This study was conducted within the project “Multi-professional cooperation in school contexts and health-promoting student care for children and youth” led by associate professors Jessica Hemberg and Pia Nyman-Kurkiala. Link to the project:

Children and adolescents experience a variety of different challenges in their everyday life. Many of these challenges affect their health and wellbeing physically, mentally, and socially. According to Articles 24 and 28 of the UN Convention on the Rights of the Child, all children under the age of 18 have the right to the best possible health, the right to health care and education (United Nations, 1989). Since most of the adolescents and children are enrolled in primary school (WHO, 2021) school-context gives an eminent possibility to encounter and support them in their everyday challenges. The school environment also offers a unique platform for health promotion work with children and adolescents, something the student welfare team, including e.g., school nurse, school doctor, school counsellor and/or school psychologist, primarily are responsible for. But the increasingly multifaceted health problems among children, adolescents and their families require investments in multiprofessional cooperation between all the occupational groups in schools. Multiprofessional collaboration is a cross-cutting term (Isoherranen, 2012) often used when describing when professional groups work together towards a common goal within a certain context to find the best solutions (Green & Johnson, 2015). The concept of multiprofessional collaboration refers to reaching a holistic understanding by combining different professional groups’ working methods, information, and know-how (Kontio, 2013). To ensure and promote good multiprofessional collaboration it is important that the different professional groups know the rights and obligations of each other (Dahlen Granrud et al., 2019).

To better understand multiprofessional collaboration in schools, knowledge is needed of how teaching staff view the different roles of the members in the student welfare team. This study focused on the role of the school nurse. School health care in Finland is a free, statutory part of primary health care, where the main focus is health promotion, and the basic idea is to find and identify students or families in need of help or support at an early stage to be able to support or if needed refer them further (Government Decree on maternity and child health clinic services, school and student health services and preventive oral health services for children and youth 6.4.2011/338; Student Welfare Act 1287/2013; Ministry of Social Affairs and Health, 2004; THL, 2021). Earlier studies highlight that an ambiguity exists between school health nurses’ and teachers’ views on the role of school health care (Maughan, 2003). The aim for the study was therefore to investigate teaching staff’s perceptions of the school nurse’s role in compulsory school and explore multiprofessional collaboration between school health care and teaching staff.

Semi-structured interviews were conducted online and face to face during year 2022 with persons (n=10) representing different groups of teaching staff from Finland-Swedish comprehensive schools in Finland. Qualitative content analysis according to Lundman and Hällgren Graneheim (2017) was used as method for analysing the results. Through the qualitative content analysis there were a total of eleven subcategories found that formed three main categories: Individual-related factors, Interpersonal factors, and Organizational factors. The findings described the teaching staff’s views of the school nurse’s role in school and factors that enhanced or hindered collaboration between them. In addition to these sub- and main categories several development ideas emerged from the interviews.

The study showed that teaching staff appreciate the school nurses as a part of the student welfare team and wanted to collaborate with them. Teaching staff have a need to collaborate with the school nurse in different cases regarding the students and their families to ensure best possible outcome but various factors, existing on different layers either enhanced or hindered the collaboration.

The teaching staff perceived the school nurse as a safe person who they could ask for help and discuss their thoughts with. The teaching staff described the school nurse as someone who looks after the student’s best interest in a holistic way, and truly cares for the student’s wellbeing and development by taking care of them both in an acute and preventive way. The school nurse offers an easily accessible, low threshold contact in schools. An important factor for this to work was the nurses’ visibility in the school environment. Without visibility, the teaching staff felt that collaboration was hindered thus it was more difficult to connect, and the daily interaction was lost, which shows the importance of the school nurse being present in the school environment, preferably daily.

The work and perception of the school nurse is linked to the person. Personal chemistry, trust, skills, and interest in the work and in collaboration affected multiprofessional collaboration between teaching staff and school nurses positively or negatively. Trusting each other and one another’s professional skills were essential for a fruitful collaboration. Therefore, lack of school nurse continuity was not surprisingly seen as a hinder for collaboration, because it caused problems in relationship building between the teachers and nurses. For building good collaboration the teachers discussed that there is also a need to safeguard direct communication and invest in common values, safe atmosphere, and collegial community in the school environment. Creating common values in the working community was regarded very important for the function of multiprofessional collaboration. Communication was somewhat hindered due to confidentiality and the different laws applying to the school nurse in comparison to the teaching staff. By asking consent from the students’ or their parents there was however a possibility to discuss the matter more freely.

The principal played a big role in the promotion and maintenance of student health and multiprofessional collaboration between teaching staff and nurses. The managements’ view was crucial to the collaboration and to the possibilities for investing time and effort into building working collaborative relationships and structures. Teaching staff wished that themselves and the school nurses would have more time and resources for collaboration and preventative work, lack of common time for e.g., meetings were seen as problematic. This was also the biggest development request from the teaching staff, more resources and time for the nurses, so that they can be at school every day of the week and for example assist teachers with health promotion in the classroom.

With this study we wanted to highlight the importance and complexity of multiprofessional collaboration between school health care and teaching staff in promoting students’ health and well-being in schools. There is a need to support factors that enable multiprofessional collaboration with a focus on student health promotion. This gives the school nurse a key role in the collaboration taking place at school since the school nurse is the schools own expert on health promotion and healthcare. The actors engaged in the collaboration need to feel that student welfare work, and thus collaboration, is meaningful, comprehensible, and manageable for them to want to become involved. The school’s management, the workplaces and society need to ensure that preventive work, health promotion and multiprofessional collaboration are valued and allocated sufficient resources.  A joint, multiprofessional investment in well-being in the school environment provide collaborative opportunities to promote the holistic health of students, to help them or their families at an early stage and thus positively affect their schooling and their future.

Link to the article:


Frida Gädda

PhD doctoral student in Health Sciences, Department of Health Sciences, Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland. Member of a research project on multiprofessional collaboration in a school context concerning health-promoting student care for children and youth and a research project on loneliness and well-being among adolescents and young adults. Other areas of research include well-being of children and adolescents and school welfare services.


Link to Åbo Akademi University profile:


Jessica Hemberg

PhD in Health Sciences, PHN, RN, Associate Professor, Senior Lecturer, Department of Health Sciences, Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland. Subject leader in pedagogical studies for teachers within Health Sciences Didactics and subject leader for leadership in health and social care. E-mail:

Pia Nyman-Kurkiala

PhD in Social Sciences, Docent in Sociology, Researcher in Social Sciences with a focus on Youth Sciences, subject leader in Youth Sciences, Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland. E-mail:


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