Victorian Guidelines

Transcription

1 Victorian Guidelines Secondary School Nursing Program

2 Victorian Secondary School Nursing Program Guidelines

3 Published by Rural and Regional Health and Aged Care Division Victorian Government Department of Human Services Melbourne Victoria May 2002 Copyright State of Victoria, Department of Human Services, 2002 This publication is copyright. No part may be reproduced by any process except in accordance with the provisions of the Copyright Act ( ) Acknowledgements Valuable contributions have been made to the development of the Secondary School Nursing Program Guidelines by the following organisations and their staff: Association of School Councils in Victoria Australian Drug Foundation Australian Education Union Australian Nursing Federation Centre for Adolescent Health Centre for Multicultural Youth Issues Community Child Health Nursing RMIT Department of Education and Training, in particular the Divisions of Student Well Being, Privacy, Legal, Health Physical Education and Sport, School Community Links and Networks and Occupational Health and Safety Department of Education and Training Regional Secondary School Nursing Contacts Department of Human Services, in particular the areas of Primary and Community Health, Mental Health, Nurse Policy, Legal, Privacy, Occupational Health and Safety, Human Resources, Community Care, Child Protection and Juvenile Justice, and Portfolio Services Department of Human Services Regional Nurse Managers Nurses Board of Victoria Office for Youth Parents Victoria Principals of five rural and five metropolitan Victorian secondary schools involved in the Secondary School Nursing Program Secondary school nurses Student welfare coordinators VicHealth Victorian Association of Secondary School Principals Victorian School Campus Nurse Group ii

4 Contents Acknowledgements i SECTION 1: Introduction Purpose Background of the SSN Implementation of the Program Program Goals Program Partnerships Program Context SECTION 2: Roles for Key Stakeholders Overview Role of the Nurse Statewide Level Regional Level Within Schools Accountability SECTION 3: Governing Structures Structures for Nurses Structures for Schools General Structures SECTION 4: Practice Guidelines Defining Terms Primary Prevention and Health Promotion Early Intervention Intervention Infrastructure SECTION 5: Program Delivery Planning Evaluation SECTION 6: References SECTION 7: Appendices Appendix One Risk and Protective Factors Appendix Two What is a Registered Nurse Appendix Three Accountability Flow Chart for Nurses Appendix Four Information Privacy: A Brief Guide Appendix Five Consent and Confidentiality Flow Chart Appendix Six Annual Action Plan Appendix Seven Health Promotion Strategy: Program Plan iii

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6 Section 1: Introduction 1.1 Purpose The purpose of the Secondary School Nursing (SSN) program guidelines is multifaceted. The guidelines aim to achieve a shared understanding amongst school staff, students, caregivers or guardians and other stakeholders of the role of the nurse, to provide a clear framework to support nurses in the implementation of their role and to articulate clearly the structure and direction of the secondary school nursing program. The guidelines also aim to provide a consistent approach to the practise of nurses in schools. It is expected that the guidelines will provide a basis for the development of local decisions that directly reflect the policies, procedures and needs of individual schools. 1.2 Background The SSN program is a policy initiative of the Victorian Government to reduce risks to young people and promote better health in the school community. The policy resulted in the introduction of a program that focuses on primary health care, primary prevention and early intervention in the secondary school system. The program complements the Primary School Nursing Program, which provides vision screening and a targeted hearing test for primary school students in their first year of school and additional support as required to students throughout their primary school years. Before implementation, research was conducted into established models of secondary school nursing practices that exist within Australia and overseas. Current initiatives of the Department of Education and Training that address the health and wellbeing of students were also used to inform the Victorian model of secondary school nursing. The model found to most similarly reflect the objectives of the proposed Victorian program was the Queensland School Based Youth Health Nurse program. This model was consequently used as a framework for the development of the Victorian Secondary School Nursing Program. A statewide reference group representatives of relevant professional organisations, peak health, youth and cultural bodies, health promotion and adolescent health specialists and school nurses was convened to oversee a consultation process and inform the program s implementation of the program. 1.3 Program Implementation The program was implemented in two stages. The first stage began in 1999, by identifying 40 schools that rated highest using the Department of Education and Training Special Learning Needs Index. The first 20 nurses were employed and located across the schools; each worked with two schools. The second stage of implementation built on the experiences of the first stage and sought to address issues through a comprehensive consultation process involving secondary school staff, school councils, students, providers of health and support services, regional Department of Education and Training and Department of Human Services staff. 1

