Making Your School Nurse Philosophy Visible.

As a school nurse, it can be challenging to make values and philosophy useful in the context of a busy and stressful workday. However, values and philosophy can help guide school nurses in their profession. This article proposes strategies for how school nurses can make their school nurse's values and philosophy visible. The first step in formulating a school nurse philosophy is to identify overall values, such as how one views society and people's equal values. A peer-mentoring group, such as a mastermind group, could offer a place to have philosophical discussions with colleagues.

Introduction

A student’s learning ability is directly related to his or her health, and therefore, the role of school nurses in bridging health care and education is important (National Association of School Nurses, 2016). Services provided by school nurses include leadership, community/public health, care coordination, and quality improvement. School nurses support student achievement in the learning process. Addressing the physical, mental, emotional, and social health needs of students is pivotal for school nurses (National Association of School Nurses, 2016). School nurses experience their profession as highly meaningful but challenging and require professional and personal development (Jönsson, Maltestam, Bengtsson-Tops, & Garmy, 2019) and self-awareness (Musliu, Vasic, Clausson, & Garmy, 2019). Philosophy could be a guide when encountering difficult school nursing dilemmas.

Discussion of Topic

At a time of rapid change, it is reassuring to know that the most read article in the Journal of School Nursing is almost 20 years old. This article addresses philosophy and our values: “Articulating Your Philosophy of Nursing” (Denehy, 2001). Janice Denehy wants to live life with an exclamation mark by standing up for what one believes, making her voice heard, making an effort, and making a difference! She urges school nurses to write down and articulate their philosophies of life and their professions. She claims that this is an effective support for action. Also, Julia Cowell (2014), the current editor of the Journal of School Nursing, asks her readers, “What is your philosophy of nursing” (p. 315). She captures the importance of courage, along with love and respect, in the school nurse’s philosophy:One way of being proactive and contribute to efforts to take care of our future is to be clear about how we want to live our lives and how we want to act in our professional lives. This could be done by reflecting over and writing down your values and your philosophy. A tip is to start with your experience. Describe an event you have experiences of, for example, a communication situation with a student or a parent, or when you have taken care of a student. Start to describe the situation and then try to reflect on the choices and decisions you made. Try to identify the values that guided you to make these choices and decisions and what philosophy carried these values. This way of writing is the so-called professional autobiography. This is a way of articulating our professional philosophies and viewing our choices and our developmental curve. Even though much of what forms the school nurse of the future lies at the level of organization and education, there is also a personal aspect involved. Perhaps it is possible to write our future? Our thoughts and imaginations about our future might impact the future. I would like all school nurses to reflect on the following questions: “Which school nurse do I want to be today? Tomorrow? In a year? In 10 years? What do I want the school nurse’s work to look like in 50 years?”

As I reflect on my philosophy of nursing, I draw on Sigma Theta Tau values of love, courage, and honor and base my practice on the philosophy that nursing care is safe and delivered with courage, caring, ethical concern, and honor for the needs of my client, whether that client is an individual, family, or community. (Cowell, 2014, p. 315)

How can we organize the work so that the school nurses have the time and opportunities to perform those invaluable tasks? A prerequisite for succeeding with these tasks is an awareness of one’s values. These values describe what is important in our lives, clarify the consequences of acting in a certain way, and make our actions rewarding in themselves to perform. Certainly, we need to highlight the school nurse’s practical experience. For example, to prevent mental ill health, work with unaccompanied children, counteract bullying, health dialogues, and immunizations, but we also need to think about the school nurse’s basic values. How does the ICN Code of Ethics for nurses (International Council of Nurses, 2012) relate? What is the individual’s philosophy as a school nurse and as a human being?

Making your values visible is consistent with the findings from a Stockholm University research group addressing New Year’s resolutions: what makes us succeed with goals and behavioral changes. They found that people who strive for different goals in their lives feel better both physically and mentally (Oscarsson, Rozental, Andersson, & Carlbring, 2017). However, it is important to focus on what matters in life. It is, therefore, important for an individual to reflect on their values and opinions concerning what is important in life. The nurse’s basic tasks consist of helping other people as the priority, and there are probably no tasks that can be considered to have been achieved and finished from one day to the next. The point of values is to clarify what we want life to be.

Writing down your values is a good starting point for living a life that is in line with these values. However, research shows (Oscarsson et al., 2017) that the likelihood of abiding by a set of values also increases if we reflect on the following things:

Goals: What short-term and long-term goals are linked to the values? What are you going to achieve in the coming week and half-year?

Behaviors: What active actions and behaviors are required to achieve your goals?

Obstacles: What obstacles or problems might you encounter along the way?

Willingness: How is your willingness to receive and handle all kinds of feelings and experiences to strive for what you value?

The first step in formulating a personal life philosophy is to identify overall values, such as how one views society and people’s equal values. These values have consequences for how we act. The next step is to formulate values that relate to the nursing profession. At this point, we can be inspired by ICN’s ethical code (International Council of Nurses, 2012) or your national nurse association’s values for nursing. Furthermore, we need to formulate values that are specifically related to our profession as school nurses. This relates to the target group we have, children and young people. Finally, our philosophy should end with some reflections on how our values relate to the values associated with nursing. Caring for yourself as well as caring for others is crucial for stressed nurses.

Current Insights and Interpretations

In my work as a school nurse researcher and a sleep scientist, I often reflect on the importance of rest and the importance of filling a nurse’s moments with meaningfulness. The health promotion that we school nurses provide for our students is also something that we should use for ourselves. It seems healing to meet people in confidence and to reflect together without being judged. I wish for all school nurses today and in the future to find good meeting places for reflection with colleagues, sometimes in pairs and sometimes in groups. A constructive way of meeting and discussing professional philosophical matters are in so-called mastermind groups (Garmy, Olsson Möller, Winberg, Magnusson, & Kalnak, 2019). A mastermind group is a peer-mentoring network composed of three to six participants. The groups meet regularly and discuss topics chosen by the group. The main purpose of a mastermind group is to help its members navigate the challenges and solve problems using their collective knowledge and experiences. Participants from self-directed mastermind groups reported that the mastermind group offered a place for conversation in confidence, an opportunity for personal and professional development, and a quality break and time for reflection. Challenges for participating in a mastermind group include prioritizing time for meetings as well as issues of trust and confidence (Garmy et al., 2019).

Conclusions

Finally, take care and be brave. And here is a call: Write down your life philosophy. I look forward to reading many professional autobiographies to make your school nurse philosophy visible to yourself and the world.