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A Guide for School Nurses BULLYING IN CHILDREN AND ADOLESCENTS: A GUIDE FOR SCHOOL NURSES Jassin M. Jouria, MD Dr. Jassin M. Jouria is a medical doctor, professor of academic medicine, and medical author. He graduated from Ross University School of Medicine and has completed his clinical clerkship training in various teaching hospitals throughout New York, including King’s County Hospital Center and Brookdale Medical Center, among others. Dr. Jouria has passed all USMLE medical board exams, and has served as a test prep tutor and instructor for Kaplan. He has developed several medical courses and curricula for a variety of educational institutions. Dr. Jouria has also served on multiple levels in the academic field including faculty member and Department Chair. Dr. Jouria continues to serve as a Subject Matter Expert for several continuing education organizations covering multiple basic medical sciences. He has also developed several continuing medical education courses covering various topics in clinical medicine. Recently, Dr. Jouria has been contracted by the University of Miami/Jackson Memorial Hospital’s Department of Surgery to develop an e-module training series for trauma patient management. Dr. Jouria is currently authoring an academic textbook on Human Anatomy & Physiology. Abstract Bullying in children and adolescents is not a new problem and has traditionally been overlooked as a serious threat to an individual. This study considers the history of bullies and known social beliefs underlying its prevalence and the way social groups and organizations, such as schools, address the pattern of bully and victim. The impacts of bullying upon individuals are addressed, as well as solutions to prevent bullying and options for victims and families. nursece4less.com nursece4less.com nursece4less.com nursece4less.com 1 Policy Statement This activity has been planned and implemented in accordance with the policies of NurseCe4Less.com and the continuing nursing education requirements of the American Nurses Credentialing Center's Commission on Accreditation for registered nurses. It is the policy of NurseCe4Less.com to ensure objectivity, transparency, and best practice in clinical education for all continuing nursing education (CNE) activities. Continuing Education Credit Designation This educational activity is credited for 3.5 hours. Nurses may only claim credit commensurate with the credit awarded for completion of this course activity. Statement of Learning Need Violence and aggression among children and adolescents are a growing and concerning occurrence, causing school and health professionals as well as public officials and policy makers to seek solutions. Bulling is defined as many things, however key concepts include the repeated attempt of person(s) to exert power over another individual or group of individuals. Common characteristics of bullying include physical to subtle forms of aggression that health professionals must understand in order to help both victim and perpetrator recognize acts of aggression and address them. Course Purpose To provide health clinicians with knowledge of bullying, its forms and effects upon children and adolescents, as well as ways to prevent it and to support healing. nursece4less.com nursece4less.com nursece4less.com nursece4less.com 2 Target Audience Advanced Practice Registered Nurses and Registered Nurses (Interdisciplinary Health Team Members, including Vocational Nurses and Medical Assistants may obtain a Certificate of Completion) Course Author & Planning Team Conflict of Interest Disclosures Jassin M. Jouria, MD, William S. Cook, PhD, Douglas Lawrence, MA, Susan DePasquale, MSN, FPMHNP-BC – all have no disclosures Acknowledgement of Commercial Support There is no commercial support for this course. Please take time to complete a self-assessment of knowledge, on page 4, sample questions before reading the article. Opportunity to complete a self-assessment of knowledge learned will be provided at the end of the course. nursece4less.com nursece4less.com nursece4less.com nursece4less.com 3 1. Providing better adult supervision at schools, especially during unstructured times, a. has not been shown to reduce bullying. b. is required if a school wants to reduce bullying. c. doesn’t really help the victim. d. is effective but too costly to implement. 2. It is the National Education Association’s top goal through its National Bullying Awareness Campaign a. to label and remove bullies from the school environment. b. to use restorative justice to restore a victim’s self-esteem. c. to reduce bullying since it cannot be eradicated completely. d. to eventually eradicate bullying in public schools. 3. True or False: There is a general consensus in the literature that zero-tolerance policies that result in automatic suspensions are not effective at stemming bullying or addressing its consequences. a. True b. False 4. Ensuring the safety of a targeted student should remain the top priority of school administrators and school personnel are strongly encouraged a. to suspend students who bully in all cases (zero-tolerance). b. to implement a continuum of positive behavioral supports. c. to be a “telling school” and publish the names of bullies. d. coach the victim with what to say after the incident. 5. Evidence-based approaches that prevent bullying in schools include a. implementing a gateway approach that involves students only at the beginning stages of bullying. b. separating prevention efforts. c. having fluid anti-bullying policies. d. collecting data to monitor bullying and increase accountability. nursece4less.com nursece4less.com nursece4less.com nursece4less.com 4 Introduction Bullying is a problem that occurs in the social environment as a whole. The aggression of bullies occurs in social contexts in which teachers and parents are generally unaware of the extent of the problem and other children are either reluctant to get involved or simply do not know how to get help. Given this situation, effective interventions must involve the entire school community rather than focus on the perpetrators and victims alone. This means that the school nurse must play a vital, important role in developing whole-school bullying policies. Administrators, teachers, parents, and student mentors also may contribute to making the school a safer environment. Through whole-school bullying policies, the school may implement curricular measures, improve the school ground environment and empower students through conflict resolution, peer counseling, and assertiveness training. School Programs And Responsibilities It is the National Education Association’s top goal in the launch of a National Bullying Awareness Campaign to reduce and eventually eradicate bullying in public schools. Convincing research indicates that this goal can best be achieved by fostering the active involvement of teachers, administrators, school support personnel, parents and community. Therefore, the National Education Association (NEA) is enlisting collaboration in this effort by joining with other national and community organizations. Bullying and harassment are community issues that need multifaceted, systematic approaches, which should include all community and national stakeholders.75,132 Adult behavior is crucial to the success of any anti-bullying initiative. All adults in school must become aware of the extent of the bully-victim nursece4less.com nursece4less.com nursece4less.com nursece4less.com 5 problems in their own school and community. Adults must become engaged in a focused and sustained effort to change the situation. There exists a number of comprehensive bullying preventive programs which can help schools restructure the existing school environment to reduce opportunities for bullying behavior and its effects. These programs focus on creating a school climate of respect, acceptance and caring. Statewide promotion of proven anti-bullying programs which are supported with staff training and continuing assistance in implementation would be a powerful intervention toward diminishing the effects of bullying behavior. Schools have a huge problem dealing with bullies; parents have an even greater responsibility to be alert and to recognize if their child is a bully or a victim. Teachers and administrators cannot afford to look the other way.133,134 In some cases of schoolyard bullying, authority figures observed the bullying but did nothing to intervene or stop it. Students, as well, may witness bullying but do nothing about it. Under zero tolerance rules, children are informed of the limits and given the means to report bullying without being targeted as snitches. A written anti-bullying policy distributed to everyone in the school community can help to send the message that bullying incidents will be taken seriously. To be effective, a policy must be fairly and consistently applied. Mapping a school’s hot spots for bullying incidents can be very helpful. Once problematic locations have been pinpointed through survey responses or a review of disciplinary records, supervision can be concentrated where it is most needed. Providing better supervision is not necessarily costly. Principals can assign teachers and staff members to have supervisory duties in these areas. To achieve permanent changes in how students interact, negative consequences should be provided and positive nursece4less.com nursece4less.com nursece4less.com nursece4less.com 6 behavior through modeling, coaching, prompting, praise and other forms of reinforcement are necessary. Schools
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