School nurses and sex education: surveillance and disciplinary practices in primary schools

Aim.  This paper is a report of a study to explore how school nurses perceive the influence of schools on their role in delivering sex and relationship education in primary schools. Background.  School nurses play a key role in sex education in English schools. However, sex education is a contentious issue meaning the sex education of children is often an area of tension within the curriculum. However, the impact of these tensions upon school nursing practice is poorly described. Method.  Three focus groups with a convenience sample of 16 nurses experienced in conducting sex and relationship education were conducted during 2006. Focus groups were audio-taped, transcribed verbatim and subjected to a thematic analysis. Findings.  Four themes were identified in the data: ‘covert surveillance’ refers to school staff conducting clandestine surveillance of the classroom actions of the nurse; ‘overt surveillance’ reflects how nurses felt they were being openly monitored by teachers in the classroom; ‘Teacher attitude’ refers to the interventions of the supervising teacher in the classroom during the sex education session and ‘resistance practices’ detailed how nurses attempted to manage the disciplinary practices of the school. Conclusion.  School nurses need to be pragmatic about the fact that there will be some attempts by the school to regulate sex education. Developing an early dialogue with the school can mediate this. Closer working practices and the involvement of school nurses in the development of sex education policy and practice is vital to ensure that they continue to make a valuable contribution to sex education in schools.