It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) provides expertise in school health and is a vital member of the school team who collaborates with community agencies to develop comprehensive emergency response procedures. The school nurse knowledgeable about the pathophysiology of physical and psychological trauma and is a valuable resource for the provision of health care and support in emergencies. (Kalekas, 2017).
BACKGROUND AND RATIONALE
“School nurses have a unique role to protect and serve the nation’s children whenever disaster strikes during the school day” (Kalekas, 2017, p. 458). Every day approximately 60 million primary and secondary aged students attend public, charter, or private schools in the United States (U. S. Department of Education [USDE], 2018). It is fundamentally important that school administration, school staff, parents, and students work together to promote and maintain a safe environment for students (Accredited Schools Online, n.d.; American Academy of Pediatrics [AAP], 2015). While emergencies in the school setting are often unpredictable, those involved in the care of students should prepare to meet the needs of those students before, during, and after an event. Emergencies that may occur at school include:
- Student, staff and visitor health-related emergencies or injuries;
- Mass casualty incidents;
- Weather-related emergencies; and
- Hazardous materials emergencies (Cowell & McDonald, 2018; Kalekas, 2017).
Preparedness in schools is a process designed to protect students and staff from harm, minimize disruption, ensure the continuity of education for students, and develop and maintain a culture of safety. (National Integration Center, 2018). To maximize success, effective management of school emergencies requires training, preparation, and planning for best practices (Trust for America’s Health [TFAH], 2017).
Utilizing their expertise in assessment, planning, implementation and evaluation, school nurses provide valuable insights for the four phases of school campus/district emergency management: Prevention/Mitigation, Preparedness, Response, Recovery (Doyle, 2013). The school nurse is a leader and integral partner with school staff and outside agencies in developing comprehensive school plans/procedures for injury prevention and first aid, facilitating evacuation, caring for students with special needs, performing triage, educating and training staff, providing surveillance, reporting (Doyle, 2013; Kalekas, 2017), and assisting survivors with their immediate psychological and emotional needs; and referral to appropriate mental health services for long-term support (Brymer et al., 2012; National Association of School Psychologists, 2017). School nurses recognize and respond to both minor and mass emergent situations thereby minimizing unnecessary delay in initiating an effective response (Cowell & McDonald, 2018; Hoffman & Silverberg, 2018). School nurses advocate for mass casualty triage and training that effectively addresses children’s unique physiology and psychological development (AAP, 2015).
To optimize student health, safety, and learning, NASN advocates for a school nurse to be present in school all day, every day, and this presence is especially beneficial in planning for and responding to emergency situations. School nurses, as healthcare providers, are an essential member of the leadership team, bringing their unique perspective to optimization of all phases of school emergency preparedness (Davis-Aldritt, 2017).
Accredited Schools Online (n.d.). Emergency Preparedness in Schools [website]. Retrieved from https://www.accreditedschoolsonline.org/resources/emergency-preparedness-in-school/
American Academy of Pediatrics. (2015). Ensuring the health of children in disasters. Pediatrics, 136(5), e1407-e1418. doi: 10.1542/peds.2015-3112.
Brymer M., Taylor M., Escudero P., Jacobs A., Kronenberg M., Macy R., … Vogel J. Psychological first aid for schools: Field operations guide, 2nd Edition. (2012). Los Angeles: National Child Traumatic Stress Network. Retrieved from http://www.esc4.net/Assets/psychological-first-aid-forschools.pdf
Cowell, J. & McDonald, C. (2018). School safety. The Journal of School Nursing, 34(4), pp.254-254. doi: 10.1177/1059840518782215
Davis-Alldritt, L. (2017). Management of diabetes. In C.A. Resha & V. L. Taliaferro (Eds.). Legal resource for school health services (pp. 305-323). Nashville, TN: SchoolNurse.com.
Doyle, J. (2013). Emergency management, crisis response, and the school nurse’s role. In J. Selekman (ed.). School nursing: A comprehensive text (2nd ed.), pp.1216-1244. Philadelphia, PA: F.A. Davis Company.
Hoffman, S. J. & Silverberg, S. L. (2018). Delays in global disease outbreak responses: Lessons from H1N1, Ebola and Zika. American Journal of Public Health, 108(3), 329-333. doi:10.2015/APH.2017.304245.
Kalekas, L. (2017). Disaster preparedness for school health services. In C.A. Resha & V. L. Taliaferro (Eds.). Legal resource for school health services (pp. 457-467). Nashville, TN: SchoolNurse.com.
National Association of School Psychologists. (2017). Large-scale natural disasters: Helping children cope [handout]. Bethesda, MD: Author. Retrieved from: https://www.nasponline.org/resources-and-publications/resources-and-podcasts/school-climate-safety-and-crisis/natural-disaster-resources/large-scale-natural-disasters-helping-children-cope
National Integration Center (2018). National incident management system overview. Federal Emergency Management Agency. Washington, DC: Author. Retrieved from: https://www.fema.gov/media-library- data/1528744120031-0c6e8ed3da3f80db03050a02f76b97c4/Alexander_NIC_NAC-May2018.pdf
Trust for America’s Health (2017). Ready or not? Protecting the public’s health from diseases, disasters, and bioterrorism. Washington DC: Author. Retrieved from https://www.tfah.org/wp-content/uploads/archive/assets/files/TFAH-2017-ReadyOrNot-Fnl.pdf
U.S. Department of Education, National Center for Education Statistics, (2018). The condition of education. Washington, D.C.: Author. Retrieved from https://nces.ed.gov/programs/coe/indicatorcgc.asp
Acknowledgement of Authors:
Pam Allsbrook, MSN, RN, NCSN
Cindy Begley, BSN, RN, NCSN
Karen Graf, MSN, RN-BC, APHN-BC
Revised: June 2014, June 2019
Suggested citation: National Association of School Nurses. (2019). Emergency Preparedness (Position Statement). Silver Spring, MD: Author.
“To optimize student health, safety and learning, it is the position of the National Association of School Nurses that a professional registered school nurse is present in every school all day, every day”
All position statements from the National Association of School Nurses will automatically expire five years after publication unless reaffirmed, revised, or retired at or before that time.