President's Message

Giving a Voice to School Nursing in Hong Kong

It was a great honour for the Hong Kong School Nurses Association (formerly the Hong Kong School Nurses Interest Group, established in 2008) to become a registered professional body to facilitate the capacity building of school nurses in Hong Kong on Aug 3, 2010. This historical event marks the beginning of a new chapter in the role development and enhancement of school nursing in Hong Kong.

In my first article as president of the Hong Kong School Nurses Association (HKSNA), I would like to present to you an overview of the history and status of school nursing in Hong Kong. The HKSNA is directly involved in this history and efforts to put nurses in Hong Kong’s schools.

Modern child health in the 21st century covers medical, social and educational sectors. Therefore, intersectional collaboration is essential for the success of optimal promotion of child health. The health care team should consist of doctors, nurses, teachers, social workers, allied health professionals and others. Nurses being a member of the team have the professional duties to promote medical health at schools.

For the past decade, the number of school nurses in Hong Kong schools has increased. This is partially the result of raising the health issues of children and adolescents in Hong Kong. Hong Kong is a metropolitan city and an international trade centre, but the role of school nurses in promoting students’ health and development has not been delineated in Hong Kong, and there is an urgent need to address this gap. The role of the school nurse is to serve as a team member in providing preventive services, early identification of problems, interventions and referrals to foster children’s health and educational success (Lee 2010a). School health services with regular student health services delivery should be planned and implemented to meet the health needs of children and adolescents, and also to empower and improve their health behaviours by delivering health education activities in their schools.

Little attention has been paid to the new practice development of school nurses in Hong Kong. My research study (2010b) aimed to describe the tasks that school nurses have reportedly been allocated in school health care in Hong Kong. An online survey was launched using a link sent to the e-mail addresses of school nurses in 2009. It was a cross-sectional study. Of 70 questionnaires distributed, 43 respondents (61.4%) completed the school nurse task survey. The respondents consisted of both females (n=42, 97.7%) and 1 male (2.3%). The majority of respondents (n=14, 32.6%) was 36-40 years of age, and 34 respondents (79%) were 36-55 years of age and older. Most respondents had been working as school nurses for less than 8 years (n=29, 67.5%) and in the same position over 8 years (n=17, 39.5%). The majority (n=34, 79.1%) had a baccalaureate or higher degree in nursing. They were asked to rank 6 essential roles out of 13 identified core roles. Health provider (n=39, 90.7%) ranked highest, followed by health assessor (n=16, 37.2%), health screener (n=11, 25.6%), health counsellor/ health educator (n=8, 18.6%), health monitor (n=10, 23.3%) and health collaborator/health liaison (n=8, 18.6%). The majority (n=26, 60%) did not rank health promotion as an essential task, and only 10 respondents (26.3%) reported that they carried out health promotion in their daily practice. Thus, any intervention to embed the role of health promotion into their work requires an information update and a change of attitude towards carrying out health promotion activities in schools (Lee 2010a). Continuing professional development should reinforce this important task in their daily practice.

The School Health Program with school nurses does make a difference in decreasing absenteeism, decreasing emergency room visits, and improving compliance with the management of chronic illnesses such as asthma and diabetes. School nurses need to increase their voices, gaining power through visibility, viability and value. This can be achieved though marketing and political involvement in communities.

Over the past few years, advocacy for school nursing has been at the forefront of the efforts of the former Hong Kong School Nurses Interest Group. School Nursing is gradually being given a voice in Hong Kong thanks to the efforts of many agencies, including NGOs and paediatric associations/societies with members who have served in partnership with the Hong Kong School Health Enhancement Consortium over the past few years. These organizations have formed collaborations to advocate for school health programmes. A ‘Task Force Healthcare Professionals at School’ has been established and is instrumental in introducing future legislation for school nurses. This group meets regularly to address the plan to write a position paper.

The society of Hong Kong can nurture and value children and adolescents and consider the implementation of the ‘one school, one nurse’ approach, which urgently needs to be integrated into school health policies in Hong Kong. To optimize school nurses’ contribution to students’ health, a more strategic approach is required, in partnership with education and coupled with research into the effectiveness of school nursing interventions. I conducted two research studies which had shown that the school nurse has a crucial role to play in the seamless provision of comprehensive health services to children and adolescents (Lee 2010a, 2010b). A report on their role, including recommendations, should be sent to local government and relevant stakeholders to encourage their support and consideration of the implementation of a ‘one school, one nurse’ health policy.

The future development of the ‘one school, one nurse’ policy envisaged by the current government for ordinary schools in Hong Kong will not occur unless the role of school nurses is clearly delineated and valued by society as reducing children’s and adolescents’ risk-taking behaviours and promoting the health and well-being of primary and secondary school students.

The Board Members of the HKSNA appreciate the promotion of best practice of school nurses and their challenges in the schools. Keep up the good work! Be visible, show viability and make your value known. The continuous collaborative efforts of the HKSNA with member groups of the Hong Kong School Health Enhancement are essential to provide health care and referrals for Hong Kong’s children so they can be healthy to learn and learn to be healthy.

I would like to take this opportunity to convey my heartfelt appreciation to all the members, honorary advisors and parties involved in the establishment of the Association. I have full confidence that the Association will make a major difference in the role development and capacity enhancement of school nursing in Hong Kong.

I would also like to invite you to join us to meet the overseas delegates in the 16th Biennial School Nurses International Conference 2011 which will be held on July 25-29, 2010 in Hong Kong.

I would like to take this opportunity to convey my heartfelt appreciation to all the members, honorary advisors and parties involved in the establishment of the Association. I have full confidence that the Association will make a major difference in the role development and capacity enhancement of school nursing in Hong Kong.

Please also accept my sincere thanks to the Conference Committee Members and involved parties to hold the 16th Biennial School Nurses (SNI) International Conference 2011 between July 25-29, 2010 in Hong Kong. Over 300 delegates from 24 countries attended the SNI Conference 2011.

Regina Lee RN, PhD
President and Founder of the Hong Kong School Nurses Association
References
Lee RLT (2010a). The role of school nurses in delivering accessible health services for primary and secondary school students in Hong Kong. Journal of Clinical Nursing. 19 (In Press).
Lee RLT (2010b). The tasks of school nursing: survey of school nurses in Hong Kong. Poster presentation at the Primary Health Care Conference. World Health Organization Global Network in Nursing and Midwives in Sao Paulo, Brazil, July 28-30, 2010.