School Nursing: Everything You Need to Know

As a school nurse with several years of secondary experience, I want to help other nurses decide if school nursing is right for them. I have been through the pros and cons and will help shed light on the solo career of the school nurse. Specialties School Article

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School Nursing: Everything You Need to Know

What is a School Nurse?

A school nurse is a licensed LPN, LVN, or RN who works in the K-12 school setting, although regulations vary from state to state. A school nurse usually works a regular school day schedule, which correlates with a teacher's daily schedule. School nurses work with students and staff and must understand triage basics. The school nurse is usually the only medical person in the school building and is the person who is responsible for making medical decisions.

What Does the School Nurse Do All Day Long?

I have worked in a secondary school, which is grades 8th through 12th, for a combination of nine years. From my experience as a school registered nurse with a BSN, my job was a mystery to almost everyone. Even my school principal was in the dark regarding my medical duties.

My initial internship, we'll call it, left me with more questions than answers. The start of the school year was hectic because there were a lot of new enrollees, and I had to make a chart for each new student. The perk was the schedule was the hours. I worked from 7:15 am until 2:45 pm. My job was to ensure that all students either had documentation that they had received all of their state-required immunizations or exemption documentation. If a student had missed an immunization and still managed to attend, we could lose state funding.

The day-to-day flow varied. Usually, there would be the same frequent fliers that would grace my door. I would distribute medication, bandages and check temperatures. Contacting parents was a daily activity when students became sick during the school day, or if they came to school sick, they would still have to go home to keep illness away from the student population. Parent calls were tough sometimes. Not all parents were concerned for their children. Some were unwilling to pick up their sick kids. Thankfully, most parents were good and grateful to have someone take care of their kids, but it's essential to know that working in a school is not all positive.

Covid-19 challenged nurses regardless of the work environment. I often had to contact parents when there was an exposure, and that phone call was never well received. Happily, those rules and regulations for Covid-19 are in the past. Hopefully, they will remain there too.

I did very well on my required observations because my school administrators didn't know what I did all day. A school nurse has a misunderstood job. No one else in the school understands what you do because it is not a traditional educational career. School nursing can be lonely, but that appealed to my introverted nature.

What About the Salary?

School nursing is not on the higher end of the nursing salary spectrum. According to Salary.com, the current median school nurse salary is $54,264. I did not make anywhere near that range as a school nurse. In contrast, a staff nurse's median salary is $88,815, also found at Salary.com. Working as a school nurse was a good fit for my family and me for years, but it was not without sacrifices. There are conveniences in exchange for a lesser wage, such as a better schedule without required nights or weekends and lengthy breaks. These are individual choices that will have to be weighed by each nurse.

Final Thoughts

School nursing is something I do not regret because it gave me a family-friendly job. I learned how to work with children and administration, a skill I'm glad to have in my pocket. I'm not too fond of adrenaline-filled days, which was a reprieve from more traditional nursing roles.

I encourage other nurses to go into the field because it is rewarding. School nurses should demand wages more in line with that of school teachers. Fair pay is significant, and so is job satisfaction. Of course, all jobs have their sticking points; that was mine. The biggest problem was feeling like an outsider while being a school staff member and being paid on a scale lower than a licensed individual would typically earn. In the county I worked for, nurses were in the same category as staff without specialized licensing, which was discouraging.

Dear future school nurses, you are an essential member of the school staff, beloved by many. You matter and make school possible for many of the students you serve. It is your job if you take the assignment to be the best school nurse you can be, and hopefully, you will gain more traction regarding wages and your visibility in the school itself.

References/Resources

School Nurse Salary in the United States: Salary.com (2023, March 28)

Staff Nurse - RN - Occupational Health Salary in the United States: Salary.com (2023, March 28)

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KariRNBSN

About KariRNBSN

My name is Kari Horner, RN, BSN. I've been a nurse since 2004, and have mostly worked within the public school system. I also have written three fictional novels, and love the written word.

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Specializes in School. Irse.

In my state only LSN licensed school nurses can call themselves the school nurse.

A RN, LPN are called building nurses.

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Specializes in Freelance Writer, RN, Health Content.

That's so fascinating. Where I live we only have LPN's and RN's. Our schools are on the smaller side, so maybe that is why we don't have too many roles in the school. Thank you so much for sharing, I love to learn about how things are done in different areas.

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Specializes in pediatrics, school nursing.
Schoolnurselpn said:

In my state only LSN licensed school nurses can call themselves the school nurse.