7 The first stage included the development of criteria to be used to select additional schools that met the program goal of placing nurses in areas of greatest health need and socioeconomic disadvantage. Criteria included socioeconomic and health factors and also considered rurality. The combination of data used to determine the 100 eligible schools included: The Special Learning Needs Index (SLN), based on information collected annually from schools. This index includes the occupation of caregivers or guardians, family status, Aboriginality, ethnicity, the number of students receiving the Education Maintenance Allowance or Youth Allowance and the number of transitory students. The Burden of Disease study, which is a detailed analysis of estimated years of life lost due to morbidity and mortality. There is a rating for each Victorian Local Government Area. The Survey of Risk and Protective Factors, conducted in 1999 by the Centre for Adolescent Health to explore young people s personal resilience. The Adolescent Health and Well-Being study was a stratified, school-based survey of a random sample of secondary schools including Government, Catholic and Independent schools. The sample included 150 metropolitan and 50 nonmetropolitan schools providing a population of 12,816 year 7, 9 and 11 students, of which 8,984 students participated with a 70 per cent response rate. Rurality and Isolation which takes into consideration the impacts of living in remote rural regions, including the health risks associated with isolation and the limited access to health services. This resulted in 50 per cent of nurses being allocated to rural schools. Using these criteria, recommendations for the selection of schools was made by the Departments of Human Services and Education and Training to the Minister for Health, who is responsible for endorsing schools involved in the program. During 2001 the second stage of the program was fully implemented, with 100 effective full time (EFT) nursing positions being provided to approximately 200 selected Government secondary schools throughout Victoria. Nurses employed in the program undergo a Police Check and are required to hold a current registration with the Nurses Board of Victoria. Nurses are registered as, or are eligible for registration as, a Division 1 Nurse, with demonstrated competence in the areas of health promotion, community health, adolescent health, mental health, sexual health, drugs and alcohol, primary health care, public health, chronic conditions and emergency clinical practice. 2

8 1.4 Program Goals The aim of the Secondary School Nursing Program is to reduce risk to young people and promote better health in the wider community. Specific goals are to: Play a key role in reducing negative health outcomes and risk taking behaviours among young people, including drug and alcohol misuse, tobacco smoking, eating disorders, obesity, depression, suicide and injuries. Focus on prevention of ill health and problem behaviours, by ensuring coordination between the school and community-based health and support services. Support the school community in addressing contemporary health and social issues facing young people and their families. Place nurses in areas of greatest health need and socioeconomic disadvantage. Provide appropriate primary health care through professional clinical nursing, including assessment, care, referral and support. Establish collaborative working relationships between primary and secondary school nurses, to assist young people in dealing with any difficulties in their transition from primary to secondary school. 1.5 Program Partnerships It is important that the program is able to be responsive and knowledgeable about the multiple factors that contribute towards the health and wellbeing of young people. The implementation of the program and its ongoing quality therefore relies on a partnership approach that involves a number of initiatives between the two Departments. Centrally, the SSN program has liaised with various Department of Human Services Divisions, to ensure consistency of policy direction and planning initiatives. The program areas involved include Community Health, Mental Health, Privacy, Community Care, Drug Policy Unit, Child Protection Unit and Public Health. The aim of this integrated approach is to support the same approach at a local level and to ensure that the SSN program operates as part of the service system Links to Department of Education The partnership between the Department of Education and Training and the Department of Human Services is integral to the success and quality of the SSN program. The Departments have worked together to identify eligible schools for the program, discuss the logistics of introducing the nurse into schools, and develop an orientation program for the nurses. Department of Education and Training policy emphasises that student welfare is the responsibility of all staff working in a whole school context and acknowledges that students are better prepared for learning when they are healthy, safe and happy. The Framework for Student Support Services in Victorian Government Schools Teacher Resource provides guidance for schools in how to strengthen student welfare and curriculum support. 3

