Saturday

Hopelessness, characterized by emotional despair and motivational helplessness, is increasingly affecting young people. In 2021, 40% of adolescents and 57% of young girls experienced persistent feelings of hopelessness, marking a concerning 60% rise over the past decade (CDC, 2023; White House, 2022). While fleeting moments of hopelessness are universal, the lack of effective coping strategies often allows these feelings to persist, leading to various negative outcomes.
Persistent hopelessness among youth is associated with alarming consequences, including heightened suicide rates, engagement in risky behaviors (such as violence, weapon possession at school, self-harm, unprotected sex, and bullying), diminished academic performance, and poorer mental and physical health (Bolland, 2003; Everson et al., 1996; Shek & Li, 2016; Wolfe et al., 2017).
Conversely, hope—defined by positive feelings and inspired actions—has been linked to numerous beneficial outcomes, fostering academic success and improved mental and physical well-being. Research indicates that individuals with higher levels of hope experience reduced depression and anxiety, lower rates of suicidal thoughts, higher graduation rates, and enhanced academic performance surpassing factors like intelligence, personality, and prior academic achievement (APA, 2013; Bashant, 2016; Day et al., 2010; Huen et al., 2015). Our research has found hope is measurable, teachable, and learnable. However, hope is not a skill we are taught. Kathryn Goetzke, through the Shine Hope Company, introduces "The Five Keys to SHINE Hope" mnemonic—Stress Skills, Happiness Habits, Inspired Actions, Nourishing Networks, and Eliminating Challenges—as a framework for instilling hope in young people. In her presentation, she aims to delve deeper into the science of hope and hopelessness while offering actionable strategies for promoting and teaching hope within schools.

School nurses are important participants in School Medicaid programs and are encouraged to lead funding and reimbursement efforts within the leadership principle of the School Nursing Practice Framework™. (NASN, 2016). Yet, the complexity of School Medicaid programs and required documentation are major barriers to implementing this program for nurses who seek to address student diversity, equity, and inclusion (Bundy & Gormley, 2022; Malcarney, 2016; The School Superintendents Association, 2019; Weeks et al, 2021). In many states, school administrators and nurses, billing companies, and state agencies have not focused on billing School Medicaid for nursing services. With the expansion of School Medicaid programs due to the Center for Medicare and Medicaid Services “free care” guidance change, nursing services and documentation are receiving more attention and scrutiny as more nursing services become eligible for reimbursement in states across the country. In this session, the speakers – nationally recognized experts in School Nursing and School Medicaid – will engage the audience in a clear overview of School Medicaid, related school nursing activities and documentation standards, an overview of how the requirements and revenue from School Medicaid programs promote diversity, equity, and inclusion in the delivery of student health services, and successes, supports, and challenges reported by school nurses. Session participants who are completely new to School Medicaid will leave with an understanding of how the program works regardless of the state in which they work. Participants who are already familiar with School Medicaid will learn about the changes affecting School Medicaid.

Students are the center of a school nurse's work, and it is our responsibility to maximize potential funding to ensure equitable access to school nursing services. School nurses are a key provider of services to students and there can be a disconnect between the nurses and key state agencies. This session will highlight the steps and share strategies we used in our collaborative efforts with the Minnesota (MN) Departments of Education, Human Services, and Health. The outcome of the work was an update to the statewide DHS Individual Education Program (IEP) Services Provider manual. One of the objectives of our work was to align and clarify the language in the manual with the language of the MN Nurse Practice Act. As a result of the alignment, school nurses were better equipped to identify billable services and maximize Third Party Reimbursement (TPR) for IEP nursing services and Special Education (SpEd) funding. In addition to the edits in the manual, professional development focusing on the role of the school nurse in SpEd and TPR was developed. Increased knowledge and understanding of the role of the school nurse in Child Find and SpEd increases access to services for students with disabilities. Skill-building strategies that school nurses can use to strengthen relationships and rapport with district and community partners to break down barriers will be shared. This work was completed as part of the CDC school health workforce grant in collaboration with the MN Department of Health.

