The National Association of School Nurses (NASN) states, “School nursing is a specialized practice of professional nursing that advances the well-being, academic success, and life-long achievement of students. To that end, school nurses facilitate positive student responses to normal development; promote health and safety; intervene with actual and potential health problems; provide case management services; and actively collaborate with others to build student and family capacity for adaptation, self management, self advocacy, and learning (NASN, 1999).”
– “What we have before us are some breathtaking opportunities disguised as insoluble problems”-
(Julia Graham Lear, 2003; John Gardner, 1965)
The worldwide emergence of vitamin D deficiency has sounded an alarm throughout the health care industry about the need for health promotion and disease prevention programs that focus on early identification, education and treatment of the disorder in order to avoid the serious spectrum of illness that follow long-term untreated vitamin D deficiency. Despite a preponderance of evidence about the critical importance of vitamin D to human health, risk assessment; screening; education; and treatment for vitamin D deficiency are not widely recognized as being a priority among most healthcare clinicians (Holick, 2006, p. 369). Resultantly, hypovitaminosis D is rarely diagnosed before the onset of serious illness. This gap in services is intensified by the fact that over the past 10 years very little research has been dedicated to investigating the effects of the deficiency on populations having the greatest risk (dark-skinned or covered Muslim females and their children). The people who are at most risk are also unfortunately the world’s least studied and most underserved. For over a century, school nurses and other public health nurses have been the mainstay for these disaffected people whose race, culture and/ or language have been barriers that denied them access to quality healthcare.
According to Julia Graham Lear, Ph.D. (2003), the Director of the Center for Health and Healthcare in Schools at George Washington University continue to support school health programs evidenced by the results of a recent survey:
However, despite the success of school health programs and the support of parents, the majority of school health centers are threatened with a loss of funding and severe staffing shortages just as the need for their expertise is rising. A major dilemma facing school health centers lies in the allocation of funding to keep nurses abreast of changing health trends. Most school nurses practice in isolation from peers in an environment where the vision of the school’s academic education leader determines the direction of healthcare programming and the decides the resources to carry out all strategic planning including those related to healthcare (Lear, 2003).
This web-based lecture series is set up in self-directed learning modules to accommodate the needs of school nurses.The course is structured to allow the learner the opportunity to visit the site at different points in the day from different locations to accommodate a demanding work schedule. For instance, the Pennsylvania School Code mandates a ratio of one certified school nurse to 1,500 students and that nurse may be covering as many as 3–5 buildings (Ficca, 2006, p. 148, ¶ 1). Such a practice environment places extreme constraints on the time that nurses have to amass the requisite knowledge for providing culturally competent care before continuing to browse the content of the site, the learner is encourage to assess personal learning needs in relationship to populations with which they have limited contact outside of work using the following needs assessment tool:
(Abdul-Aziz, 2009)
This course was developed to meet the competency requirements for a Masters of Science in Nursing (MSN) degree from the University of Phoenix, which was successfully completed 31DEC2010 with a grade of A. It was designed to meet the varied needs associated with visual, auditory and kinesthetic learning styles by offering printed study materials, a link to a podcast led by an expert in the field of Vitamin D Deficiency and a PowerPoint presentation. At the end of the course materials the student can link to a quiz and complete a course evaluation with permission the Coca Cola’s Beverage Institute.
Upon completing the course the learner should have a better understanding of:
- Cultural practices of Muslims that might magnify the severity of vitamin D deficiency
- Research that supports the identification of the spectrum of illnesses associated with vitamin D deficiency
- Adult versus child specific symptomatology related to vitamin D deficiency
- An algorithm that supports clinical decision-making regarding student and/ or family referral for education, diagnostics or treatment
CERTIFICATE OF ORIGINALITY: I certify that the information contained herein is my original work and has not previously been submitted by me or anyone else from any class except as referenced. I further declare I have cited all sources from which I used language, ideas, and information, whether quoted verbatim or paraphrased, and that any assistance of any kind, which I received while producing this paper, has been acknowledged in the References section. I have obtained written permission from the copyright holder for any trademarked material, logos, or images from the Internet or other sources. I further agree that my name typed on the line below is intended to have, and shall have, the same validity as my handwritten signature.
Student’s signature Saida Abdul-Aziz, RN, BSHA, MSN, MBA-HCM
Nursesaida's Blog 
The Vitamin D problem has a history in the USA, especially with city children because of the lack of sunlight exposure. This led to the practice of fortifying milk with Vitamin D. I have read about the Muslim community experiencing this problem but has the research include any other groups, culture, having the same problem today? Many other cultures also practice modest dress or lifestyle could lead to same problem, is there any data on this? Just a point of research that may be helpful.
Comment by Chris Doherty — December 16, 2009 @ 10:56 am |
Thank you Chris
Yes in fact similar research has been carried out on orthodox Jewish women who also wear modest dress, have similar lifestyles and traditional food preparation patterns. I read a study about orthodox Jewish teenagers in New Yor City and the introduction of weight bearing exercises to determine whether their bone health improved but the outcomes were inconclusive. The males had better bone health even though they were similarly covered all the time. Outside that religious group, I can only think of cloistered nuns. Do you have any suggestions? I would greatly appreciate your assistance because I do plan to go further. Thank you again.
Comment by nursesaida — December 16, 2009 @ 12:40 pm |
I feel that routine screening for high-risk children should be done by the school nurse for vitamin D deficiency, and that he or she should ensure that school children get adequate amounts of the vitamin through a combination of diet, supplements, and exposure to sunlight through parental education. I feel the school nurse is an integral part of improving the health and educational success of children.
Comment by Lisa Haas — December 16, 2009 @ 7:38 pm |
Thank you Lisa
From your comments on the site, I see that your RN experiences do concur with school nurse screening for vitamin D deficiency. Although school nuses have little time and resources, I also believe that a quick assessment can identify so many potential high risk individuals who would benefit from ediucation and referal. Thank you for your comments. Saida
Comment by nursesaida — December 16, 2009 @ 9:00 pm |
I appreciate the fact that your study focuses on screening the high-risk school aged children. Early education is the key to prevention. As a member of the Islamic culture, and having worn the traditional garb covering for religious purposes for many years, the shield from sunlight which could lead to the Vitamin D deficiency, has not been considered by me. However, as I experience at least two of the risk factor conditions, (although the exact etiology has not been determined), it does increase my focus on the possible association. I value the goal of early screening and detection of Vitamin D deficiency, related to decreased sunlight exposure.
Comment by Marilyn Scott, RN — December 18, 2009 @ 9:24 am |