9 The Framework fundamental to the implementation of the SSN program in school communities is underpinned by four major concepts: Four Levels of Activity: Primary prevention that builds a sense of belonging and promotes wellbeing across the school. Early intervention that strengthens coping skills and reduces risk for students. Intervention that provides access to support and treatment. Restoring wellbeing by providing an appropriate response to extraordinary traumas, emergencies and tragedies that may occur. Continuity of Care. Partnerships between Schools and the Community. Accountability. The major emphasis of the framework is on prevention, with the goal of providing population-based strategies as well as targeted programs to provide young people with skills and strategies to enhance their resilience. Resilience refers to the capacity to cope with extreme and stressful life situations. The Department of Education and Training Framework for Student Support Services Teacher Resource 1 states: encouraging resilience is a teaching and learning strategy 2. Research indicates that certain social experiences and arrangements foster resilience in children and young people; others reduce resilience. To promote an ongoing status of health and wellbeing, health promotion programs and activities developed by nurses should be based on objectives that address risk factors and enhance protective factors (see Appendix 1 for a list of risk and protective factors) Links to Primary School Nursing The SSN program is part of a comprehensive school nursing program. Both primary and secondary school nurses work together to provide students with relevant health information, tools to access additional resources and a continuity of support for students during the transition from primary to secondary school. The Primary School Nursing Program offers a free service to all Victorian primary schools and English Language Centre schools. The Department of Human Services employs registered nurses to: Visit primary schools and conduct a health assessment in a student s first year of school. Provide advice, information and if appropriate, referral to other services. Be involved in health promotion aimed at maintaining and improving the health and wellbeing of children and their families. Provide support to families and school communities by providing information and education on issues relation to school aged children. 1 Department of Education, Employment and Training Framework for Student Support Services in Victorian Government Schools Teacher Resource (p 14), State of Victoria Hawkins, J. and Catalano R., 1993, Communities that Care: Risk and Protective Focused Prevention Using the Social Development Strategy, Developmental Research and Programs Incorporated. 4

10 1.6 Program Context Two key models of health service delivery underpin the SSN program and are used by nurses to guide their work in schools Social Model of Health The social model of health is a framework that considers health in line with the World Health Organisation s definition: health is a complete state of physical, mental and social wellbeing, not merely the absence of disease or infirmity. This definition of health highlights the importance of understanding health and disease within the personal, social and cultural context specific to the person or community whose health is being considered. It is not possible to decide how best to support the improvement of health without understanding this context. 3 A social model of health is a conceptual framework for thinking about health. Within this framework, improvements in health and wellbeing are achieved by directing efforts towards addressing the social and environmental determinants of health, in tandem with biological and medical factors. Using the social model of health framework provides a common basis for the interface between health and education. Both nurses and school staff acknowledge that students bring with them from their home and community a wide range of strengths and weaknesses that will impact upon their wellbeing and their potential to learn. This is highlighted in a quote documented in the Evaluation of the School Focused Youth Service and taken from the International Commission on Education for the Twenty-first Century: the problems of the social environment can no longer be left behind at the school gates: poverty, hunger, violence and drugs enter classrooms with the children, whereas in the not so distant past they were kept outside with the unschooled Health Promotion Health promotion is the process of enabling people to increase control over and improve their health. To reach a state of complete physical, mental and social wellbeing, an individual or group must be able to identify and realise aspirations, satisfy needs and change or cope with their environment 5. Health is a positive concept emphasising social and personal resources, as well as physical capacities. Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy lifestyles to wellbeing. 6 3 Aged Community and Mental Health and Public Health, Primary Care Partnerships Draft Health Promotion Guidelines December 2000 (p 15), Victoria Government Department of Human Services, Melbourne Victoria, November Success Works, Evaluation of the School Focused Youth Service Summary, Education Victoria and Department of Human Services, March World Health Organisation 1986, The Ottawa Charter for Health Promotion, Geneva 6 Aged Community and Mental Health and Mental Health, Primary Care Partnerships Draft Health Promotion Guidelines December 2000, Victorian Government Department of Human Services, Melbourne Victoria, November

11 The purpose of the SSN program and the role of the nurse aims to ensure that current health promotion initiatives in schools are not stifled, but further enhanced, by the nurse s appointment at the school. Health promotion is the foundation for the work of the nurses within the school. In some schools, this will mean that they are able to build on initiatives such as: Work initiated through the Health Promoting Schools Project. The role of health educators who are involved in health promotion activities and are permanent staff members or visitors to the school. Existing connections with community health promotion agencies. The health promotion focus within the curriculum. Health promotion strategies and programs will be adapted to the local needs. The most effective health promotion requires a set of mixed interventions that reflect the social, cultural and economic status of the local community. A single health issue cannot be addressed completely through one single strategy; a multi-pronged approach is more effective. For example: A school and the nurse agree that drug and alcohol misuse is an issue. They develop strategies to address this issue, involving: A student forum with experts from the drug and alcohol field. Forum followed by some small group discussions with students and teachers. Information posters and brochures offered to students and their caregivers. Students work with the nurse and drama teacher to depict drug and alcohol issues for young people in a play. Combining strategies in this way will reinforce messages and affect individual and organisational change. Nurses have the capacity to develop a combination of interventions, which may include strategies under all or some of the following areas of their work: Primary prevention and health promotion Early intervention Intervention Restoring wellbeing. Health promotion strategies implemented by school nurses will operate as a catalyst for change in school policy and/or procedure, in the attitudes of the school community, in the behaviour of individual students and in the access provided by local health agencies to young people and their health needs. 6

