The Double Bind of School Nurses and Policy Implementation: Intersecting the Street-Level Bureaucracy Framework and Teaching Sexual Health Education

As described in the Framework for 21st Century School Nursing Practice, school nurses bridge the realities of health and education policy within the school community every day. This role is inclusive of helping teach sexual health education (SHE) to students. We were interested in characterizing how...

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Bibliographic Details
Published in:The Journal of school nursing 2021-08, Vol.37 (4), p.280-291
Main Authors: Dickson, Elizabeth, Brindis, Claire D.
Format: Article
Language:English
Subjects:
Barriers
Decision Making
Educational Administration
Educational Objectives
Educational Policy
Guidelines
Health Education
High School Students
Middle School Students
Nursing
Professional Autonomy
Program Implementation
Rural Areas
School Nurses
Sex Education
Teaching Methods
Telephone Surveys
Urban Areas
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Summary:As described in the Framework for 21st Century School Nursing Practice, school nurses bridge the realities of health and education policy within the school community every day. This role is inclusive of helping teach sexual health education (SHE) to students. We were interested in characterizing how school nurses navigate requirements of health education policy to provide their students with the SHE content that they need. Using data from a larger study, we organized a subset of school nurse data within the street-level bureaucracy framework to better understand the many challenges school nurses face in implementing SHE policy. School nurses’ involvement in SHE policy implementation was congruent with characteristics of the framework. This included using their professional discretion to manage dilemmas, working with inadequate resources, unclear policy expectations, lack of support, and ambiguous policy goals. Trusted relationships with teachers and students helped school nurses with their SHE policy implementation responsibilities.
ISSN:1059-8405
1546-8364
DOI:10.1177/1059840519868764