|
INTRODUCTION
Children have always suffered the effects of violence. Violence may range from bullying to physical or sexual abuse, assault, murder, or war. School violence is "any behavior that violates a school's educational mission or climate of respect or jeopardizes the intent of the school to be free of aggression against persons or property, drugs, weapons, disruptions, and disorder." according to the Center for the Prevention of School Violence (2002). Students and staff need to feel safe in school in order to concentrate on education and learning. Violent acts are varied and have been identified as major barriers to learning (CMHS, 1999).
Parents and the community need to know that students are safe and that the school community is acting to minimize violence. The National Association of School Nurses (NASN) supports the belief that schools and communities must work together to foster safe school environments through the reduction of violence with zero tolerance for weapons, a focus on anger management, peer mediation, and counseling. School nurses can promote an atmosphere of respect through the development of programs to address the need for problem-solving and conflict resolution skills. Schools must provide a "safe zone" for children and adults in which violence is not tolerated. Strong school and community supported programs should be implemented to deal with violence.
BACKGROUND
High profile violent incidents in schools make headlines and are sensationalized in news reports. Lawmakers, parents, and community leaders call for action to "make our schools safe again." Yet, violence, among youth, particularly older teens, is much more likely to occur outside of school (DeVoe et al., 2004). In 2002, there were 877,700 young people 10-24 years of age reported as injured by violence (CDC, 2004), and homicide has become the second leading cause of death for young people 10-24 years of age and the leading cause of death among African-American youth (Anderson & Smith, 2003).
In school, violent deaths are most likely to occur at the beginning or end of the day, or at lunch. Between 1994 and 1999, 172 students were killed at school or school-related events (Anderson, Kaufman, et al., 2001). Although the incidence of death by violence in schools has not grown, the incidence of reported bullying in school has increased since 1999, with bullying more common in public schools and in rural communities (DeVoe et.al., 2004).
Understanding the risk factors that indicate increased potential for a young person to be harmed by violence, and those protective factors that foster resilience may lead to programs that can prevent violence in and outside of school. Recent research identifies those factors, but has yet to answer how any one individual may be influenced either positively or negatively by any combination of factors, or how those factors interact. (DHHS, 2001).
Risk factors listed in Youth Violence: A Report of the Surgeon General (DHHS, 2001) include:
Individual risk factors
Attention deficits/hyperactivity
Antisocial beliefs and attitudes
History of early aggressive behavior
Involvement with drugs, alcohol, or tobacco
Early involvement in general offenses
Low IQ
Poor behavioral control
Social cognitive or information-processing deficits
Family risk factors
Authoritarian childrearing attitudes
Exposure to violence and family conflict
Harsh, lax, or inconsistent disciplinary practices
Lack of involvement in the child’s life
Low emotional attachment to parents or caregivers
Low parental education and income
Parental substance abuse and criminality
Poor family functioning
Poor monitoring and supervision of children
Peer/School risk factors
Association with delinquent peers
Involvement in gangs
Social rejection by peers
Lack of involvement in conventional activities
Poor academic performance
Low commitment to school and school failure
Neighborhood/Community risk factors
Diminished economic opportunity
High concentrations of poor residents
High levels of transiency
High levels of family disruption
Low community participation
Socially disorganized neighborhoods
Protective factors listed include:
Individual protective factors
Intolerant attitude toward deviance
High IQ
Positive social orientation
Positive relationship with at least one caring adult
Family protective factors
Warm, nurturing parenting style
Clear limit setting and respect for growing autonomy of the adolescent
Peer/School protective factors
Commitment to school
Involvement in social activities
POSITION STATEMENT AND RATIONALE
Schools should be "safe zones" and adopt positions of no tolerance for weapons, crime, violence or bullying. Schools and communities must thoughtfully plan to proactively change behaviors in their quest to create a positive, healthy, and safe environment. School nurses have the unique ability to address problems holistically, from a physical, emotional, and social perspective. School nurses are prepared to deal with the physical and emotional results of violence, to contribute to positive youth development and academic success, and to collaborate with school and community teams toward violence prevention and intervention
It is the position of the National Association of School Nurses that school nurses have expertise to assist students to develop problem-solving and conflict resolution techniques, coping and anger management skills, and positive self-images. Furthermore, it is the position of the NASN that school nurses should be active members of crisis intervention teams and curriculum committees, and be involved in the development and planning of intervention and prevention programs.
