Partnership with Families

Family is the constant in a child’s life. Family engagement in school is one of the major predictors of student academic success. School nurses have direct contact with families of students with special health care needs on a regular basis. Families look to school nurses for understanding as well as practical help. School nurses contribute to the climate of welcoming and honoring families and their role and involvement in their student’s health at school.

School nurses balance decision-making regarding health services in school among the interests of the health and learning needs of the student, the preferences and choice of the family, the orders of the health care provider, and the legal mandates and capacity of the school system. Communication and negotiation are essential.

Families report feeling engaged and honored when professionals:

• Provide trust.
• Display clinical competence.
• Demonstrate care – “being there.”
• See the child as a whole person.
• Recognize and enhance family choice and power.

Parents of students with chronic health care needs attending school are responsible for:

• Notifying the school of the student’s medical needs.
• Supplying the school with orders from the health care provider for any medication or special health related procedures that are required at school.
• Supplying the school with written permission for the school to provide nursing care at school.
• Supplying the school with the medication, equipment, and supplies necessary for nursing care to be provided at school.

Berlin and Fowkes’ LEARN Model guides the professional school nurse in implementing a trusting, culturally competent, caring practice with families. The acronym LEARN represents the process of listening, explaining, acknowledging, recommending, and negotiating.

• The nurse must first listen to the family-student perception of the problem. This listening must be done in a non-judgmental manner, using encouraging comments such as, “Tell me more.
• The second step is for the nurse to explain his/her perception of the problem.
• The next key step is for the nurse to acknowledge not only the differences between the two perceptions of the problem, but the similarities as well. In developing a culturally responsive approach to care, the nurse must recognize differences and build upon similarities.
• The fourth step is to make recommendations that involve the family-student expression of perspectives and preferences.
• The final step is to negotiate a treatment plan, considering that it is beneficial to incorporate selected aspects of the family-student’s culture into the plan.