Dünyada ve Türkiye’de Okul Hemşireliğinin Gelişimi

Okul sağlığı hizmetleri halk sağlığı hemşirelerinin okullardaki sağlık gereksinimlerini görüp, müdahale etmeleriyle ortaya çıkan bir hareket olarak başlamıştır. İlk olarak İngiltere ve Fransa'da görülen bu hareket 19. yüzyılda Amerika'da, Cumhuriyetle birlikte de Türkiye'de görülmüştür. Savaşlar, göç, sanayileşme, yoksulluk ve okul sağlığı hizmetlerine gereksinim duyulmasına neden olmuştur. Halk sağlığı hemşireleri yaptıkları ev ziyaretleri, düzenli kontroller ve sağlık kayıtları ile okul sağlığına önemli katkıda bulunmuşlardır. Bu durum hükümetlerin ve gönüllü kuruluşların hemşirelerin okul sağlığının sürdürülmesindeki gerekliliğini fark etmesi ve okullarda hemşire görevlendirmesiyle sonuçlanmıştır. Okul sağlığı hizmetlerinin gelişmiş olduğu ülkelerde hemşireler sağlığı geliştirici programların planlanması ve uygulanmasında ön sıralarda yer almaktadır. Çoğu hemşire bir ya da birden fazla okula tek başına okul sağlığı hizmetleri sunabilmektedir. Bu hemşireler lisans eğitiminden sonra sertifika eğitimi almakta ve sertifikalarını belli sürelerle yenilemektedir. Türkiye’de ise okul hemşireliği ile ilgili mevzuatta çeşitli düzenlemeler olmasına karşın çözülmesi gereken bazı konular mevcuttur. Bu makalede, dünyadan ve Türkiye’den örneklerle okul hemşireliğinin günümüze kadar olan gelişimi ve Türkiye’deki okul hemşireliği hizmetleri incelenmektedir.

The Development of School Nursing Around the World and in Turkey

School health services started as a movement that emerged when public health nurses saw the health needs of schools and intervened. This movement, first seen in England and France, was first seen in America in the nineteenth century and in Turkey with the establishment of the republic. Wars, migration, industrialization, and poverty have all led to the need for school health services. Public health nurses have made important contributions to school health through home visits, regular check-ups, and accurate health records. This has resulted in governments and voluntary organizations recognizing the need for nurses to maintain school health and appointing nurses in schools. In countries where school health services have developed, nurses are at the forefront in planning and implementing health promotion programs. Most nurses can provide health services alone to one or more schools. These nurses receive certification training after their undergraduate education and renew their certifications for a certain period of time. Although there are various regulations in school nursing legislation in Turkey, there are some issues that need to be solved. In this article, the development of school nursing, with examples from around the world and from Turkey, and school nursing services in Turkey are examined.

___

  • 1. Murray R. Introduction to the American Academy of Pediatrics policy statement. J Sch Nurs. 2008;24(5):267. doi: 10.1177/1059840508325403.
  • 2. Özcan C, Kılınç S, Gülmez H. Türkiye’de okul sağlığı ve yasal durum. Ankara Medical Journal.2013;13(2):71-81. Available from: http://www. ankaramedicaljournal.com/download/article-file/19706
  • 3. Wolfe LC, Selekman J. School nurses: What it was and what it is. Pediatric Nursing. 2002;28(4):403-7. Available from: https://www.ncbi. nlm.nih.gov/pubmed/12226964
  • 4. Meeks L, Heit P, Page R. School health services and healthful school environment promoting and protecting health and safety. Comprehensive School Health Education: The McGraw-Hill Companies; 2013.
  • 5. Ayaz S. İlköğretim öğretmenlerinin okul sağlığı hemşireliğine ilişkin görüşler. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi. 2014:1(2):42-52. Available from: http://dergipark.ulakbim.gov.tr/ hunhemsire/article/view/5000154745/0
  • 6. Anderson LJW, Schaffer MA, Hiltz C, O'Leary SA, Luehr RE, Yoney EL. Public health interventions: School nurse practice stories. J Sch Nurs. 2017:1059840517721951. doi: 10.1177/1059840517721951.
