Defense Date

3-24-2026

Graduation Date

Spring 5-9-2026

Availability

Immediate Access

Submission Type

thesis

Degree Name

EdD

Department

Educational Studies (General Education)

School

School of Education

Committee Chair

Fran Serenka

Committee Member

Reva Mathieu

Committee Member

Ruth Irwin

Keywords

school, nurse, episodic, care, scop of practice

Abstract

This qualitative dissertation explored the underutilization of certified school nurses (CSNs) in PK–12 educational settings across urban, suburban, and rural school districts in western Pennsylvania. Despite their advanced preparation and wide-ranging scope of practice, school nurses are often limited to providing episodic care, including first aid, medication administration, and treatment of minor injuries. This limited use reflects a significant misalignment with their professional scope of practice, which encompasses chronic disease management, health education, mental health support, care coordination, and leadership in public health. Guided by role theory (Biddle, 1986), this study examined how school nurses perceived and interpreted their professional roles and the extent to which they were empowered to practice within their full scope of practice. Using interpretive phenomenological analysis, the research investigated the lived experiences of 10–15 CSNs through semistructured interviews, focusing on the community, cultural, and administrative barriers that restricted the professional scope of practice for this role. Three main research questions guided this study: (1) How do CSNs in PK–12 settings experience and interpret the contrast between their professional scope of practice as defined by certification and their enacted role within their district? (2) How do certified school nurses describe the degree of alignment between their daily responsibilities and their professional scope of practice? (3) How do school nurses experience and interpret the barriers that influence their ability to perform their professional roles in school settings? (3a) How do school nurses make sense of expectations placed on them by administrators, families, and policy? (3b) How do these interpretations shape school nurses’ sense of professional efficacy, identity, and practice?

Findings from this study highlighted significant ambiguity and conflict in school nursing practice, often stemming from administrative misunderstandings, insufficient staffing, and a lack of systemic support. The implications of these findings suggest a need for policy reform, professional advocacy, and increased administrative education regarding the full capacity and potential of school nurses. Ultimately, this research underscored the school nurse’s role as an essential component of student health, educational equity, and school success.

Language

English

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