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There is a need for rigorous research documenting the important role of school nurses in facilitating positive health outcomes among students. Poorly managed care can affect student absenteeism rates, which are associated with academic performance and school funding, and students in underresourced schools are at particularly higher risk of suffering chronic conditions (e.g., asthma, diabetes) that necessitate proper care and management. The San Jose Unified School District (SJUSD) Nurse Demonstration Project was developed as a five-year endeavor to expand school nursing and formally link school nurses to a school-based health clinic. The initiative provides for full-time school nurses at four elementary and middle schools in SJUSD, and a nurse practitioner at School Health Clinics of Santa Clara County. The objectives are to: (1) improve access to primary care and prevention services, specifically asthma and chronic condition management and (2) facilitate the establishment of a medical home for students. Evaluation of the project employs a mixed methods research design, including a logic model, an intervention and control study design (comparing outcome measures in the four demonstration schools with five “control” schools), parent, teacher, and school administrator feedback, systematic nurse reports, and quantitative analysis of school health and administrative data, including health conditions and absenteeism information. Key findings in Phase I of the project are discussed, including improvement in screening and referrals, follow-up care among students with asthma, and mean days absent due to illness. With increasing budget cuts to public schools, documenting the impact of full-time school nurses will remain crucial in leveraging support and resources for school health services. Findings of this project indicate that school nurses provide valuable services and could be a major player in providing and coordinating effective management and prevention of chronic disease among children.

The role of the school nurse has evolved. It has expanded from administering first aid and promoting hand washing to key participation in program planning for health and educational outcomes for the school-aged child. Nurses provide leadership in promoting a healthy and safe school environment, case management of chronically ill children, collaboration between family and school, and referral to essential community resources. Additionally, the school nurse is a valuable resource on the multidisciplinary special education team. The school nurse is the health care expert in the school and is in a unique position to meet the actual and potential needs of all students – including those with special needs.

This paper analyzes the market for registered nurses in the U.S. during the period from 1978 to 1995, but is specifically concerned with how the prospect of treating patients with HIV or AIDS may have affected the supply of entrants into nursing. Using cross-sectional time-series data, we find that concern about the risk of contracting AIDS reduced admissions to nursing schools by as much as 15%. In states with a higher incidence of AIDS, such as New York, we find a much larger effect. Since the deterrent effect of AIDS was not limited to those considering whether to enter nursing school, our estimates represent a lower bound on the reduction in supply. However, we also find that the deterrent effect declined over time, as it became clear that the disease could not be transmitted by casual contact.

Our findings suggest that substantial welfare costs are imposed by regulations that require all nurses to treat patients with HIV or AIDS.

This chapter is concerned with the varied legitimizing discourses used by midwives to frame their identities in relation to their work. This sociological issue is particularly important in the context of an occupation, such as this one, that exists at the border of competing service claims. Drawing on 26 in-depth interviews, I use narrative analysis to examine the stories that midwives tell about their work. Through these women’s work narratives, I show the complex intersection of narrative, culture, institution, and biography (Chase, 1995, 2001; DeVault, 1999).

Given that the workforce constitutes a principal resource of primary care, appraisal of models of care requires thorough investigation of the health workforce in all Models of Child Health Appraised (MOCHA) countries. This chapter explores this in terms of workforce composition, remuneration, qualifications and training in relation to the needs of children and young people. We have focused on two principal disciplines of primary care; medicine and nursing, with a specific focus on training and skills to care for children in primary care, particularly those with complex care needs, adolescents and vulnerable groups. We found significant disparities in workforce provision and remuneration, in training curricula and in resultant skills of physicians and nurses in European Union and European Economic Area Countries. A lack of overarching standards and recognition of some of the specific needs of children reflected in training of physicians and nurses may lead to suboptimal care for children. There are, of course, many other professions that also contribute to primary care services for children, some of which are discussed in Chapter 15, but we have not had resources to study these to the same detail.

In a climate of ongoing political, economic, technological, and cultural changes in Western, Central, and Eastern Europe, this chapter describes the kinds of changes happening with the health care system and the preparation of health care professionals in one selected country, that of Hungary. Emphasis will be focused on the nursing sub-sector of the health system. Some comparison and contrast will be done between these systems in Hungary and the U.S. Changes will be presented in the context of the European Union and the Bolonga Declaration.

This chapter examines the process by which men enter registered nursing. Research on men's entrance into atypical fields has looked at either motivational or career paths differences between men and women. I integrate these approaches by examining how men's prior work experience influences their subsequent career decisions and motivations. I find that men who are nurses are more likely to have had a prior health-care job, and this exposure helps them to recast nursing from a “female-only” job to an acceptable career choice. This reorientation job experience is a way for men to overcome informal barriers of “social control” (Jacobs, 1989) to entering a female-dominated occupation. These findings have implications for current efforts by many states and organizations that seek to expand the registered nursing workforce.