School nurses are happy to act as confidantes for children with health or emotional problems. But they too have worries and frustrations which they have shared with the University of York's Social Policy Research Unit.
Some schools are apparently discouraging nurses from offering sex education or organising health promotion events which might distract pupils from academic work. And lack of privacy is hampering nurses' efforts to persuade children to attend school "drop-in" clinics.
The unit's report on school nursing in England says that the room offered to nurses is often next to the head's office or the dining hall. As one 13-year-old girl said: "It's private inside, she never tells anyone what you're talking about, but it's not private because everyone knows you've been there."
The researchers say that schools' "gatekeeping" role is minimised where there are good working relationships between teachers and nurses. "Where relationships were working well, teachers and nurses saw the nurse as 'part of the furniture' or 'part of the family'."
The researchers built up a picture of the present state of the school nursing service by interviewing 105 heads, teachers, nurses, NHS managers and local authority staff. They also organised discussion groups for parents and secondary school pupils.
Although they found that the nurse was welcomed in many schools, they say that there was often confusion over roles. Their study suggests that the job has four key elements: safeguarding the health and welfare of children, acting as a confidante, promoting healthy living, and supporting families. But they say that schools and NHS trusts need to consider how the service can be best used.
* "Keeping Children Healthy: the role of school nursing", by Jane Lightfoot and Wendy Bines is available, priced pound;5 (inc p amp;p), from The Publications Office, Social Policy Unit, University of York, Heslington, York Y01 5DD.