Neuman states that nurses intervene in various stages of stressor invasion known as primary prevention, secondary prevention, and tertiary prevention (Fawcett, 2000).
Primary Prevention
Primary prevention focuses on preventing stress and reducing risk factors for encountering stress. The role of the school nurse concerning the primary prevention of bullying is to help staff identify students at risk. The school nurse may also consider referring parents to programs within the community such as parenting classes, family counseling, divorce mediation, and support groups.
Primary prevention can include implementing a school-wide bullying prevention program. This process begins with educating the parents, school staff, and most importantly the principal. Research shows that principals who had bully prevention training were seven times more likely to have a bullying prevention committee than those without training (Dake, Price, Telljohann, & Funk, 2004).
Secondary PreventionSecondary prevention is concerned with the treatment of symptoms caused by stressors, and implementation can begin at any time after symptoms occur (Fawcett, 2000). The programs mentioned in the literature review touch on the concept of both primary and secondary prevention, but the
Tertiary Prevention
Finally, tertiary prevention focuses on the phase following treatment in which the nurse assists the student in maintaining stability and conserving the student’s energy (Fawcett, 2000). The role of the school nurse in this final step is to provide reassessment, support, and encouragement for the student. Coordinating follow-up visits for the student is important for monitoring progress and providing positive reinforcement. Further treatment may involve a multidisciplinary approach, which the school nurse can help coordinate. School nurses can collaborate with physicians, social service, mental health professionals, and, when appropriate, law enforcement.