12 Section 2: Roles of Key Stakeholders PRINCIPLE: Clarity around the roles of each of the stakeholders is integral to the successful partnership required to have a positive impact on the health and wellbeing of students. 2.1 Overview The secondary school nurse is a member of the school welfare team. Most nurses work with two schools, usually within neighbouring locations. As a member of the welfare team, the nurse will require the support of the school and the Principal and will work within the school s charter. The roles of the various stakeholders involved in the SSN program will differ according to the: School structure. Specific needs of the school community. Delivery of services to students. School decision making processes. The following role statements provide an overall description of the relationship each stakeholder has with the nurse working in the school. Section 4 of the guidelines provides further detail on the roles and responsibilities of stakeholders, in relation to specific situations experienced on a day-to-day basis. 2.2 Role of the Nurse Over recent years Victorian Government schools have moved towards a selfmanaging approach that offers greater freedom and flexibility in the delivery of education and provision of resources. Schools are still guided by curriculum standards and statewide policy, but they have a greater capacity to meet the needs of their student and community population. Given the nurse and the school community will work together to achieve the goals of the program, the nurse s role will vary at a local level, according to the cultural and health needs of the specific school community. Many schools have done a lot of work in developing welfare and health promotion structures and programs for students, establishing referral processes with external agencies and building structures for community involvement. The nurse s role will strengthen the school s existing programs and processes, evaluate health promotion activities and health education, and inform the school of opportunities for additional welfare and health promotion processes. The nurse is employed by the Department of Human Services and is managed by the Regional Nurse Manager. The nurse is required to work within the protocol, policies, management structures and processes of the school and within the nurse s mandated legislative (see Section 3 and Appendix 4) and registration responsibilities (see Appendix 2). 7

13 The nurse is also expected to become familiar with the cultural diversity of students in the school, to ensure cultural sensitivity in the information they present, the activities they conduct and their involvement with students generally Target Group Although all students can access the nurse for health information or support, the focus of the program will be on students in the junior years of secondary school and students identified as being at risk of experiencing reduced resilience (as identified in above) or a reduced status of health and wellbeing Health Promotion One of the key roles of the nurse is health promotion and primary prevention. In response to needs and priorities identified by both the nurse and the school staff, the nurse, in collaboration with the appropriate school staff, will develop health promotion initiatives. For example: Health promotion activities linked to National and State health priorities such as Dental Health and Sunsmart Awareness campaigns. Health promotion programs on current issues of concern identified by the school and/or nurse, such as smoking, sexual health, drug use and mental health issues. Provide health education as part of a team teaching approach in a classroom setting and on an individual or small group basis. Provide in-service education to staff on current health issues affecting the school community. Conduct education / discussion forums for caregivers or guardians. Participate in health curricula development and in planning for school health promotion activities. Liaise with year level coordinators regarding appropriate curriculum framework and delivery that, for example, may be related to science or health and physical education Health Counselling Consultation The nurse will provide individual student support that is either initiated by the student, or through consultation with the school welfare team, or initiated by the nurse. These individual activities will involve discussions with students and can include: Identifying mental, social and emotional health as well as physical health issues that may require further investigation. Seeking secondary consultations from expert health professionals. Making appropriate referrals to local agencies. Assisting students to access health information and support. Supporting students to access health services within the community. Working with families to address students health and wellbeing issues. 8