Workforce shortages and budget limitations are making it harder for schools to meet recommended school nurse-to-student ratios. The problem has reached a crisis point in rural communities where nurse recruitment and retention are particularly challenging. School nurse-led telehealth is skilled school nurse care supported by the principles of the NASN School Nursing Practice Framework™, just completed in a virtual manner. Telehealth ensures the health and wellness needs of every student are met, even those living in rural and underserved communities, such as Indian reservations. This session will explore how school nurse-led telehealth can increase health equity and improve health outcomes by providing students access to school health services and a school nurse in schools with limited or no access to a school nurse because of barriers, such as distance, transportation, poverty, and lack of healthcare professionals. Learn how school nurses use their expertise to provide the principles of the Framework in each school community. Beyond the benefits of good health, participants will learn the cascading benefits of virtual care and how it can be a ‘force multiplier,’ filling gaps to meet other student needs such as speech, OT, PT, or counseling. Participants will understand how on-site nurses can collaborate with their virtual partners to ensure the entire district has access to school health services, resulting in less time spent traveling between schools to provide care and reducing isolation. In addition, new school nurses can receive training and support throughout the onboarding process, which is not always possible, especially in districts with one nurse for multiple buildings. Telehealth is not intended to replace in-school nurses but rather extend their reach to serve students better. The virtual model offers a convenient and cost-effective way to provide high-quality care on demand to support onsite personnel while improving student health equity.

This session will equip the school nurse to create school environments that minimize asthma triggers and other impediments to living well with asthma. By applying this systems-level guidance to promote the integration of environmental management of pediatric asthma into school health practice, the school nurse can address some key health equity issues while providing best-practice care for their students. This educational activity supports the school nurses’ development of skills and knowledge to effectively manage and improve health outcomes for children with asthma. Following this approach, interdisciplinary teams can achieve successful asthma management for children and their caregivers that builds student and family capacity for asthma self-management, self-advocacy, and learning. This session encourages school nurses to actively collaborate with students, parents, and healthcare providers to identify environmental triggers and implement evidence-based environmental interventions for asthma. Uncontrolled asthma, leading to increased school absenteeism, hurts both health and academic outcomes. To support health equity, the school nurse is ideally situated to provide asthma education and support access to the school environment and a medical home. All students, regardless of medical diagnosis, deserve health equity, “a fair and just opportunity to achieve their highest level of health.” Historically, specific communities have experienced higher morbidity and mortality related to asthma, i.e. families experiencing poverty, African American families, and Native American/Indigenous families. We will cover school nurse-specific health equity strategies to help address these disparate asthma outcomes.

Health equity and a safe and inclusive school environment, go hand in hand with student success and well-being (Willgerodt, 2021). Promoting diversity, equity, and inclusion takes intentional and consistent action by individuals and groups. Progress has been challenging as well as slow (Lebrun-Harris et al, 2022; Rattermann et al, 2021). This program addresses barriers that marginalized populations face by exploring the root causes and discussing solutions to facilitate change through a trauma-informed lens. The Minority Stress Model (Goldbach 2021) indicates that marginalized populations experience higher levels of physical and mental health issues due to increased discrimination and prejudice (Neiman et al, 2023) Likewise, racism, implicit biases, generational trauma, and other social determinants of health present barriers to achieving health equity (Gratz et al, 2023; Ramos et al, 2022). School nurses are in a unique position to provide support to students in accessing services, promoting school connectedness, and breaking down barriers to care. By critically examining the systems in which they work, nurses can be at the forefront, exploring ways to make changes from an individual to a systemic level. This interactive session will provide space for self-reflection, group discussion, and practical skills to support nurses in advocating for change to the systems that are perpetuating oppression and harming students. Using NASN’s School Nursing Practice Framework™ (Maughn, et al, 2016) as a guideline, nurses will enhance their ability to identify gaps in the systems and strategies they can begin implementing on their campuses.

This session will inform school nurses of the power in recognizing their professional identity to elevate school nursing and improve student outcomes. Nurses across the globe are experiencing disillusionment in their role as professional caregivers. Nurses are portrayed as heroes and yet they feel lost and frustrated under the weight of this idealistic portrayal. Disillusionment stems from experiences that make one question strongly held beliefs as the positive professional expectations begin to tarnish over time. Confusion can lead to feeling hopeless and lost due to this fallacy, or idealization of our profession. An identity crisis is an opportunity for growth. Identity loss can be found through recognition of our authentic professional identity, and possibly even foster equity. In this session, we will discuss the beauty of transformation and how to use the liminal spaces to grow. The four domains of professional identity are: knowledge, values and ethics, professional comportment, and nurse as leader, which intersect with the School Nursing Practice Framework™. Nurses will learn a new language with which to describe their professional identity to make sense of their role in school health. Nurses must first know who they are, value who they are, and understand what they stand for to propel school nursing forward. The time is now to embrace professional identity to advance the nursing profession and improve student outcomes. A strong sense of professional identity can help school nurses stay the course, improving nurse meaning-making and sense of belonging.