Professors Offer Guidelines on Putting Advocacy into Action

August, 2006

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School nurses talk during a break. Opportunities to network give nurses from around the state a chance to share their ideas and resources.

Kathleen Barta and Marianne Neighbors, professors of nursing at the Eleanor Mann School of Nursing, outlined in their preliminary presentation at the School Nurse Summer Institute how school nurses can make a difference on the health issues Dr. Joseph Bates raised in his keynote address. Bates is deputy state public health officer and chief science officer in the state Division of Health.

"Advocating for Children's Health: the School Nurse's Role" was the theme of the Aug. 2-4 institute. It is in its sixth year.

Barta said 110 nurses, including the state school nurse consultant from Missouri and a group of her nurses, registered for the institute that she and Neighbors established. That's nearly double the number who attended last year. The organizers have developed a theme each year based on evaluations filled out by participants the previous year.

Bates said the school nurses' advocacy for children's health can make the difference when state legislators find themselves closely divided on a health issue.

School nurses have blossomed from being substitute moms who hand out Band-Aids and hugs to being counselors, leaders, caregivers and case managers, while not losing the essence of nursing, which is caring, Neighbors said. The participants received buttons proclaiming their child advocacy role in an informational packet.

– Joey Cox, a school nurse at Siloam Springs and the past president of a regional school nurses association, said when she attended the institute for the first time last year she expected to learn about data collection but was surprised to discover the value of the networking she did during the three days. She kept in touch with several school nurses in Conway during the past school year.

"Wear your button so that parents, staff and administrators know your role and give you credit for it," Neighbors said.

She asked the school nurses to write down their definition of "advocacy" and share it with tablemates, then discussed several definitions she found in a standard dictionary, a medical dictionary and from various established advocacy groups. They all boiled down to pleading another's case, representing that person in moving toward a desired goal and speaking out for the protection of someone's rights. Advocacy means educating others about children's needs and seeking ways to meet those needs, Neighbors explained.

"People respect you and love you, families turn to you, schools think you are important," she said. "You have an advantage. You have your foot in the door."

School nurses usually feel most comfortable with advocating for issues on a local level because they know the people and the needs, but Neighbors urged the school nurses to push the boundaries of their comfort zone, to move from basic advocacy to more complex involvement. Professional associations can provide data and other background information to help school nurses persuade others to support a needed change, she said.

"School districts all have unique problems but we also have some with statewide impact, such as obesity," she said. "Often, you can get a policy changed at the local level, but that policy change might be a good idea for the whole state. We may hear about something going on in Harrison that we want to do. You may like to do things in your own back yard, but you may also be able to help others. We'll jump on your bandwagon."

Barta reminded the school nurses of Bates' assertion that they are influential people.

"We hope you take the experience from this learning community and find ways to expand your sphere of influence," she said. "Continue to make a difference."

The institute is timed to occur a few weeks before the school year starts so that the nurses have time to immerse themselves in the ideas presented, Barta said. She described different levels of advocacy and strategies to implement them. Questions to be considered include who benefits from the proposed change and who loses, what the long-term consequences are, how the issue can be framed so that people without medical knowledge can understand it, what the financial costs are and whether the change can be enforced.

She gave the example of the debate in Fayetteville over banning smoking in restaurants. The state has since issued a similar ban on smoking in most public places. In both cases, the health effects were weighed against the economic costs, Barta said.

School nurses can craft stories based on their experiences while still protecting confidentiality to show the human side of issues, she said.

"Use compelling stories to illustrate the impact of an issue," Barta said.

In telling the school nurses that sessions in the institute would include a look at children's mental health, Barta used a story from her own experience. She was working with a nursing student in a maternity ward. After the student collected assessment data about an infant, Barta decided she would involve the newborn's 4-year-old brother by asking what he would teach his baby sister. This was two months after the Sept. 11, 2001, terrorist attacks on New York and Washington.

"This little boy said, 'I'm going to teach her about Osama (bin Laden),'" Barta related. "We can't say that children are immune to what is going on around them. That little boy is now a second- or third-grader. Can he sleep well at night? Can he pay attention in class? I hope his school nurse is asking questions.

"I want you to think about a story from your experience. Practice telling it to the people here and know that you can tell it to influential people in your school district."

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Contact:

Heidi Stambuck, director of communications
College of Education and Health Professions
(479) 575-3138, stambuck@uark.edu

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