Today's school nurses not only deal with the typical bruises and tummy aches that have always been part of school life, but must now contend with a student population that is increasingly more medically fragile.
Nurses began working in schools in the 1800s to identify and quarantine people with communicable diseases. Now, their main responsibility is to provide nursing care and health counseling to students with increasingly complex medical conditions and chronic illnesses, disabilities, challenges and special needs such as ADHD and autism, to name a few. Some school nurses are devoted to one-on-one care with medically needy students who otherwise would not be able to attend school.
According to the National Association of School Nurses (NASN) (2019) report, "only 39 percent of schools employ a full-time school nurse, while 35 percent of schools employ a part-time school nurse. Twenty five percent of schools do not a have a school nurse at all".
The National Association of School Nurse’s (NASN) definition of School Nursing: “a specialized practice of nursing, protects and promotes student health, facilitates optimal development, and advances academic success. School nurses, grounded in ethical and evidence-based practice, are the leaders who bridge health care and education, provide care coordination, advocate for quality student-centered care, and collaborate to design systems that allow individuals and communities to develop their full potential.” (NASN Board of Directors February 2017).
Skills/Qualities
Must possess a broad knowledge base that covers pediatric, public health and mental health nursing as well as school law and policy.
Must have Leadership qualities and the ability to work both independently and collaboratively to manage health programs effectively and advocate for needed change.
Should have strong interpersonal skills and enjoy working with children, teens, family members, educators and administrators of diverse backgrounds.
Work Environment
School nurses spend most of their workday in the school health office in public, private, vocational, alternative and early childhood schools across the United States. They also move around the school assisting students, attending meetings, giving presentations, and observing learning.
Some positions require the school nurse to travel between schools. Most school nurses work regular daytime school hours, many of whom enjoy the same Summer and holiday vacations as students.
Experienced school nurses may advance to positions of greater responsibility in which they coordinate school health programs at the district or state level. Others go on to work for public health agencies. Nurses who hold a doctorate may conduct research in the field of school nursing or teach classes at the university level.
Duties/Responsibilities
School nursing has multiple components and the role of the school nurse is a broad one, dependent on many factors, including the school setting (rural, urban, suburban), health needs of the student population and the availability of specialized instructional student support services and programs. Some of the duties include:
Develop and implement health plans in accordance with federal laws which require schools to develop individualized education plans for students with disabilities.
Dispense medications and show teachers how to administer care.
Work with educators to set developmentally appropriate learning standards for physical education programs.
Serve as a resource for faculty teaching health-related content.
Assess the physical as well as emotional status of students.
Provide health assessments of students to determine eye problems, hearing impairment, growth and other health problems that may negatively affect the student's studies.
Implement plans for intervention and remedies as well as follow ups for students who are ill.
Provide crisis intervention in cases of injuries and acute illnesses or emotional problems.
Develop plans for the control of contagious diseases by way of immunizations, timely discovery, and close monitoring.
Facilitate normal development and positive student response to interventions.
Provide leadership in promoting health and safety, including a healthy environment.
Provide quality health care and intervene with actual and potential health problems.
Use clinical judgment in providing case management services.
Actively collaborate with others to build student and family capacity for adaptation, self-management, self advocacy and learning.
Education
Some schools employ LPNs. However, the NASN recommends an RN with a BSN.
Additional training and background checks may be required in some states.
School nurses may pursue voluntary national certification, which is administered jointly by the NASN and the National Board for Certification of School Nurses.
Most schools prefer nurses with at least two years experience in an acute care setting.
The enactment of the Affordable Care Act could provide an opportunity to strengthen a nurse program that serves the nation's 52 million school-age children. For many of these students, the school nurse is the sole provider of access to health care.
Health care reform's emphasis on wellness is consistent with the goals of school nurses, who provide continuity of care and promote healthy lifestyles for students during their most critical developmental years. They perform early intervention services such as periodic assessments for vision, hearing and dental problems with the goal of removing barriers to learning.
Salary (2020)
School nurses enjoy competitive salaries.
According to ZipRecruiter, the yearly salary for a School Nurse in the U.S. is $60,739.
According to salary.com, the average School Nurse salary in the U.S. is $51,074 and ranges between $40,807 and $64,478.
Specializes in ICU/community health/school nursing.
Welcome to our little corner - there's a thing about wearing pink on Wednesdays. You might browse the previous posts about lice, communicable disease, and new school nurses for some priceless tips, head-banging comments, and laugh-out-loud moments.
I have submitted a couple applications to different schools in the area. How long should I wait to follow-up with them? What is your opinion of a staffing agency/contract in order to get into a school instead of a direct hire with the school district?
I was using an agency when I subbed and I really did not like it. The agency's main goal is to maintain the contract. If you have problems with your admin team putting you into unsafe situations, not having protocols that meet current practices and/or don't understand your scope of practice, you are out of luck. The only good thing about them is that they do allow you to get a foot in the door.
Specializes in Pediatric nursing: ED, forensic, neuro, triage.
I have 10.5 years pediatric experience ranging from ambulatory, ER, Urgent Care, Child-maltreatment, and neurology (mainly epilepsy). I am interested in trying school nursing but am wondering what the balance is between actual nursing care and documentation and paperwork.
I got a heavy dose of medical writing, phone calls, paperwork, forms, etc while in a pediatric epilepsy clinic.
I've recently done some sub nurse shifts at an elementary school and loved it. But I know that the role goes way beyond just tending the the steady stream of various ailments (I smell like poop, lost a tooth, bloody nose, falls, fights, headaches, stomach aches, headaches, asthma, "I feel tired" and scheduled medications).
Would anyone be willing to share the pros and cons? Do the pros outweigh the cons? Any specific tips you could share or things to watch for?
From where you are coming from...the pros outweigh the cons, hands down! There will be documentation and parent contacts and staff issues but nothing like working in those facilities. And the best part, having the nursing experience and confidence you do...you will LOVE the autonomy of just being you in your clinic. I wholeheartedly urge you to go for it!
What Old Dude said! Also, snow/weather days (depending where you live), federal holidays, school breaks, SUMMER.
Plus, I love watching the kids grow up. I work with older students (7th-12th) where appreciation isn't as vast as elementary level, but when it comes your way from a student in that age range it is very special as it isn't forced and is truly heartfelt. I love those moments.
Specializes in ICU/community health/school nursing.
You are going to be so valuable to that school with your skills!!
You will not feel "as busy" in a school clinic - until you do, and then you're really busy. But I leave at 1515 every day whether I was busy or not. Essentially you've got the nurse part down; you just need to figure out the "school" part, and the first year, like any first year, is figuring out policy and procedure and what to send kids home for and how. You'll do fine.
As far as paperwork, documents and other school business stuff goes - I am super busy with it August-October then it starts to slow down, I get busy with it again at the end of the year with Kinder enrollment & prepping for the next year. When I say busy it is not like hospital busy - I never stay late or feel the need to come in early nor do I take work home. I can still take my breaks, take a lunch break - I may be eating at my desk some days but at least I am able to eat. Your first year may be challenging just because you are learning about the kids, parents, teachers, policy and about the way things are done in a school setting, things get much easier after the first year.
ruby_jane, BSN, RN
3,142 Posts
Welcome to our little corner - there's a thing about wearing pink on Wednesdays. You might browse the previous posts about lice, communicable disease, and new school nurses for some priceless tips, head-banging comments, and laugh-out-loud moments.