Vision, Voice, Visibility

Abstract

‘‘It was the best of times, it was the worst of times!’’ (Dickens, 1859). These words by Charles Dickens well describe our world and the environment faced by school nurses today. The current economic downturn has had an impact on each of us in many ways. State and local governments are struggling to find ways to provide services on limited budgets. School districts have been forced to reduce salaries and cut staff. Many of the families that we serve have lost their income and their health insurance or have had it significantly reduced. School nurses are seeing increasing numbers of students with acute and chronic health conditions, as well as mental health needs. Many lack a medical home, and their needs remain unmet. Our families count on school nurses to fill the void. It seems that the increased needs of students and reduced funding for school health services have met on a collision course. Yet, with every challenge comesanopportunity— an opportunity to seek new and innovative solutions. The economic climate has forced us to take an in-depth look at our practice. It has forced us to examine our worth and define our value. Although school nurses have always been aware of the value of the health services they provide, now more than ever, it is time to demonstrate evidence of that value. This is an exciting time to be a school nurse! We are embarking on uncharted waters in the era of health care. Research has shown that although the United States spends far more on health care than any other nation, we live shorter lives and have a higher infant mortality rate than many other developed countries. Despite its vast medical resources, the United States ranks just 34th in the world in life expectancy. We fare little better in infant mortality, ranking 29th in the world, tied withSlovakiaandPoland(MacDorman&Mathews, 2009). A recent article in Time magazine