School nurses are tasked to provide care for children and families in the communities they serve. It is not unusual to have a variety of religions represented in the local population of a region that, at times, may challenge the nurse in rendering usual and customary care.

School nurses play a pivotal role in navigating a child's health and therefore must be sensitive to the cultural needs of each child on an individual level. The Office of Minority Health defines culture as "integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups." Becoming culturally competent is not just about race or ethnicity, it also includes religious beliefs that may significantly differ from the school nurse's personal beliefs.

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Communication is the cornerstone of creating a care plan for a student in the case of religious beliefs regarding medical interventions. It is essential that the school nurse invites an open dialogue with families regarding expectations of care for the child. One cannot assume a lack of medical intervention based on a religion is noted on school forms. For example, a student's file may state Christian Science as the religion, which traditionally does not accept medical care for its denomination, but the family may have varying degrees of practice within that religion.

If a parent chooses to not have any medical intervention for the student, the school nurse must communicate with the parent to create a clear plan of action in the event of an emergency. Asking detailed questions in a respectful manner is essential to come to an agreement and plan of action. While nurses do not have to necessarily agree with the medical plan based on religious beliefs, the nurse must honor these beliefs unless there is direct harm to the child, at which point the nurse would be mandated to report the issue to Child Protective Services.

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The school nurse interacts with students and families in their communities on a daily basis. Being informed of the customs and traditions of the ever-changing environment is essential for these public health nurses to continue with positive and open relationships for the improved health of the children. Putting aside personal religious beliefs, nurses must first seek knowledge of other religions, through dialogue and communication, to be truly culturally competent.