You are a grade school nurse and have valued the role first lady Michelle Obama has played in creating healthier school meal standards. Partly because of her efforts, Congress during the past several years has required more fruits, vegetables and whole grains in lunch lines and also has set limits on sodium, sugar and fat. Not everyone, however, is happy with those restrictions. The school board is debating a policy that would no longer allow parents to bring cupcakes to classrooms to celebrate a childs birthday because the treats are not healthy for the young students based on federal nutrition guidelines. Some parents are saying the new policy would turn the school into a food Nazi, and they are adamantly opposed to the new guideline. You have been invited in your role as school nurse to weigh in on the debate at the next parent teacher meeting.
What the ANA and the Code of Ethics say
You understand that advocacy for the children and families you serve is central to your professional role and identity as a school nurse. The ANA Code of Ethics for Nurses reads: The nurses primary commitment is to the patient, whether an individual, family, group or community. The nurse promotes, advocates for and strives to protect the health, safety and rights of the patient. ANA Code of Ethics for Nurses (2001), provisions 2 and 3. The ANAs Social Policy Statement: The Essence of the Profession identifies advocacy as an essential nursing action: The aims of nursing actions (also nursing interventions) are to protect, promote, and optimize health; to prevent illness and injury; to alleviate suffering; and to advocate for individuals, families, communities and populations. Nursing actions are theoretically defined, evidence-based and require developed intellectual competencies.
While you have to admit school lunches are healthier today because of the new federal guidelines, you value a limited role for the government in deciding what children are allowed to eat. You want families to make these decisions and can identify with parents wanting to celebrate a childs birthday with cupcakes. Although concerned for obese children and adults, you believe that anyone who wants to eat nutritiously and live an active lifestyle can. You have no problem with your son and daughter enjoying the occasional birthday cupcake at school. You plan to not support the proposed policy banning cupcakes at the next PTA meeting.
Alternatively, you value the role government can play in promoting healthy behaviors and support a policy that complies with federal guidelines designed to promote healthy nutrition for the nations health. You understand individuals are capable of making nutritious food choices but realize some individuals may need guidance to make this happen. School seems to be a perfect environment for modeling ways to celebrate events such as birthdays with nutritious fun foods. The proposed policy can educate children and their families about ways to do this. You plan to support the policy banning cupcakes.
As you decide whether to support the proposed policy you become aware of the many considerations including political that might influence your thinking and decision. The Code of Ethics for Nurses and Social Policy Statement clearly delineate nursings advocacy responsibilities, but you have to decide whether an occasional birthday cupcake is deleterious to school childrens health. You ultimately choose a compromise. You use this opportunity to teach parents about the importance of the new federal guidelines for school lunches and urge parents to help their children make healthy food choices both in and out of school. You explain that government, school and parents working together and reinforcing this message create a win-win strategy that can only benefit children. But you also report that you do not believe an occasional birthday cupcake is problematic, and thus you do not support the proposed policy banning cupcakes in school.