  • 7. Loschiavo J. Fast facts for the school nurse: School nursing in a nutshell. 2 ed. New York: Springer Publishing Company; 2015.
  • 8. Bebiş H, Özdemir Ö. Kreşlerde okul sağlığı hizmetleri ve hemşirelik. Turk J Public Health. 2013;11(3):186-96. Available from: https:// dergipark.org.tr/download/article-file/152966
  • 9. Wright J. Public health in history - Public health reform and the emergence of school nursing. British Journal of School Nursing. 2011;6(6):304-5. Available from: http://bucks.collections.crest.ac. uk/9668/
  • 10. Dock LL. A history of nursing; the evolution of nursing systems from the earliest times to the foundation of the first English and American training schools for nurses. 1912.Availablefrom:https://archive.org/ stream/historyofnursing03nutt/historyofnursing03nutt_djvu.txt
  • 11. Maurer FA, Smith CM. Community / Public health nursing practice health for families and Populations. 5th ed. Elsevier; 2013.
  • 12. Wold SJ. School health services: History and trends. In: Schwab NC, Gelfman MHB, editors. Legal issues in school health services. Sunrise River Press; 2005.
  • 13. Zaiger DS. School nursing services: The early years. The Journal of School Nursing. 2000;16(1):11-9. doi: 10.1177/105984050001600302.
  • 14. Ska M. A public health nursing service in France. Am J Nurs. 1955;55(9):1084-6. Available from: https://www.ncbi.nlm.nih.gov/ pubmed/13248889
  • 15. Vilian C. In France, school health education. Hygie. 1984;3(4):26-8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/6510919
  • 16. OECD. Health workforce policies in OECD countries: Right jobs, right skills, right places. Paris; 2016. Available from: http://www.oecd.org/ publications/health-workforce-policies-in-oecd-countries9789264239517-en.htm
  • 17. Dariel OPD, Waelli M, Ricketts TC. France’s transition to academic nursing: The theory-practice gap. Journal of Nursing Education and Practice. 2014;4(10):88-100.
  • 18. IAPN. Advanced practice nursing in France. 2014. Available from: https://internationalapn.org/2014/06/29/france/
  • 19. Nay O, Béjean S, Benamouzig D, Bergeron H, Castel P, Ventelou B. Achieving universal health coverage in France: Policy reforms and the challenge of inequalities. The Lancet. 2016;387(10034):2236-49. doi: 10.1016/S0140-6736(16)00580-8.
  • 20. NIH. Health education for young people approaches and methods. 2001. Available from: https://www.ncbi.nlm.nih.gov/books/NBK7118/
  • 21. The guidelines of the Health Act [internet]. Gouvernement.fr. 2014. Available from: http://www.gouvernement.fr/en/the-guidelines-of-thehealth-act
  • 22. Eve S, Pham AD, Blaizot X, Turck M, Raginel T. Human papillomaviruses vaccination: Parental awareness and acceptance of the vaccine for children in Lower Normandy schools and informative campaign during the 2015-2016 school year. Rev Epidemiol Sante Publique. 2017;65(4):255-63. Available from: https://www.ncbi.nlm.nih.gov/ pubmed/28410863
  • 23. WHO. School policy framework implementation of the who global strategy on diet, phisical activity and health. Switzerland; 2008. Available from: http://www.who.int/dietphysicalactivity/SPF-en-2008. pdf
  • 24. Thornbory G. Public health nursing: A textbook for health visitors, school nurses and occupational health nurses. Smith M, Sherwin S, editors. John Wiley & Sons; 2013.
  • 25. Gardner PA. A brief history of the rise and fall of the School Medical Service in England. Public Health. 2008;122(3):261-7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/17959209
  • 26. Croghan E, Johnson C, Aveyard P. School nurses: Policies, working practices, roles and value perceptions. Nursing and Health Care Management and Policy. 2004;47(4):377-85. Available from: https:// www.ncbi.nlm.nih.gov/pubmed/15271156
  • 27. Cates J. The evolution of public health work for trained nurses. Perspectives in Public Health. 1923;44(9):375-8.
