The Emergency Care Experience and Demand for Support of School Nurse

Article information

Res Community Public Health Nurs. 2017;28(2):182-195

Publication date (electronic) : 2017 June 12

doi : https://doi.org/10.12799/jkachn.2017.28.2.182

¹Graduate School, Seoul National University · Sinmoc Elementary School, Seoul, Korea

²College of Nursing, Seoul National University, Seoul, Korea

Corresponding author: Lee, In Sook College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea. Tel: +82-2-740-8828, Fax: +82-2-741-1574, E-mail: lisook@snu.ac.kr

Received 2017 April 04; Revised 2017 May 29; Accepted 2017 June 16.

Abstract

Purpose

This study explores school nurses' emergency care experiences and their needs for systemic institutional support.

Methods

Data were collected in 2016 from the interviews with five focus groups comprising thirty school nurses. Qualitative content analysis was then performed using the collected data.

Results

The study found that school nurses were vulnerable to over-reaction in uncertain situations as the school's sole health service provider. The study's findings are divided into ten categories. 1) Major obstacles to overcome as the sole health service provider, 2) Assessing an uncertain situation and making appropriate decisions, 3) Providing limited first aid while maintaining control over the situation, 4) Referring or transferring a student to a hospital that creates tensions and raises cost, 5) Becoming an advocate for information disclosure and treatment, 6) Ensuring follow-up actions and proper transfer of responsibility, 7) Making preparations for future emergency, 8) Responding to conflicts arising from over-reaction as a safeguard and professional expertise, 9) Need for the development of standardized manual for school emergency care, 10) Need for practical case-based training.

Conclusion

The findings of this study should contribute to the development of the programs aimed at improving school emergency care and the professional competence of school nurse.

Keywords: Focus groups; Qualitative research; Emergency nursing; School nursing; School health services

Table 1.

General Characteristics of Participants

Table 2.

Categories of School Emergency Nursing Experiences and Demand for Support by Participants

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Table 1.

General Characteristics of Participants

Variables	Categories	Total (N=30)	Group A (n=7)	Group B (n=5)	Group C (n=6)	Group D (n=6)	Group E (n=6)
Variables	Categories	n or M±SD	n or M±SD	n or M±SD	n or M±SD	n or M±SD	n or M±SD
Age (year)	＜30	39.53±10.37	32.29±7.63	38.40±10.31	34.33±4.32	38.50±4.28	55.17±5.42
	30~39	6	4	0	2	0	0
	40~49	14	2	4	4	4	0
	50~59	4	1	0	0	2	1
	＞59	5	0	1	0	0	4
		1	0	0	0	0	1
Education	Doctoral degree	1	0	0	0	1	0
	Master's degree	3	0	0	1	2	0
	Bachelor's degree	25	7	5	5	3	5
	Associate degree	1	0	0	0	0	1
	Experience in school (y)	8.16±9.83	0.62±0.19	1.65±0.60	3.81±2.38	10.15±3.25	25.14±7.19
	Experience in hospital (y)	4.69±3.26	4.54±2.83	7.67±1.95	3.85±2.98	2.77±1.98	5.42±4.51
School	Elementary school	14	3	3	3	2	3
	Middle school	8	2	1	1	2	2
	High school	8	2	1	2	2	1
Size of school	＜500	693.87±303.66	775.29±495.87	535.00±378.98	616.50±86.10	748.00±143.25	762.50±225.21
	500~999	7	2	4	0	0	1
	＞999	20	4	0	6	6	4
		3	1	1	0	0	1
District office of education	Gangnam, Seocho	2	1	0	1	0	0
	Gangseo, Yangchon	3	0	1	0	2	0
	Nambu	2	0	0	0	0	2
	Dogbu	3	0	2	0	0	1
	Dongjak, Gwanak	2	1	0	0	0	1
	Bukbu	4	1	0	2	1	0
	Seobu	5	1	0	2	2	0
	Seongdong, Gwangjin	1	0	0	0	0	1
	Seongbuk, Gangbuk	3	2	1	0	0	0
	Jungbu	5	1	1	1	1	1

Group A=Novice group,＜1year of experience in school; Group B=Advanced beginner group, 1year≤and＜3years of experience in school; Group C=Competent group, 3years≤and＜6years of experience in school; Group D=Proficient 1 group, 6years≤and＜16years of experience in school; Group E=Proficient 2 group,≥16years of experience in school.

Table 2.

Categories of School Emergency Nursing Experiences and Demand for Support by Participants

Theme	Categories	Sub categories
The emergency school nursing rendered and their key characteristics	Major obstacles to overcome as the	․ Unforgettable experiences causing anxiety and fear
	sole health service provider	․ Important things for the sole health service provider to overcome
		․ Excessive complaints happening due to complex cause and response
	Assessing an uncertain situation and making appropriate decisions	․ Insufficient assessment data and limited decision making ․ Unclear decision criteria
		․ To assess and decide comprehensively
		․ To consider parental standards
		․ To make decisions comprehensively based on their own experiences
	Providing limited first aid while	․ To control situation as an only health professional
	maintaining control over the	․ To give first aid with the limited range and resources
	situation	․ Lack of confidence in first aid
	Referring or transferring a student to	․ To Arrange how to transfer and refer to hospital
	a hospital that sets off tensions and	․ Inconsistent transfer and hospital referral provoking conflicts
	raises cost	․ Provoking various burden
	Becoming an advocate for	․ To provide accurate and sufficient information based on a detailed
	information disclosure and	record
	treatment	․ To be a therapeutic advocate
	Ensuring follow-up actions and	․ Lessons learned and satisfactory follow-up to customers.
	proper transfer of responsibility	․ Transfer of responsibility
	Making preparations for future	․ To prepare school emergency plan by itself
	emergency	․ To secure emergency resources by itself
		․ To care for child with special healthcare needs and noncooperation
		from parents
		․ Improve professionalism through personal efforts
	Responding to conflicts arising from	․ To over-reaction
	over-reaction as a safeguard and	․ Professional conflicts
	professional expertise
School emergency nurses' demand for support	Need for the development of	․ Importance of standardized emergency nursing
	standardized manual for school	․ Standardized emergency nursing manual
	emergency care
	Need for practical case-based training	․ A school emergency nursing case-based training
		․ Systematic practical training