14 2.2.4 Networking The nurse will be required to have knowledge of relevant points of referral for students and be aware of services, activities and events that are happening in the local area. The nurse will build on networks that have been developed by school staff and establish additional relevant networks to further facilitate links between the students, the school community and community-based agencies. As part of their role, the nurse will be expected to: Act as a resource and referral person in linking the school and students to appropriate community services. Facilitate joint planning and program delivery to meet identified school needs. Develop service and referral protocols with other primary health care services. Promote the secondary school nurse role at both the school and community level. Facilitate appropriate access for students to existing primary health care and community-based agencies. Develop joint programs. Represent school health needs in broader health planning, for example, community health plans and municipal public health plans. In many instances, school staff will already have developed networks with local services or positions that the nurse can become familiar with and build on. Local services may include: Child and Adolescent Mental Health Services Community Health Services Department of Human Services Health Promotion Officers Divisions of General Practice Drug and Alcohol Services Family Planning and Sexual Health Clinics Family Violence and Child Protection Services Maternal and Child Health Nurses Mental Health Promotion Officers Migrant Resource Centres Student Support Service Officers (Guidance officers, psychologists, social workers, speech therapists) Visiting Teachers (hearing, visual and physical) Women s Health Services Youth Specific Health Services. In addition, there are currently two State Government initiatives that provide useful points of contact for nurses: Primary Care Partnership School Focused Youth Service. These two initiatives bring together a diverse range of primary health providers, all working together to reduce duplication of services, develop evidence-based health promotion activities and improve service delivery. 9

15 Primary Care Partnership The Primary Care Partnership (PCP) is an initiative of the Department of Human Services. They are voluntary alliances of primary health care providers, usually covering two or three local government areas. PCPs aim to improve the health and wellbeing of their catchment s population by better coordination of planning and service delivery in response to identified needs. PCPs are responsible for producing Community Health Plans that have the capacity to inform the health needs of young people in the school localities. Each PCP makes their own decision about which service providers and other organisations participate in their alliance. However, the core group of agencies will typically include the following services: Community health. Primary health care services funded and delivered by local government. Home and Community Care (HACC), including District Nursing. General practitioners. Psychiatric disability support. Psychogeriatric Assessment and Treatment Teams. Aged care assessment. Women s health. Aboriginal community-controlled health services. Sexual assault. Dental health. Community drug treatment services. Local ethnospecific health services. Children s and Family services. Disability services. Maternal and Child Health services. School Focused Youth Service The School Focused Youth Service (SFYS) is a joint initiative between the Department of Human Services and the Department of Education and Training in partnership with the Association of Independent Schools of Victoria and the Catholic Education Office. The aim of the SFYS is to develop an integrated service response for young people who are at risk of developing behaviours that may make them vulnerable to self harm, suicide or attempted suicide, or who are displaying behaviours requiring further support and intervention. The objectives of the SFYS is to: Establish collaborative structures and mechanisms between schools and the relevant youth services and community services that support young people including welfare, health and mental health agencies. Provide linkages for agencies and schools that have a client base of young people and directly support young people. Improve linkages, cohesiveness and integration of service provision for young people displaying at risk behaviours who require support and attention. 10

16 Purchase services to meet gaps in the current service system, as identified at the local level First Aid Although the nurse s primary function is not that of first aid provider, schools will be able to utilise the expertise of the nurse in developing first aid policy and advising existing first aid providers when appropriate. Nurses will do this by working in partnership with the school staff responsible for first aid and care of student s health needs. Whilst nurses are able to provide updates on first aid information to teachers, their role does not extend to the delivery of first aid training for teachers Portfolios In some regions nurses may carry a portfolio responsibility for specific health issues. Portfolios represent areas of health in which nurses have a particular expertise or interest. Nurses will continue to maintain a broad knowledge of all areas of health care, however, this model can facilitate ways of creating efficiencies in workload. The portfolio model can provide a regional structure to encourage the sharing of knowledge and expertise and streamline dissemination of information and resources through individual nurses Core Knowledge and Skills Nurses employed in the SSN program will hold a current registration with the Nurses Board of Victoria. They will be registered, or eligible for registration, as a Division 1 nurse. Nurses are expected to maintain current knowledge and skills in core areas required of their role: Emergency clinical practice, including cardiac pulmonary resuscitation (CPR). Mental health. Health promotion. Adolescent health and development. Sexual health. Drugs and alcohol. Primary health care. Public health. Chronic conditions such as diabetes and asthma. Community health. See section for further information about professional development for nurses First Aid and Emergency Response Secondary school nurses must demonstrate that they have the required competencies with regard to the provision of first aid and emergency response, including CPR. Annual updates specifically designed for registered nurses in the following areas are considered mandatory: Cardiac Pulmonary Resuscitation (CPR) Asthma crisis. 11

