Inclusion of an FNP is effective but not available in most
settings. The FNP was assigned to Head Start and performed
these attendance activities with Head Start and two elementary
schools in addition to regular job duties of maintaining
immunization and other records, conducting screenings, and
securing care for students in nine schools. The majority of
students who reported illness in fact was not sick and did not
need the diagnostic and prescriptive services the FNP could
offer. Only 13 students that the FNP examined met the
objective criteria for an ICD-9 diagnosis at the time of the
visit. It is logical that the school nurse could call to assess
symptoms and triage sick children to the FNP, and school
nurses can do home visits. It is difficult for the school nurse
to break away from stream of children who present to the
school nurse office, but where the nurse is itinerant or unable
to call families, another staff member could make the initial
call to determine who is truly sick and triage to the school
nurse.