Community and Organizational Resources

 Community and Organizational Resources

    Since the emergence of public health nursing in the 20th century, community health nursing (CHN) in public schools has been one of the important settings for nurses (Stamler & Yiu, 2012). This is because poor health has been associated with a child’s reduction in academic performance , having effects on the child’s future economic and social wellbeing (Stamler & Yiu, 2012). CHN's in school can play a key role in achieving and maintaining the health of students.  

        For most of the 20th century, the role of CHN in schools has been at the individual and family level, providing classroom health teaching, health screening, immunization programs and as advisory agent to staff about student health status (Stamler & Yiu, 2012). The interventions of the CHN were based on the biomedical model (focusing on maintain the absence of disease through immunization, screening and treatment) (Stamler & Yiu, 2012). Schools functioned as a setting for the nurse to enter the neighbouring community through communication & collaboration with other services and health professionals such as doctor, pharmacists , businesses & others within the community (Stamler & Yiu, 2012). The nurse would also conduct home visits getting to know the families of the students (Stamler & Yiu, 2012). In the mid 1970s CHNs began addressing lifestyle issues through health education, health awareness, and counselling on top of the usual screening and prevention programs (Stamler & Yiu, 2012).  

     With the development of the Ottawa Charter, CHNs changed their paradigm towards health promotion, focusing on the idea that health is developed and sustained within people’s environments. Thus, schools are an important environment for health promotion for youth and families (ie. Social Determinants of Health) (Stamler & Yiu, 2012). However, the ability of the CHNs to function in the community became severely impeded starting in the 1990s and into the 21st century as healthcare restructuring came into effect, funds were redistributed, and changing public health mandates all resulted in severe reduction or elimination of CHNs in schools (Stamler & Yiu, 2012). Even so, CHNs have maintained their advocacy principles and actions for school based health promotion (Stamler & Yiu, 2012). CHNs have continued to influence political decisions and lobby for the health promotion in public schools (Stamler & Yiu, 2012).

      An example of implementation of community programs is done under the Ministry of Ontario’s “Use of Schools Program”. According to the Ontario Ministry of Education (OME) (2006), schools are recognized as hubs for community activities, and as such the OME provides affordable access to the use of schools for community purposes (OME, 2006). Activities are mainly non-profit focus, with an emphasis placed on fair and equal access, social group activities and creation of a positive climate for youth. Implementation of programs under the ministry’s Use of Schools Program is done by local organizations and community leaders, including the CHN. 

       Throughout Canada, the practice of the community health nurse is government by the standards of practice of the Community Health Nurses of Canada (CHNC), as well as the public health nursing competencies, and the roles and activities described by the Canadian Public Health Association (CPHA) (Stamler & Yiu, 2012). The roles of the school CHNs focus on the individual student(s), groups (ie. classes), and the entire school population (ie. the role of CHNs in schools are all encompassing an comprehensive) (Stamler & Yiu, 2012). School CHNs utilize resources from different sources (ie. Ontario Public Health, local organizations, students and school staff) to accomplish their goals under the standard, competencies, and roles (Stamler & Yiu, 2012).

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