School Nurses & Bullying

School nurses can have a pivotal role in caring for students who are bullied

It was 1974, and the kids in school were calling me a lesbian. I didn’t even know what it meant back then. Without the internet and social media, we relied on information more from each other and our parents than anything else.

I was in the 7th grade middle school. The bullying began with me being made fun of on the walk to school every morning by two girls who lived on my street. I was the new girl in the neighborhood and these kids quickly found out that by making fun of me, they could make me feel bad about myself.

It wasn’t long after the name calling began that the two of them, along with other friends in their clique began to spread rumors about me throughout the school that I was a lesbian. Soon, other students began to join in, calling me names, insinuating that I was gay.

The bullying progressed to me being pushed and shoved in the hallways and continued to become more physical, as time went on. Teachers then began to join in with the bullies by making fun of me in class and encouraging these kids, by laughing along with them when they insulted me in front of the class.

The situation peaked when this gang of what had grown to a group of about 10 boys and girls, were waiting for me in the woods on my way home from school with lit matches. When I was tipped off by a friend about the potential ambush, I was able to find another way home from school.

Ending the Cycle

Fortunately, I was not set on fire that day. Everyone in the school was aware of them coming after me, but me. These kids spent the day bragging about attacking me after school to everyone and no one did anything about it, not even the teachers who knew.

When my parents went to the administrators in the school, I was approached by the assistant principal who angrily demanded that I stop causing trouble. The bullying ended in our family having to move away from the town – but it never really ended for me. Those years left me scarred. Scars that have followed me throughout an entire lifetime.

Now I am in my 50s, and I think back painfully to those terrible years of my childhood and what went on. After all these years have passed, I feel relieved to see a new awareness of bullying beginning. A dialogue starting and laws being passed to protect the children.

I have a daughter of my own now and I never want her to go through what I have. I understand that if these laws are going to make a difference in the schools, all individuals who come in contact with children must be involved in anti-bullying actions, which includes the school nurses.

How can school nurses help? Get to know the bullying laws in your own states, as each state has their own laws.

Letter of the Law

Bullying is an intentional act that causes harm to others, and may involve verbal harassment, verbal or non-verbal threats, physical assault, stalking, or other methods of coercion such as manipulation, blackmail, or extortion.

Bullying is aggressive behavior that intends to hurt, threaten or frighten another person. An imbalance of power between the aggressor and the victim is usually involved. Bullying can occur in a variety of settings, including schools, workplaces, political or military settings, and others.1

Laws and policies governing bullying vary by state. As of March 2007, 30 states had enacted harassment, intimidation and bullying statutes.1

In Pennsylvania, Gov. Edward Rendell signed into law, Act 61, on July 9, 2008, which contains the school bullying laws in Pennylvania.1 This law requires individual schools to develop and implement anti-bullying policies that facilitate reporting bullying and taking disciplinary action. This law also includes cyber-bullying.1 Every Pennsylvania school is required to have anti-bullying policy incorporated into their code of student conduct. The policy must identify disciplinary actions for bullying and designate a school staff person to receive complaints of bullying.2

The following is an example of a school policy defining bullying:

any physical act or gesture or any verbally, written or electronically; communicated expression that a reasonable person should expect will have the effect of physically harming a student or damaging a student’s property; placing a student in reasonable fear of physical harm or damage or his/her property; substantially disrupting the instructional program or the orderly operations of the school; or bullying so severe, persistent, or pervasive that it creates an intimidating, hostile educational environment for the student who is bullied.1

Pivotal Nursing Role

School nurses can have a pivotal role in caring for students who are bullied because they have a rapport with students that is different compared to that of other employees. Because the school nurse is not a disciplinarian, students are more likely to confide in the nurse.

As a result, nurses are often on the front lines of bullying, being the first adult the victim and the bully go to for help-which makes nursing the ideal profession to coordinate care for those involved in bullying episodes.3

In the elementary school, the school nurse can play an important role by assessing, planning, and coordinating care for the victims and perpetrators of bullying.3

According to a new study in the May 2011 issue of the journal Pediatrics the school nurse’s office is often a haven for children who have been bullied, and their aggressors.

Eric Vernberg, PhD, a professor in the child psychology program at the University of Kansas, and his fellow authors found that both groups of children tend to present to the school nurse for somatic complaints, illnesses and injuries more often than other students.4

As a result, Vernberg and his fellow authors have recommended that healthcare providers be involved in screening and identification, as well as initiating an appropriate intervention to the situation. They feel that school nurses can play a significant role in addressing bullying and its effects on children. School nurses can lead prevention efforts, contribute to school-wide or district-wide anti-bullying programs.4

“School nurses are really on the front line of being able to deal with this,” said Judith Vessey, PhD, MBA, RN, professor of nursing at Boston College in Massachusetts, and a national expert on the issue of bullying.

Students regularly designate the school nurse’s office as one of the safest spots in the school. Knowing that there is someone to talk to who also has the power to actually do something about the situation can be reassuring for children.4

“The school nurse can be that person,” said Jon Lemich, program assistant for the National Association of School Nurses, and a former teacher.4

The school nurse can be on the lookout for signs of the following behaviors:

aggressive behavior that provokes negative reactions;
repetitive aggressive behavior over time;
a balance of power of some sort.

The nurse can monitor absenteeism and logs of visits to the nurse’s office. When addressing a student, the nurse needs to ask the right questions to find out how the child is really feeling.

“I think it’s the question behind the question that you need to ask,” said Vessey, explaining that a nurse might ask a child who shows up with a playground injury why he was running and if he was running from someone or something.”4

School nurses can also teach children ways for dealing with bullies who are using electronic forms of communication to be aggressive toward them. They can encourage students to delete unwanted emails without reading them, ignore text messages and report problems to parents and teachers.4

Bullies Refuse to Grow Up

If your school does not provide specific bully prevention training to the school nurses or have you involved in bully prevention efforts, approach your nurse leaders and school district about getting the school nurse’s involved in bully prevention strategies.

Because of staffing issues and high student-to-nurse ratios, it may be difficult at first to get a program initiated, but try to persevere and get some kind of program in place.

Vessey agrees that it is crucial for healthcare providers – and others – to get involved and intervene whenever bullying happens. “We know that children who bully often grow up to be adults who bully,” said Vessey, adding “And we know that children who are bullied may have difficulty reaching their full potential as adults.”4

As living proof myself of the pain that can be inflicted by bullying, I feel that what we do now to protect the children from bullies will have a profound effect on every single one of their futures and our future.

The following websites have bully-free training for school nurses:

For School Nurses/Training & Services/Bully Free Program:
Bully Free Program For School Nurses:
Early Identification and Intervention Bullying Prevention:

This article appeared Sept. 21 in the online edition of ADVANCE. 

1. Bullying Law & Legal Definition (2011). Retrieved May 11, 2012 from the World Wide Web:
2. Nicholson, J., School Bullying Laws in Pennsylvania: Available online at Search on “school nurses bullying laws.”
3. Dishington, L. (2006) Overview of Bullying. Retrieved May 12, 2012 from the World Wide Web:
4. Larson, J. (2011) School Nurses Positioned to Address Bullying; Available online at

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