ROLE OF THE SCHOOL NURSE
School nurses have expertise to collaborate with school and community members to implement programs that will proactively change behaviors and lead to the creation of a positive, healthy and safe environment.
School nurses are active members of the crisis intervention teams and as such, assure that their school community has an effective program in place, including periodic evaluation of the program.
School nurses, as trusted health professionals, identify issues related to poor self-esteem and self-worth, which can lead to isolationism and feeling of rejection among students. Studies indicate that when students have a positive connection with a trusted adult, anti-social acts are reduced significantly (U.S. Department of Education, 1998).
School nurses address problems holistically, including examining the physical, emotional, and social perspectives. School nurses can contribute insight into developmentally appropriate behaviors.
School nurses can assess the student and family functioning and ability to cope with changing life stresses. School nurses can provide support and understanding to students whose mental health is threatened by the mental illness of a family member.
School nurses have the benefit and knowledge of effective treatment and medical issues related to behavioral concerns.
School nurses are prepared to deal with the physical and emotional results of violence and to contribute to positive youth development and academic success.
School nurses are uniquely positioned to recognize the early warning signs that may lead to violence, provide education and counseling, identification and referral for services and monitor and follow-up with treatment programs.
School nurses are effective child advocates and can lobby for appropriate interventions and controls to address violence against children, including local and national efforts to establish safe schools and communities. By combining efforts with other professionals who share similar beliefs and goals, a strong coordinated interdisciplinary program for safe schools and communities can be developed. A comprehensive coordinated community model that includes prevention, early recognition, and treatment of mental health issues that may contribute to violent outcomes should be implemented.
REFERENCES
Anderson, M.A., Kaufman, J., Simon, T.R., Barrios, L., Paulozzi, L., Ryan, G., et al. (2001). School-associated violent deaths in the United States, 1994-1999. Journal of the American Medical Association. 286:2695-702.
Anderson, R.N., Smith, B.L. (2003) Deaths: leading causes for 2001. National Vital Statistics Report 2003; 52(9):1-86.
Center for Mental Health in Schools (CMHS).School Mental Health Project. UCLA. (2000, revised 2004). An introductory packet on violence prevention and safe schools. Available online http://smhp.psych.ucla.edu
Center for the Prevention of School Violence. (2002). At www.cpsv.org
Centers for Disease Control and Prevention (CDC). (2004). Web-based injury statistics query and reporting system (WISQARS). Available online http://www.cdc.gov/ncipc/wisqars
DeRanieri, J.T., Clements, P.T., Clark, K., Kuhn, D.W., & Manno, M.S. (2004). War, terrorism, and children. Journal of School Nursing, 20(2), 69-75.
DeVoe, J.F., Kaufman, P., Miller, A., Noonan, M., Snyder, T.D. & Baum, K. (2004) Indicators of school crime and safety. 2004. Washington, DC: U.S. Department of Education & U.S. Department of Justice.
Lamb, J. M., Puskar, K. R., Sereika, S., Patterson, K., Kaufmann, J. A. (2003). Anger assessment in rural high school students. The Journal of School Nursing: 19(1), 30–40.
National Association of School Nurses. (2003). Issue brief: Peer bullying. Scarborough, ME & Castle Rock, CO: Author.
National Institute of Mental Health. (2000). Child and adolescent violence research. Washington, DC. U.S. Department of Health and Human Services, National Institute of Health (# 00-4706).
Strawhacker, M. T. (2002). School violence: An overview. The Journal of School Nursing, 18(2), 68–72.
Thomas, S. P. (2003). Identifying and intervening with girls at risk for violence. Journal of School Nursing. 19(3). 130–139.
U.S. Department of Education. (1998). Early warning. timely response: A guide to safe schools. Retrieved online January 20, 2000. http://www.ed.gov/about/offices/list/osers/osep/gtss.html
U.S. Department of Health and Human Services. (2001). Youth violence: a report of the Surgeon General Available online www.surgeongeneral.gov/library/youthviolence
Werle, G. D. (2004). The lived experience of violence: Using storytelling as a teaching tool with middle school students. Journal of School Nursing, 20(2), 81–87.
2005 |