  • 28. Nutting MA. A history of nursing; the evolution of nursing systems from the earliest times to the foundation of the first English and American training schools for nurses. 1912. Available from: https://archive.org/ details/historyofnursing041912nutt
  • 29. Dock LL. A History of nursing from the earlist times to the present day with special reference to the work of the past thirty years. American Journal of Psychiatry. 1913;70(1):275-6. doi: 10.1176/ajp.70.1.275.
  • 30. Wilson MM. The educational value of the school nurses’ work. Journal of the Royal Sanitary Institute. 1932;53:225-31.
  • 31. Sherwin S, Smith M. School nursing and school health practice. In: Thornbory G, editor. Public health nursing: A textbook for health visitors, school nurses and occupational health nurses. 1st ed. John Wiley & Sons; 2013.
  • 32. Madge N, Franklin A. Needs and provision: Change, Challenge and School Nursing. London: Jessica Kingsley 325 Publishers; 2003. p. 9- 20.
  • 33. National Children's Bureau. Nursing in schools: How school nurses support pupils with long-term health conditions. 2016. Available from: https://www.ncb.org.uk/sites/default/files/uploads/documents/ Research_reports/Nursing%20in%20Schools%20-%20Final.pdf
  • 34. Wolfe I, Sigfrid L, Chanchlani N, Lenton S. Child health systems in the United Kingdom (England). J Pediatr. 2016;177(Suppl.):S217-S42. Available from: http://www.jpeds.com/article/S0022-3476(16)30164-0/ pdf
  • 35. Maximising the school nursing team contribution to the public health of schoolaged children [internet]. GOV.UK. 2014. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/ uploads/attachment_data/file/303769/Service_specifications.pdf
  • 36. The Queen's Nursing Institute. Transition to the school nursing service. 2017. Available from: https://www.qni.org.uk/wp-content/ uploads/2017/01/Transition-to-School-Nursing.pdf
  • 37. Campbell S. Is school nursing dnr?. Community Practitioner. 2018;91(1):30-4. Available from: https://search.proquest.com/ docview/1994847465
  • 38. Hoekstra BA, Young VL, Eley CV, Hawking MK, McNulty CA. School Nurses' perspectives on the role of the school nurse in health education and health promotion in England: A qualitative study. BMC Nurs. 2016;15:73. doi: 10.1186/s12912-016-0194-y.
  • 39. Vessey JA, McGowan KA. A successful public health experiment: School nursing. Pediatric Nursing. 2006;32(3):255-6. Available from: https:// www.ncbi.nlm.nih.gov/pubmed/16802684
  • 40. Passarelli C. School nursing: Trends for the future. The Journal of School Health. 1994;64(4):141-9.
  • 41. San Diego County Office of Education. A brief history of school nursing. 2013. Available from: http://www.sdcoe.net/studentservices/studentsupport/Documents/Nursing/school-nursing-history.pdf
  • 42. Hawkins JW, Hayes ER, Corliss CP. School nursing in America 1902- 1994: A return to public health nursing. Public Health Nursing. 1994;11(6):416-25. Available from: https://www.ncbi.nlm.nih.gov/ pubmed/7870660
  • 43. Houlahan B. Origins of school nursing. The Journal of School Nursing. 2017;19(9):1-8. doi: 10.1177/1059840517735874.
  • 44. Lillian D. Wald [internet]. New World Encyclopedia. Available from: http://www.newworldencyclopedia.org/entry/Lillian_Wald
  • 45. Lillian D. Wald [internet]. Jewish Women's Archive. Available from: https://jwa.org/encyclopedia/article/wald-lillian-d
  • 46. Lois N, Wyche J. Evolution of school health programs. Schools and health : Our nation's investment. National Academies Press; 1997. p. 33-79. Available from: https://www.nap.edu/catalog/5153/schools-andhealth-our-nations-investment
  • 47. Dock LL. School-nurse experiment in New York. Am J Nurs. 1902;3(2):108-10.
  • 48. Allender AJ, Rector C, Warner KD. Public settings for community health nursing. Community Health Nursing Promoting and Protecting the Public's Health. 7th ed. China: Wolters Kluwer Lippincott Williams & Wilkins; 2010. p. 838.