17 A current certificate in first aid is also considered mandatory; additional updates in first aid procedure may be undertaken at the nurse s discretion. Additional regular updates are recommended in mental health emergencies or crisis. This will ensure that secondary school nurses are able to advise the school on any changes to first aid and emergency procedures. Nurses will be responsible for ensuring they receive updates as mentioned above. See Section for further information about professional development for nurses. In line with the nurse s legislated duty of care, the nurse at the scene of an emergency will provide appropriate nursing care. 2.3 Statewide Level Role of Government Program Staff At a statewide level, the Department of Human Services and the Department of Education and Training work in partnership to implement the Secondary School Nursing Program. Department of Human Services The SSN program is located in Primary and Community Health, which is a unit of the Rural and Regional Health and Aged Care Services Division. At central office level, staff support the program through: The development of policy. Keeping the Minister for Health informed of the progress of the program and of any new developments. Providing comments on funded programs in response to questions from Ministers. Coordinating the statewide presentation of information. Resourcing regional staff. Managing the program budget. Ensuring key performance indicators are met. Development and implementation of program guidelines. Department of Education and Training The SSN program is located in the Student Welfare Unit, which is part of the Student Wellbeing Branch of the School and Community Development Division. The role of program staff within the Student Welfare Unit includes: Providing input to policy and program development. Liaison with Department of Human Services staff. Consultation with relevant Department staff to assure consistency and integration of other programs with the SSN program. Liaison with regional staff concerning implementation of the SSN program. Providing information to senior management of any new developments in the program. 12

18 2.4 Regional Level Role of Regional Nurse Manager The Regional Nurse Manager is employed by the Department of Human Services and is based at a regional office. This requires a comprehensive understanding of school nursing and adolescent health. The SSN program employs nurses under a classification of 4A, meaning they do not require clinical supervision. Therefore, although desirable, it is not mandatory for the Regional Nurse Manager to be a registered nurse. The Nurse Manager has line management responsibility for all nurses employed in their region. Their role in relation to the secondary school nurses falls under the following headings: Human Resources Manage human resource obligations, for example: performance management, travel reimbursement, leave applications. Ensure that debriefing mechanisms are accessible to nurses when required. Monitor workloads to ensure nurse health and wellbeing. Provide day-to-day support as required. Be responsible for the employment of SSNs within their region. Professional Development Coordinate relevant professional development for nurses. Provide opportunities for peer support and sharing of current information through regular regional meetings. Provide nurses with accessible, updated, current relevant health information and resources. Administration Ensure all Departmental equipment is maintained and work environments comply with occupational health and safety standards. Evaluation of the program, for example: school s commitment to program and nurses ability to carry out the role. Ensure the completion of Annual Action Plans. Coordinate the Regional Reference Group to ensure ongoing development of the role within the schools. Liaison Provide input to and feedback from statewide program meetings. Liaise with principals and student welfare teams in schools as required throughout the year for planning, support to nurses, support for development of processes within the school. Ensure nurses liaise with primary school nursing staff to ensure a team approach to child and adolescent health. Liaise with regional Department of Education and Training office to ensure a joint approach and support for the program. 13

19 The Regional Nurse Manager will also be responsible for dealing with performance issues, disciplinary procedures and industrial disputes (see Section Performance Management for details) Role of Regional Department of Education and Training Secondary School Nurse Contact Department of Education and Training Regional Directors have nominated a contact person for the program in each region. This person may hold different positions at different regional offices. The contact person responsible for the SSN program: Liaises with Department of Human Services Regional Nurse Managers on matters relevant to the SSN program. Promotes linkages between SSN program and Department of Education and Training regional initiatives. Improves linkages and communication between agencies and schools Role of Regional Communication and Consultation Regional discussions between key stakeholders encourage networking and resolution of regional issues. They are an excellent forum for discussing ongoing quality approaches to the activities of the nurse in secondary schools. A regional discussion can take the form of a Regional Reference Group, or Regional Nurse Managers can facilitate communication channels through visits to schools. It is expected that key stakeholders may include: Principals. Community health services. Student welfare team. Adolescent mental health services. Drug and alcohol services. School Focused Youth Service. Koori Education Development Officer. Nominated member of local Aboriginal Education Consultative Group. Regional Department of Education and Training staff. Regional Department of Human Services staff. The role of regional discussions is to: Provide ongoing monitoring and evaluation of the program at a regional level. Link to external regional planning processes and strategy development. Provide a forum to discuss further development of the program. Provide a forum to share experiences of good practice. 2.5 Within Schools The Principal The Principal of the school has a management and leadership function that requires the development of integrated strategies to maximise opportunities for all students within the school to receive a quality education. The Principal supports the work of the school council and is responsible for the day-to-day operation of the school. 14

