National certified school nurses' perceptions of their roles, the organizations where they work, and their ability to exercise informal leadership: A descriptive case study

As school nurses work to integrate health and wellness initiatives into the organizations in which they work, they need to work in partnership with school leaders to create the link between health and student achievement, by addressing the needs of the whole child.; This study explored the extent to which national certified school nurses reported assuming leadership roles, especially in terms of promoting health and wellness activities in their public schools. Although leadership in school nursing is essential, a gap exists in the literature regarding school nurses' interest and capacity to assume leadership roles.; The national certified or "expert" school nurses in this study responded to questions related to their perceptions of their ability to adhere to the professional school nurse standards, their understandings of the schools where they worked, and their leadership styles in an effort to examine how expert school nurses were able to exercise informal leadership.; The findings indicated that these school nurses perceived that collaboration, trust, and administrative support assisted them in promoting health and wellness initiatives in their respective schools. In addition, adhering to the professional school nurse standards to guide their practice contributed to their abilities to exercise informal leadership. However, their limited understandings of schools as an organization, limited resources, and a disconnection between school health programs and overall school goals were some of the factors that interfered with their ability to exercise informal leadership.; There were several conclusions in this study. They included: (a) collaborative relationships between school nurses, school personnel, and families are important to encourage best practices in school nursing; (b) there are some features of school organizations that expert school nurses perceived interfered with their ability to exercise informal leadership; and (c) school nurse have a legitimate role to play in public schools beyond proving direct care to students within the health room.