A RN, LPN are called building nurses.

I'm curious to know what the qualifications are for that - like, do you need to have a RN/BSN first and then get licensed separately? Or is it a completely separate program where you don't go to nursing school? In Massachusetts, you need to hold at least a BSN and then either go on and get an MSN or take the national certification exam through NCSN. 

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Specializes in Freelance Writer, RN, Health Content.

Hello Schoolnurselpn,

In Maryland, you can become an LPN after 1 year in a nursing program, and you can go an additional year to become an RN. That's what I did, and most nurses went on to complete the RN program because it was difficult to get accepted into a program and so it was easier to go through it from the start if possible. There are also nursing BSN, RN degrees that can be taken through 4-year colleges. I personally finished my associate's degree in nursing and passed RN licensure, but then years later I completed my BSN through an online college.

Best of luck to you ?

KariRNBSN

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Another option is to join a staffing agency. I fell into school nursing by working for a Summer camp that an agency set me up with. In September they asked if I wanted to work in a school and I gave it a shot and loved it. Agency pays very well, but of course no benefits or guarantee of placement. I do it thou because I like working in different school and for different grades.

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Specializes in Freelance Writer, RN, Health Content.

That makes sense, you would get a good variety I'm sure. In my school system, we always are low on nurse substitutes. 

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Specializes in School Nursing.

I left labor and delivery after only 7 months as a new grad for outpatient GI. Hated that too and now I am a school nurse. I initially took a pay cut but felt it was worth it for my mental health, my salary was 55k. However I found out one of the other school nurses who had even less experience than I did was making 63k and I immediately asked my principal why that was and if I could get the same. Luckily he agreed and now I am making 67k including my Summer job. It will increase again once I have my PEL. I was making 76k as a night shift nurse so I don't see a huge difference in pay now. My mental health is so much better, I get to see all my friends and family

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Specializes in pediatrics, school nursing.
Julie419 said:

I left labor and delivery after only 7 months as a new grad for outpatient GI. Hated that too and now I am a school nurse. I initially took a pay cut but felt it was worth it for my mental health, my salary was 55k. However I found out one of the other school nurses who had even less experience than I did was making 63k and I immediately asked my principal why that was and if I could get the same. Luckily he agreed and now I am making 67k including my Summer job. It will increase again once I have my PEL. I was making 76k as a night shift nurse so I don't see a huge difference in pay now. My mental health is so much better, I get to see all my friends and family

The Work-Life balance with school nursing (Pandemic-era aside) is phenomenal. I am always talking up being a school nurse because you cannot find a better full time job as a nurse that allows you to have so much time for life outside of work. I worked LTC, primary care, bedside, and specialty outpatient before this, and I was always exhausted and not up for anything during my time off. Now, I enjoy multiple hobbies, a regular exercise class, and lots of time with friends and family. I'd take the pay cut again in a heartbeat. I also keep a part time job at a private school where I work around 5-6 hours per week. 

I, like you, was making around 76k doing overnights and then as a care coordinator in an outpatient specialty and dropped to around 48k when I took my SN job. I make significantly more now, with 6 years experience, but it is still no where near what I made in the hospital system, however, hour to hour, I make a comparatively similar rate. It's just that I only work 5 days per week, 9 months out of the year in total! 

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Specializes in School Nursing.
k1p1ssk said:

The Work-Life balance with school nursing (Pandemic-era aside) is phenomenal. I am always talking up being a school nurse because you cannot find a better full time job as a nurse that allows you to have so much time for life outside of work. I worked LTC, primary care, bedside, and specialty outpatient before this, and I was always exhausted and not up for anything during my time off. Now, I enjoy multiple hobbies, a regular exercise class, and lots of time with friends and family. I'd take the pay cut again in a heartbeat. I also keep a part time job at a private school where I work around 5-6 hours per week. 

I, like you, was making around 76k doing overnights and then as a care coordinator in an outpatient specialty and dropped to around 48k when I took my SN job. I make significantly more now, with 6 years experience, but it is still no where near what I made in the hospital system, however, hour to hour, I make a comparatively similar rate. It's just that I only work 5 days per week, 9 months out of the year in total! 

That's amazing! That's how I see it, though we make less than bedside we are also working way less. If I averaged out the hourly pay to include the entire year, I'd be making way more than bedside. But the time off is way more worth it, it's also nice to not be so stressed all the time ?

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