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How Have You Used the Framework in Your Practice?


How Have You Used the Framework in Your Practice?

Years ago, my grandmother introduced me to another nurse by saying, “This is my granddaughter, she used to be a nurse but now works with computers.” I was shocked. I used a computer, but anyone who knows me would not be coming to me for computer advice. 

I have thought of this experience often and why would she describe my job as a school nurse and school nurse consultant this way? I realized I did not articulate what I did clearly and my job was never the same thing every day. This makes it hard to clearly articulate what we do.

NASN developed the Framework for 21st Century School Nursing PracticeTM to help practicing school nurses explain to others the various aspects of their job. The Framework was also meant to help school nurses prioritize activities. Our activities should center on what our students and schools need and we have many demands. In addition, some educators are not clear on what our potential can be and focus on their historical understanding of school nursing. We all know that times have changed – students come to school sicker and with complex social and emotional needs, technology is changing, and evidence is more readily available to improve our practice.

When we developed the Framework, we asked for feedback and reviewed all of it. One concern raised several times was that the Framework was nice, but that individual school nurses could not apply it to their practice. Hopefully, you have had an opportunity to hear the podcast about the Framework article published in the January 2016 NASN School Nurse where examples are provided of how the Framework could be applied to practice. Did you know a downloadable version of the Framework is also on NASN’s website for you to use?

That is just the beginning. The general session at NASN’s 2016 Annual Conference will provide an overview of the Framework and explains how it can be used in practice. Real-life school nurses just like you (and me) will share how they have successfully used the Framework. We will also provide tips about how to advocate for change using the Framework.

I would love to hear how you have used the Framework in your practice. Please let me know in one of the following ways.

1. Enter a comment on this blog post.

2. Write a blog.

3. Record your story on video and then share your video file in a discussion post.

NOTE: If you do write a blog, share a video, or send a discussion post, please let me know by entering a comment on this blog. You will need to login to SchoolNurseNet to comment, blog, or send a discussion post.




02-07-2017 15:57

Hi, my name is Dina Joseph. I am new to this job , so all the info I'm getting is so helpful. I am so happy to be a part of school nursing. I will use the Framework for 21st Century School Nursing to help me create new ideas for our students and staff. Again, thanks.

Dina Joseph
Hi Erin,
My name is Jennifer Norton and I am a CSN in Lancaster, PA. I am finishing my Master’s Degree in School Nursing and Leadership this summer at Eastern Mennonite University and have chosen care coordination as the foundation for my capstone project. I am focusing my efforts on multi-disciplinary care coordination at the middle school level. Our school district and community have many high quality support programs for students; however, these programs often function independently of one another, leading to duplication of services and lack of team collaboration.
We are working towards improving collaboration and communication between teachers, staff, administrators and families so that students and families can be connected to interventions earlier, utilizing the vast amount of professional expertise available. A new referral process and documentation will be initiated so that we will have data over time to measure the impact of interventions of student health and success.
Our state association has brainstormed ways to increase membership and participation in leadership roles. I volunteered to write an introduction letter to school nurse participants of a leadership course and then expanded it to share with all school nurses in our state. Included is a success story that came out of collaboration with the medical director of our local emergency room. An excerpt is shared below:
Hi fellow Vermont School Nurses,
Did you know that leadership is one of the Key Principles in the National Association of School Nurses’ (NASN) Framework for 21st Century School Nursing Practice? The framework describes leaders as advocates, change agents, and those who participate in system level leadership. I wanted to share with you one way that you can use your enthusiasm and skills to promote school nursing at the state level. The mission of the Vermont State School Nurses' Association (VSSNA) is to “advance the practice of School Nursing and to provide leadership in the delivery of quality health programs to the Vermont school community.” The organization is dedicated to the development of school nurses professionally in providing and promoting continuing education, encouraging and assisting nurses in improvement of comprehensive health education, and collaborating with other organizations to improve school health services! I highly encourage you to join the organization and perhaps even consider a leadership role! The VSSNA Board of Directors is a volunteer group that organizes conferences, brings nurses together on a local level for professional development, and represents Vermont school nurses to other organizations, both on a local and national level. There are many opportunities to execute your leadership skills and gain contact hours, too!
I want to share a success story of collaboration between the VSSNA in District 3 and their local Emergency Room- In February of this year, Dr. Mark Depman, Medical Director of the ER at the University of Vermont Health Network-Central Vermont Medical Center along with the nursing supervisor of the ER shared their expertise with the nurses of District 3. Dr. Depman engaged in a discussion with nurses about the role of the nurse in the school setting and took a few ideas and questions back to his staff, including thoughts to address challenges in getting orders to school for students seen in the ER. Dr. Depman shared that he has a “new and deepened respect for the work we all do and the demands on our profession!” In late March, a student brought to my office discharge paperwork from the emergency department at Central Vermont Medical Center. The form indicates “School Release” and provided additional instructions specifically for returning to school. I was thrilled to see that Dr. Depman not only listened to our concerns and challenges, but then acted upon them to provide greater communication in order to keep our students healthy, safe and ready to learn!
- Excited to see how others are incorporating the framework!

04-21-2016 09:22

We have a team of 8 school nurses here in Holland, MI. We meet as a team monthly. As our QI project this year we have each taken a framework principal and presented at a team meeting. The assignment was to research the principal and then present how it applies to our practice. Things we could do better, things we could change and things we are already doing great. It has been a great learning experience. We have 2 more principal presentations. The next step is to compile what we have discussed r/t proposed changes and work on implementing. Great tool. Thanks. Jane Borr, Holland Hospital School Nurse Manager