The Roles and Challenges of School Nurses Caring for Children with Medical Complexity in Japan

Area of Science:

• Pediatric Nursing
• School Health Services
• Healthcare Workforce Challenges

Background:

• Increasing prevalence of children with medical complexity necessitates enhanced school nursing support.
• Current challenges include a lack of standardized criteria and defined job descriptions for school nurses.
• This impacts personnel recruitment and retention in school settings.

Purpose of the Study:

• To investigate the current status of school nurses.
• To understand school nurses' perceptions of their professional roles.
• To identify barriers affecting the provision of effective care by school nurses.

Main Methods:

• A paper-based questionnaire survey was administered to school nurses in City A, Japan.
• Semistructured interviews were conducted with participants following the survey.
• Data were collected from 34 school nurses, achieving a 71% response rate.

Main Results:

• Key motivators for school nurses included witnessing student growth and ensuring student safety.
• Many nurses reported role ambiguity and low self-esteem, describing themselves as "extra workers."
• Significant anxiety and role-related challenges were identified.

Conclusions:

• School nurses experience substantial role-related challenges and anxiety.
• There is a critical need for developing clear guidelines for school nursing practice.
• Systematic support and structured training programs are essential to address identified issues.