share concern for the well-being of persons served
at the centers. This includes participants in inquiry
groups, parents/guardians, school faculty, and non-
instructional staff, after-school groups, parent/
teacher organizations, and school advisory coun-
cils. The services provided within this circle might
include: (a) consultation and collaboration:building
relationships and community, answering inquiries
on matters of health and well-being, providing in-
service and health education, serving on school
committees, reviewing policies and procedures; (b)
appraisal and evaluation:conducting community
assessments, appraising care provided, evaluating
outcomes, and promoting programs that enhance
well-being for individuals and communities.
SECOND CIRCLE
The second circle draws attention to the wider con-
text of concern and influence for well being and in-
cludes structured and organized groups whose
members also share concern for the education and
well-being of the persons served at the centers but
within a wider range or jurisdiction such as a dis-
trict or county. Examples of these policy-making or
advising groups include the school district and
county public health department, the county
health-care district, Children’s Service Council,
American Lung Association, and the American Red
Cross. Local funders who offer support for use of
the model include the Health Care District of Palm
Beach County, which offered initial support, and
the Quantum Foundation, the ongoing sustaining
funder. The services provided in this circle include
(a) consultation and collaboration:building rela-
tionships and community with members of these
groups, contributing to policy appraisal, develop-
ment, and evaluation, leading and serving on teams
and committees responsible for overseeing the care
of students and families, and providing school
nurse education; (b) research and evaluation:as-
sessing school health services, describing research
findings for best practices related to school and
community health, and designing research projects
focused on school/community health issues and or
school/community nursing practice.
THIRD CIRCLE
The third circle includes state, regional, national,
and international organizations with whom we are
related in various ways. Services within this circle
are focused on (a) consultation and collaboration:
building relationships and community with mem-
bers and collaborating about scholarship, policy,
outcomes, practice, research, educational needs of
school nurses and advanced practice nurses, and
sustainability through ongoing and additional
funding; (b) appraisal and evaluation:school nurs-
ing and advanced practice faculty organizations
offer a milieu for discussion and appraisal of the
services provided at the centers. Organizations in
this circle include Florida Department of Health:
Office of School Health, Florida Association of
School Nurses, Florida Association of School
Health, National Association of School Nurses, Na-
tional Assembly of School-Based Health Centers,
and the National Nursing Centers Consortium.CONNECTION OF CORE
TO CONCENTRIC CIRCLES
Connections of the core to the concentric circles of
services illuminate the appreciation of the com-
plexity of the practice within the Community
Nursing Practice Model. The core service ofconsul-
tation and collaborationis a primary focus of prac-
tice, beginning with nursing and social work
colleagues and extending to participating clients,
families, policy makers, funders, and legislators.
This value-laden service has been essential to the
viability and sustainability of this model. It pro-
motes the stance of humility that guides the re-
spectful question throughout the circles: How can
we be helpful to you? The answer directs the cre-
ation of respectful individualized care and program
development. Essential health-care services are
created within the core and extend into the first
circle.
Connections to the second circle unfold from
the collaborating relationships with colleagues in
the health department, school district, health-care
district, and other groups taking the lead with
school and community health. Committees on
which center administrators and staff serve meet
regularly to discuss school and community health
issues and to seek consensus on possible solutions.
These committees include the School Health Task
Force and Advisory Groups and the Access Palm
Beach County collaboration. The health depart-
ment provides consultation on health and practice
matters; the school district provides the physicalCHAPTER 25 Developing a Community Nursing Practice Model 395