School Nursing Is Public Health Nursing.

Beverly Heinze-Lacey Director of SHIELD

Breakfast:  Most days just a bowl of cereal – not much time in the morning. My favorite is blueberry pancakes, though.

Hometown: Born and raised in Lawrence, MA

Extracurriculars: I paint and love doing anything outdoors: hiking, biking, walking, going to the beach, and gardening.

Did you know that the Activist Lab houses multiple, grant-funded training centers that provide continuing education for public health professionals? These partnerships allow us to develop the highest quality offerings and technical assistance that address the needs of an evolving public health workforce. Our training centers include the New England Public Health Training Center (NEPHTC), the School Health Institute for Education and Leadership Development (SHIELD), and the Local Public Health Institute of Massachusetts (LPHI).

We sat down with Beverly Heinze-Lacey, the Director of SHIELD, to hear more about how SHIELD’s work impacts public health, the importance of SBIRT training, and how it feels to be doing this work at BUSPH as an alumna.

SHIELD is a workforce training center funded by the Massachusetts Department of Public Health that delivers professional development trainings to Massachusetts school nurses, in particular. However, their trainings are relevant to other school health professionals, as well.

How does SHIELD’s work impact public health?

Well, to put it simply, school nursing is public health nursing. School nurses work with children, families, communities, as well as public health departments and educators. The primary goal for school nurses is to keep children safe, healthy, and ready to learn. When you think about what this means, it is anything that you can imagine around public health: do they have homes? Are they being well fed? Are they safe in their homes? Do they have the proper immunizations? If there is a communicable disease in the community how do we manage it in schools? Overall, school nurses serve the population’s health.

SHIELD impact is in providing high-quality training to school nurses so that they are able to use best practices in delivering school health services.

SHIELD is also collaborating with PHX to provide leadership training to school and public health nurses. This new program was piloted in June and we have our first leadership team of about 20 nurses who are working on a project to design a mentoring program for new school nurses. Long-term through this training program, we hope to build a cadre of nurse leaders who will be change agents in school and public health.

SHIELD has been at the forefront of providing SBIRT training across Massachusetts. What is this training, and why is it important?

SBIRT stands for Screening, Brief Intervention, and Referral to Treatment. SBIRT in Schools is a universal verbal substance use screening program that has recently been implemented in all public schools across the state. When the Governor signed the opioid law in March 2016, Massachusetts became the first state in the country to mandate verbal substance use screening in adolescents. The law requires schools to screen students in two grades and, for the most part, students in grades 7 and 9 are being screened.

Since the law passed, SHIELD has been working closely with the MDPH and MASBIRT TTA to deliver trainings in how to implement SBIRT to school districts across the state. SHIELD provides the infrastructure for training delivery while MDPH and MASBIRT TTA provide the training.

SBIRT engages students in conversations about substance use, reinforces their healthy choices, and uses motivational interviewing to work with the students who are engaging in substance use behaviors to identify reasons and options to change.

Data suggest that the positive reinforcement delivered during the SBIRT screening process encourages kids to continue on their healthy path and not use any substances. Screeners also talk with students about tools that they can use to continue to stay safe. SBIRT helps identify students who are at risk of harm from substance use, and in these cases, appropriate referrals can be made for services. SBIRT also identifies students who may be experimenting and the screening process provides opportunities to educate and work with students on making positive changes and, hopefully, stop any substance use behaviors.

One of the great things about SBIRT is that we are building relationships with the students. They are finding out they have trusted adults that they can talk to about any topic and some are coming forward to seek help with difficult issues. Because SBIRT is a new mandate, data are just beginning to come in, so it will be a while before we understand the implications of this program on student health. We do know that the screenings are going very well and school professionals are appreciating the opportunity to work together in a multidisciplinary approach to address this complex issue.

What led you to be interested in this work?

I fell into school nursing. I had been working in public health until I chose to stay home to raise my children for a while. When I decided to return to work, the local school nurse suggested working in schools and when I took the job I was surprised to realize that school health is public health. I always thought of a school nurse as putting on Band-Aids and patting the kids on the head, but it is actually a very difficult, complex job. I think it was the hardest job that I have ever done because of the breadth and depth of the things that you need to know and do.

When the SHIELD position opened, I was excited because I really like to be engaged in the teaching end of school nursing. If you think about it SHIELD’s job is helping school nurses be the best that they can be so their students are well taken care of. But, what does that look like? Figuring out how to offer the best quality training possible is what really interests me about this work.

Looking forward, what is your hope for SHIELD?

At a very basic level, I want SHIELD to deliver quality training that provides a best practice approach to school nursing. Long term, I hope that SHIELD will be viewed as a premier training resource, not just in Massachusetts but also beyond. Also, school nurses are very isolated. When you work in a hospital, you have nurse colleagues to consult with, but when you are a school nurse, you’re pretty much alone. So, I hope we can reduce some of that isolation through the variety of trainings we offer.

What is it like being a BUSPH alum and doing the work here?

BUSPH is a lot different now from when I attended. I got a fantastic education then, but when I hear about the classes and programs available to students now, I wish I could go back and do it again because the opportunities are so fantastic.

Being in a setting where people value quality education and public health and making a difference is really exciting to me.