20 The Principal has responsibility for ensuring that the nurse is aware of and works within the schools protocols, policies, processes and management structures. The Principal is fundamental to the success of the SSN program within the school. They contribute by: Supporting the aims and objectives of the SSN program, by ensuring that the nurse has the capacity to implement the program guidelines, and where necessary, working with the nurse to develop protocols that further enhance the program guidelines. Providing support to the nurse that will ensure that programs and services to students can occur with maximum efficiency and effectiveness. Providing regular reports to the school council to keep them informed of the nurse s activities. Ensuring that the whole school supports the nurse and the role of the nurse. The Principal also has a role in overseeing the successful orientation of new nurses and the integration of the SSN program into the school community. They need to ensure that: Students have access to the nurse, either individually or as part of structured events. The nurse is well-oriented to the systems and policies of the school. The nurse is aware of Department of Education and Training policies that will impact upon the role of the nurse within the school. The nurse is involved in relevant school initiatives. The nurse is acknowledged as a valuable contributor and an integral part of the school. There is direct involvement by relevant staff, including themselves, in the annual planning process to identify the direction for the work of the nurse. The nurse has access to basic office supplies. The nurse has a safe workplace. The school community, school council, caregivers or guardians, staff and students are aware of the role of the nurse and the benefits the role brings to the school. Reporting The nurse will provide reports to the Principal on a quarterly basis. These reports are informal and keep the Principal up-to-date with what the nurse is involved in and any consistent issues being raised by students. The Principal will be expected to forward the nurse s quarterly report to the school council for their information School Welfare Team The Framework for Student Support Services in Victorian Government Schools outlines current Department of Education and Training policy directions for provision of student welfare in schools. Within this framework, schools will be responsible for the development of appropriate welfare structures, to ensure the provision of a positive and supportive school environment and the delivery of coordinated and comprehensive services for students. 15

21 To facilitate this, schools determine a structure, such as a school welfare team, that is established to deliver: A coordinated whole school approach to student welfare within the school. Identification of student needs and development of appropriate welfare and curriculum policy. The development of statements that describe the delivery of student welfare, including referral protocols and the supporting role of school staff. The development of networks and protocols with community agencies and service providers, to ensure the continuity of care through the provision of a full range of services for young people at risk. As a member of the school welfare team, the nurse will work to complement and strengthen the team s activities and can play a key role in facilitating the above outcomes. Within the school welfare team, the nurse s role is to: Identify existing welfare and health promotion processes, protocols and practices, to enable the nurse to work within current structures and enhance the role of the school welfare team. Work collaboratively with other members of the team, particularly the Student Welfare Coordinator, on issues surrounding the health and wellbeing of students in the school. Keep abreast of and inform the school welfare team of community-based contacts that are additional to those identified by the school, and that could further support the school welfare team in regard to secondary consultations and referrals. Attend regular team meetings to maintain communication links with others in the team. Liaise with staff associated with student welfare in primary schools and/or with primary school nurses, to support the transition of students from primary school to secondary school, especially those that the primary school nurse or welfare staff have had contact with and are identified as having special needs or at risk. In some schools the regional Student Support Services Officer (SSSO) is a member of the school welfare team. SSSOs can provide assistance to schools in planning and providing support to students, their families and teachers Student Welfare Coordinator The Department of Education and Training has made funds available for a staff member to be responsible for the welfare of students. Schools can allocate these funds in various ways, either: Employing a full time Student Welfare Coordinator. Allocating responsibility to Year Level Coordinators. Allocating responsibility to the Assistant Principal. The nominated staff member who fulfils the welfare role provides a central coordination point, initiating and strengthening the full range of services to 16

