School-based health services are most effective when their staff have the right knowledge, skills and attitudes.
Each semester, Aorere College in Auckland offers two student nurses from Manukau Institute of Technology’s nursing programme a seven-week full-time placement in its health centre.
At the beginning of the placement, the centre’s three registered permanent nurses introduce the student nurses to the school environment and how it operates. Then the student nurses observe as the three registered nurses work with young people in the health centre. When they feel confident, the students begin assisting with the physical aspects of Year 9 Home, Education/Employment, Eating, Activities, Drugs and Alcohol, Sexuality, Suicide and Depression, Safety (HEEADSSS) assessments. They discuss consent and confidentiality with the young people.
As student nurses gain experience, they begin to undertake full HEEADSSS assessments by themselves. Registered nurses determine student nurses’ readiness to perform the full assessment by checking their notes and supervising their clinical work. Throughout the learning process, the registered nurses ensure that nursing students clearly understand the limits of their scope of practice, and that they ask for help when they need it.
As part of the placement, each student nurse undertakes an individual project: running a promotion, developing a resource or making a presentation. As a result of this, the health centre has gained resources for preventing rheumatic fever, reducing screen time, reducing sleep deprivation and curating useful phone apps for young people.
In addition, each student nurse contributes to the ongoing development of the health centre’s orientation folder, which includes:
- an introduction to Aorere College and its health centre
- details of health-related support services available through the College
- school policies on documentation of consultations and the administration of medication
- tips for working with young people.
The folder contains a checklist of the learning opportunities available to student nurses during their placement. Student nurses can use this to track the skills and experience they gain.
Throughout their placements, student nurses gain experience of working with different disciplines. District nurses, a family planning nurse, an asthma nurse educator, health support workers, mental health liaison workers, physiotherapists and doctors all make regular visits to Aorere College. In addition, each student nurse spends some time at an ear clinic run by public health nurses. As a result, the placement gives student nurses a broad practical education. As Kerrie Salwey, one of the College’s registered nurses, says, ‘Sometimes on a placement students only really get to know that placement, but our students get exposed to a whole lot of other services as well.’
When they begin their placements, many of the student nurses have little understanding of the range of issues school-based health services deal with, and the range of services they offer. ‘It’s quite an eye-opener for them to see all the different things young people can actually access,’ says Kerrie. ‘Placement students often come to us with the view that there’s not going to be a lot happening. They’re surprised to see mental and sexual health issues, and that we actually deal with a lot of it on site. It’s not what they were expecting.’