  • 49. Cohn SD. Legal issues in school nursing practice. L Med & Health Care. 1984;12:219-21. Available from: https://www.ncbi.nlm.nih.gov/ pubmed/6568382
  • 50. Broussard L. School nursing: Not just band-aids any more!. J Spec Pediatr Nurs. 2004;9(3):77-83. Available from: https://www.ncbi.nlm. nih.gov/pubmed/15553549
  • 51. Apple RD. School health is community health: School nursing in the early twentieth century in the USA. History of Education Review. 2017;46(2):136-49. doi: 10.1108/HER-01-2016-0001.
  • 52. Frana PL. Coordinating the experts and the masses: The professions of health and the creation of American community health, 1915-1940. Retrospective Theses and Dissertations; 1999. doi: 10.31274/ rtd-180813-13719.
  • 53. Oregon Health Authority, Public Health Division Administrative Overview. 2014. Available from: https://sos.oregon.gov/archives/ Documents/recordsmgmt/sched/overview-health-public.pdf
  • 54. Hawkins JW, Hayes ER, Corliss CP. School nursing in America 1902- 1994: A return to public health nursing. Public Health Nursing. 1994;11(6):416-25. Available from: https://www.ncbi.nlm.nih.gov/ pubmed/7870660
  • 55. Temel AB, Bahar Z, Ergün A, Kadıoğlu H, Erol S, Öncel S, et al. Okul dönemindeki çocukların sağlığının geliştirilmesi. Ankara: Vize Basın Yayın; 2016.
  • 56. U.S. Department of Health, Education and Welfare. A summary of selected legislation relating to the handicapped. 1968:1953-1967.
  • 57. NASN. Our History. Available from: https://www.nasn.org/about-nasn/ about/our-history
  • 58. Snyder AA. Nursing law and education law: A practice dilemma for school Nurses. Med Law. 1996;15:271-6. Available from: https://www. ncbi.nlm.nih.gov/pubmed/8908980
  • 59. NASN. School Nurses in the U.S. 2017. Available from: https://www. nasn.org/nasn-resources/publications
  • 60. Maughan E, Mangena AS. The 2013 NASN school nurse survey: Advancing school nursing practice. NASN Sch Nurse. 2014;29(2):76-83. doi: 10.1177/1942602X14523135.
  • 61. Willgerodt MA, Brock DM, Maughan ED. Public school nursing practice in the United States. The Journal of School Nursing. 2018;19(9):1-13. doi: 10.1177/1059840517752456.
  • 62. Yıldız E. Okul sağlığı hemşireliği. In: Erci B, editor. Halk sağlığı hemşireliği. 2nd ed. Elâzığ: Nobel Tıp; 2016. p. 112-21.
  • 63. Meydanlıoğlu A, Gözüm S. Türkiye’de okul sağlığını geliştiren uygulama ve programlar. Bahar Z, editör. Yaşam Döngüsünde Sağlığı Geliştirme: Hemşirelik Uygulamaları. 1. Baskı. Ankara: Türkiye Klinikleri; 2019. p.16-23. Available from: https://www.turkiyeklinikleri.com/article/enturkiyede-okul-sagligini-gelistiren-uygulama-ve-programlar-84848. html.
