice” when addressing “health justice.” Understanding the actual causes of problems is vital to establishing coherent solutions. Too often, people do not ask questions about social determinants of health.

Sheila Caldwell then introduced the Framework for 21st Century Nursing Practice™, which was developed by the National Association of School Nurses (NASN). According to publications by NASN, “The Framework provides structure and focus for the key principles and components of current day, evidence-based school nursing practice. It is aligned with the Whole School, Whole Community, Whole Child model that calls for a collaborative approach to learning and health (ASCD & CDC, 2014).” Eileen Gavin followed up with a presentation on the work that school nurses do to address mental health in schools. She stated that 32% of work time is spent in addressing mental health, yet training and support for this aspect of nursing is minimal. NJCCN will be addressing this concern through day-long workshops to provide much-needed training in mental health care for school nurses.

For the second half of the day, attendees broke into small groups and examined the key principles as defined in the Framework for 21st Century Nursing Practice™ (Standards of Practice, Care Coordination, Leadership, Quality Improvement, and Community/Public Health). Under the direction of Robert Phillips and Sonya De Almeida, each group broke a principle down into priorities and then drafted an action plan for high priority items. These action plans will be finalized at a follow-up retreat in April. We were thrilled to see the high energy level and enthusiastic commitment from attendees, and we look forward to seeing how the work of this grant unfolds!