The Complexity of Translating National Guidelines into Real-World Practice: School Nurses’ Health Dialogue with First Graders and Their Caregivers

This study explores how school nurses in Norway plan and conduct health dialogues with first graders and their caregivers. Using an exploratory qualitative design, data were generated through six focus group discussions and 10 individual interviews with school nurses from diverse contexts, including rural and urban areas, small and large communities, and varying socioeconomic and cultural backgrounds. Reflexive thematic analysis by Braun and Clarke constructed three intersecting themes : strategies for trust-based relationships , conflict between quality and quantity , and striving for consistency and professional autonomy . Results highlight the complexities of translating National Guidelines into real-world practice, emphasizing the demanding nature of school nurses’ work. The study underscores the need for clearer guidelines to support school nurses in delivering meaningful, health-promoting dialogues tailored to the diverse needs of children and their caregivers.