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School nurse management of children’s questions when they are involved in primary school sex education: an exploratory study

  • Hilary Piercy (a1) and Mark Hayter (a2)

The aim of this paper is to explore school nurses’ experiences of teaching Sex and Relationships Education (SRE) as part of the primary school curriculum. In particular, it focuses on the questions that the children ask during the lessons and the strategies the nurses employ in managing those questions.


School-based SRE is an important aspect of children’s education. However, it is a highly politicised and controversial area, which is a matter of concern to a number of stakeholders. In the primary school setting, school nurses are commonly involved in delivery of the programme. Their input is particularly valued, because they are ‘specialist outsiders’ who create an environment that is conducive to discussion of sensitive topics. To date, there is little understanding of the skills that they employ in managing the educational needs of primary school children within the confines of a pre-agreed school curriculum.


Semistructured focus group interviews were conducted with small groups of school nurses from a single geographical location in the Midlands region of England. Data were analysed using a thematic analysis approach.


Data identified the ways in which the nurses viewed and responded to the children’s agenda, which was realised in the form of questions. In particular, it focuses on what they deemed to be inappropriate questions and the basis on which this label was applied. Five strategies for managing these inappropriate questions were identifiable from the data. Their deployment is explored in relation to the tensions implicit in the realisation of sexualised realities in a classroom setting.

Corresponding author
Address for correspondence: Hilary Piercy, Faculty of Health and Wellbeing, Collegiate Crescent Campus, 51-53 Broomgrove Road, Sheffield Hallam University, Sheffield, S1 1 WB, UK. Email:
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Albrecht T., Johnson G., Walther J. 1993: Understanding communication processes in focus groups. In Morgan, D., editor, Successful focus groups: advancing the state of the art. Newbury Park: Sage Publications, 5164.
Alldred P., David M. 2007: Get real about sex: the politics and practice of sex education. Maidenhead: Open University Press.
Aronson, J. 1994: A pragmatic view of thematic analysis. The qualitative report 2(1): Spring. Retrieved August 2006, from
Buston K., Wight D., Hart G. 2002: Inside the sex education classroom: the importance of context in engaging pupils. Culture, Health and Sexuality 4, 317335.
Buston K., Wight D., Scott S. 2001: Difficulty and diversity: the context and practice of sex education. British Journal of Sociology of Education 22, 353368.
Cotton L., Brazier J., Hall D., Lindsay G., Marsh P., Polnay L., Wiliams T. 2000: School nursing: costs and benefits. Journal of Advanced Nursing 31, 10631071.
Croghan E., Johnson C., Aveyard P. 2003: School nurses: policies, working practices, roles and value perceptions. Journal of Advanced Nursing 47, 377385.
Cumper P. 2006: Let’s talk about sex: balancing children’s rights and parental responsibilities. Legal Studies 26, 88108.
DfEE. 1996: Education Act. London: HMSO.
DfEE. 1999: National healthy school standard: sex and relationship education. London: Department for Education and Employment, HMSO.
DfEE. 2000: Sex and Relationship Education Guidance. London: Department for Education and Employment.
DfEE. 2000: Learning and Skills Act. London: HMSO.
DfEE. 2002: Education Act. London: HMSO.
Diorio J., Munro J. 2000: Doing harm in the name of protection: menstruation as a topic for sex education. Gender and Education 12, 347365.
Edouard L. 2006: In condoms we trust; to each, one’s own. Journal of Family Planning and Reproductive Health Care 32, 262264.
Epstein D., Johnson R. 1998: Schooling sexualities. Buckingham: Open University Press.
Fine M. 1988: Sexuality, schooling and adolescent females: the missing discourse of desire. Harvard Educational Review 58, 2953.
Foucault M. 1978: The will to knowledge. The history of sexuality: 1. London: Penguin Books.
Frey J., Fontana A. 1993: The group interview in social research. In Morgan, D., editor, Successful focus groups: advancing the state of the art. Newbury Park: Sage Publications , 2034.
Halstead M., Waite S. 2002: Worlds apart: the sexual values of boys and girls. Education and Health 20, 1723.
Hampshire J. 2005: The politics of School Sex Education Policy in England and Wales from the 1940s to the 1960s. Social History of Medicine 18, 87105.
Hampshire J., Lewis J. 2004: ‘The ravages of permissiveness’: sex education and the permissive society. Twentieth Century British History 15, 290312.
Hirst J. 2004: Researching young people’s sexuality and learning about sex; experience, need and sex and relationship education. Culture, Health and Sexuality 6, 115129.
Lightfoot J., Bines W. 2001: Working to keep school children healthy: the complementary roles of school staff and school nurses. Journal of Public Health Medicine 22, 7480.
Lincoln Y.S., Guba E. 1985: Naturalistic inquiry. California: Sage Publications.
Measor L., Tiffin C., Fry K. 1996: Gender and sex education: a study of adolescent responses. Gender and Education 8, 275288.
Measor L., Tiffin C., Miller K. 1999: The impact of health professionals’ involvement in sex education in schools. Nursing Times Research 4, 386393.
Measor L., Tiffin C., Miller K. 2000: Young people’s views on sex education. London: Routledge/Falmer.
Monk D. 1998: Sex education and HIV/AIDS: political conflict and legal resolution. Children and Society 12, 295305.
Morgan D., Kreuger R. 1993: When to use focus groups and why. In Morgan, D., editor, Successful focus groups: advancing the state of the art. Newbury Park: Sage Publications , 319.
OFSTED. 2002: Sex and relationships. London: HMI.
OFSTED. 2007: Time for change? Personal, social and health education. London: HMI.
Piercy H., Haynes G. 2006: Coherent, comprehensive and continuous: developing a curriculum for effective sex and relationship education in an English primary school. Education and Health 24, 1215.
Salkeld, L. 2007: Outcry over explicit sex education video shown to five-year-olds. Daily Mail. 26th February.
SEU. 1999: Teenage pregnancy report. London: Social Exclusion Unit.
Strange V., Oakley A., Forrest S. 2003: Mixed-sex or single-sex sex education: how would young people like their sex education and why. Gender and Education 15, 201214.
Venis S. 2005: Lunch with the Lancet – Sarah Philpott. Lancet 365, 565.
Wilkinson S. 2004: Focus group research. In Silverman, D., editor, Qualitative research: theory, method and practice. London: Sage Publications , 177199.
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Primary Health Care Research & Development
  • ISSN: 1463-4236
  • EISSN: 1477-1128
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