  • 64. MEB. Okul sağlığı faaliyetleri. 1998/93 Genelge. Available from: http:// mevzuat.meb.gov.tr/dosyalar/1367.pdf
  • 65. Türkiye Halk Sağlığı Kurumu. Okulda sağlığın korunması ve geliştirilmesi programı uygulama kılavuzu. 2017. Available from: https://dosyaism.saglik.gov.tr/Eklenti/26312,klavuzpdf.pdf
  • 66. T.C. Millî Eğitim Bakanlığı. Okul sağlığı 2017. Available from: https:// okulsagligi.meb.gov.tr/meb_iys_dosyalar/2017_03/24172657_OKUL_ SAYLIYININ_KORUNMASI_VE_GELYYTYRLMESY_PROGRAMI_ UYGULAMA_KILAVUZU_3256836380940747639.Pdf
  • 67. TC. Sağlık Bakanlığı. Temel Sağlık Hizmetleri Genel Müdürlüğü. Okul sağlığı hizmetleri hakkında genelge (2008/58). Available from: https:// www.saglik.gov.tr/TR,11125/okul-sagligi-hizmetleri-hakkinda-genelge. html
  • 68. Yıldırım N. Türkiye’de okul sağlığı hemşireliği. Türkiye Klinikleri J Public Health Nurs-Special Topics. 2015;1(1):33-9. Available from: http://www.turkiyeklinikleri.com/article/en-turkiyede-okul-sagligihemsireligi-71048.html
  • 69. MEB. Millî Eğitim Bakanlığına bağlı okul pansiyonlari yönetmeliği. 1983. Available from: http://www.mevzuat.gov.tr/ MevzuatMetin/3.5.836950.pdf
  • 70. MEB. Millî Eğitim Bakanlığı ortaöğretim kurumlari yönetmeliği. 2013. Available from: https://ogm.meb.gov.tr/meb_iys_ dosyalar/2016_11/03111224_ooky.pdf
  • 71. MEB. Özel öğrenci barinma hizmetleri yönetmeliği. 2017. Available from: http://www.meb.gov.tr/quotozel-ogrenci-barinma-hizmetleriyonetmeligiquot-yayimlandi/haber/13544/tr
  • 72. MEB. Milli eğitim istatistikleri örgün eğitim 2016/'17. Ankara; 2017. Available from: https://sgb.meb.gov.tr/meb_iys_ dosyalar/2017_09/08151328_meb_istatistikleri_orgun_ egitim_2016_2017.pdf
  • 73. Emiroğlu ON, Baybuğa MS, Örsal Ö, Tokur Kesgin M. Okul sağlığı hemşirelerinin mesleki rolleri ve hemşirelik tanılarına ilişkin algılamaları. HEMAR_G. 2007;2:37-45. Available from: http://hemarge.org.tr/ ckfinder/userfiles/files/2007/2007-vol9-sayi2-165.pdf
  • 74. Altuntaş S, Baykal Ü. Okul hemşirelerinin iş, iş ortamı, rol ve sorumluluklarına yönelik görüşleri. Hemşirelikte Eğitim ve Araştırma Dergisi. 2012;9(1):43-50. Available from: https://www.journalagent. com/kuhead/pdfs/KUHEAD_9_1_43_50.pdf
  • 75. Halk Sağlığı Günleri III. Ulusal Okul Sağlığı Sempozyumu “Okul Sağlığında Ağız ve Diş Sağlığı” Konuşma Metinleri ve Bildiri Özetleri. 08-09 Eylül 2014. Ankara. Available from: https://kutuphane. halksagligiokulu.org/jm/index.php/kuetuephane/119/view_bl/77/ cocuk-ergen-sagl-g/324/halk-sagl-g-guenleri-iii-ulusal-okul-sagl-gsempozyumu?tab=getmybooksTab&is_show_data=1
  • 76. NASN. Education, licensure, and certification of school nurses. 2017. Available from: https://www.nasn.org/nasn/advocacy/professionalpractice-documents/position-statements/ps-education
  • 77. Calvin College GR. Student nurses as school nurse extenders. Journal of Pediatric Nursing. 2012;27:734-41. Available from: https://www. ncbi.nlm.nih.gov/pubmed/22414539
  • 78. NASN. Certification. 2017. Available from: https://www.nasn.org/nasn/ nasn-resources/professional-topics/certification
  • 79. Cluskey M, Schwend K. The Role of the school nurse in special education. 2015;30:1-18. doi: 10.1108/S0270-401320150000030008.
  • 80. NASN. Position statement: Role of the school nurse. 2012. Available from: https://www.nasn.org/advocacy/professional-practice-documents/ position-statements
  • 81. Morberg SIV, Lagerström M, Dellve L. The perceived perceptions of head school nurses in developing school nursing roles within schools. Journal of Nursing Management. 2009;17(7):813-21. doi: 10.1111/j.1365-2834.2008.00956.x