22 support the wellbeing of all students. The Student Welfare Coordinator (or equivalent) and the nurse work together as team colleagues. The role of the Student Welfare Coordinator or nominated welfare staff may include: Working with the nurse in the development and implementation of initiatives that affect the health and wellbeing of the school community. Providing orientation for the nurse in understanding the systems of the school and the structure of the school welfare team. Providing the nurse with information about established networks and contacts in the local area. Informing the nurse of the school s referral protocols with relevant internal and external services, including protective service protocols. Participating, if requested by the nurse or Regional Nurse Manager, in performance assessments for the nurse. Providing input to the Annual Action Plan and evaluation processes associated with the work of the nurse. Jointly discussing potential professional development opportunities for school staff that will impact upon the health and wellbeing of students Students and Caregivers or Guardians Students and caregivers or guardians have various roles within a school environment. They are members of school councils, parent associations, student representative committees or other organising committees that are focused on specific activities or events. Integrating the views and ideas of students and caregivers or guardians into discussion about the role and direction of the school nurse provides an important perspective from the recipients of the service. The primary role of students and caregivers or guardians in relation to the school nurse may include participating in opportunities to provide input into: The role of the nurse and the service offered. The annual planning processes, by participating in surveys or discussions with the nurse School Council The school council is an elected group of caregivers or guardians, community members and staff representatives who are responsible for the management of the school. Their general roles and responsibilities include: Determining the general educational policy, goals and priorities of the school within the framework of the school charter and statewide guidelines. Developing the school charter. Monitoring and evaluating the performance of the school. Reporting annually to the school community and Department of Education and Training. Approving and monitoring the school budget. Making recommendations to the Education Secretary on the appointment of the school Principal. Entering contracts consistent with the school charter. Developing a student code of conduct. 17

23 Employing non-teaching staff and casual relief teachers. General oversight of the buildings and grounds, facilitating the provision of cleaning and sanitation services. Stimulating interest in the school. In relation to the school nurse, the school council has a role in: Providing input to the nurse s annual planning processes. Ensuring that the nurse is aware of the school charter, policies and priorities and how they link with her role. Providing input to protocol development where appropriate. Developing and endorsing health education policy. Endorsing health education curriculum development processes. Approving health education curriculum. Endorsing school health and wellbeing initiatives, including the distribution of health pamphlets. 2.6 Accountability Employment of the Secondary School Nurse The employment of the secondary school nurse is the responsibility of the regional office of the Department of Human Services. Nurses will be required to undergo a Police Check prior to employment. A standard position description that contains a selection criteria based on core competencies is used to employ all nurses. Regional offices of the Department of Human Services identify the selection process to best suit their needs. It is recommended that a Principal or nominated staff member from the schools involved (if schools have been selected), or a nominated representative from a school in the area is involved with the Regional Nurse Manager on the selection panel. In some instances, regional Department of Education and Training staff will also be involved in the selection process. Nurses are required to perform their duties in accordance with the duties and responsibilities of a State Registered Nurse Division 1 (see Appendix 2 for details of nurse registration). Registered nurses are required to demonstrate competence, which they must maintain to keep their registration (renewed annually). Nurses will present Regional Nurse Managers with renewed registration certificates The Nurse Accountable to Department of Human Services Nurses are accountable to the Department as their employer (through the Regional Nurse Manager) and have a responsibility to adhere to all policies and processes, including the policy relating to duty of care. The Duty of Care Policy requires all staff to take reasonable care of a person. Department staff must take reasonable care to avoid causing injury to people in the delivery of its services. 18

24 Accountable to School At the same time nurses are required to work within the policies and frameworks of the school/s and broader Department of Education and Training policies, as long as they do not contradict Department of Human Services policy or the nurses legislative responsibility. Where relevant existing school policy and processes are in place, the nurse and Principal will work together to identify how they impact on the role of the nurse. If necessary, additional processes can be established to support the nurse in providing a service to students, within the legislative and ethical boundaries that apply. Accountable to Public Nurses are also accountable through their registration to the public. Nurses have a responsibility to the individual, society and the profession to provide safe, competent nursing care, which is responsive to individual, group and community needs. All nurses are personally accountable for their practice in whichever setting the practice occurs, however they cannot be held responsible for factors outside of their control which may affect the practice setting or the care provided The School Accountability to the Nurse Eligible schools that have agreed to participate in the SSN program have invited the nurse into the school as a member of the school welfare team. The school is responsible for providing a safe working environment for the nurse. This will include ensuring that every effort is made to foster student access to the nurse and to support the nurse in their role of improving the health and wellbeing of students, for the purpose of maintaining their capacity to learn. The school also has a responsibility to participate in the development of the SSN program s annual action planning process and to support the achievement of objectives identified as priorities for the year Reporting The nurse will be required to establish regular reporting mechanisms on the programs and services that have been provided. The reports will include: Evaluation of programs. Details of planned events. Consistent health issues arising for young people. Positive outcomes. Reports will be provided to: The Regional Nurse Manager on a monthly basis, The Principal on a quarterly basis. These reports can be verbal or printed and will keep the Principal up-to-date with what the nurse is involved in and any issues consistently raised by students. The Principal will be expected to forward a quarterly report to the school council for their information. 7 Australian Nursing Council, ANCI Code of Professional Conduct for Nurses in Australia, ANCI July