Registered nurses (RNs) have an ethical responsibility to collaborate, thereby promoting the scope of nursing practice and working to positively influence health outcomes. This responsibility encompasses RNs employed as school nurses (SNs). Examples of SN collaboration with campus, school district, and community health partners exist. However, SNs’ commitment to collaboration in these relationships has not been examined.

Chapter 2, “COVID-19: Planning and Postpandemic Partnerships,” explores surges in school nursing partnerships that occur during healthcare emergencies. The significance of partnering with SNs in the school, school district, and community setting is discussed. The need to develop school nursing partnerships that extend beyond healthcare crises is established.

Chapter 3, “Development of a School Nursing Collaboration Instrument: A Pilot Study,” describes the psychometric soundness and results of an instrument designed to explore collaborative experiences of SNs with campus, school district, and community health partners. Although reliability is confirmed, differences between the Likert-type responses and free responses indicate the need for instrument revision. Resulting recommendations for a revised instrument to understand SNs’ perceptions of their role as a collaborator are presented.

Chapter 4 provides results of the primary study, a survey distributed to a random sample of United States school nurses via their professional organization, using the revised Bullard School Nurse Collaboration Survey (BSNCS-R). In the study, the instrument, which focuses on SNs’ commitment to collaboration, is tested for psychometric soundness; reliability of the instrument is confirmed. Three components of commitment to collaboration at the campus, school district, and community level, which together comprise total commitment to collaboration, are analyzed through multiple linear regression to evaluate their relationship with collaboration. Written responses to a free-response survey question are coded by themes and evaluated using descriptive statistics.

Finally, Chapter 5 provides a summary of the body of work regarding school nurse collaboration. Implications for school nursing practice are discussed. Plans for continuing research are presented.

Date of publication

Spring 4-10-2023

Document Type




Persistent identifier


Committee members

Dr. Jenifer Chilton, Dr. Barbara McAlister, Dr. Frank Dykes


Doctor of Philosophy in Nursing

Included in

Nursing Commons