Dissertations, Theses, and Capstone Projects

Date of Degree

4-2023

Document Type

Dissertation

Degree Name

Ph.D.

Program

Nursing

Advisor

Steven Baumann

Committee Members

Ellen McCabe

Anthony Picciano

Danny Willis

Subject Categories

Nursing | Public Health and Community Nursing

Keywords

school nurse, school health, mental health, phenomenology, caring

Abstract

Mental health issues have for years been on the rise among our nation’s schoolchildren, and the COVID-19 pandemic has only served to aggravate what can now be called a crisis. Researchers agree that timely assessment, diagnosis, and treatment of mental health concerns in children are critical to maintaining their growth and development and could potentially aid in decreasing serious mental health events as they move into adulthood. While in an ideal world, each child would have a family medical provider, the fact is that for many children, the school nurse is the child’s sole provider of health care. Many times, school nurses are the first to encounter a child who is struggling with a mental health concern when they present in the school health office. School nurses are positioned to positively impact a child’s mental health by assessing student needs and implementing programs or referrals for students, however, many studies have reported school nurses feel ill-prepared or have faced barriers in assessing or caring for students’ mental health needs.

This phenomenologic exploration describes the lived experience of school nurses caring for children with mental health concerns and uncovers how school nurses experience support in this role. Amedeo Giorgi’s descriptive phenomenological method guides this study, which includes personal interviews with eight school nurses from across the United States. A description of the structure and meaning of their experience is uncovered through data analysis, and five themes are presented: The frustrating feelings of caring, Taking on distress while trying to make sense of it all, Left to pick up the pieces, The lonely member of the team, and Stay in your own lane. These themes bring to light school nurses’ unique life world experiences with this phenomenon. The results of this study can inform school nursing through implementation of workforce policies and practices that support mental and emotional health of students through assessment, identification, and referral for mental health concerns, as well as the creation of supportive, collaborative environments for school nurses to work in. Tenets of Watson’s caring science theory are demonstrated in the personal interactions and caring moments the school nurses describe, adding to the epistemology of caring in nursing, and helping to better understand the caring nature of the school nurse/student relationship.

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