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.
I turn to you in a time of need...I am a community health clinical instructor and I have several students assigned to schools this year. I am not a school nurse and am at a bit of a loss as to what to tell them when they ask: "what do school nurses do?"
I tell them that school nurses are integral to the health care continuum as they work to implement preventative care, health promotion and disease prevention, as well as manage medically complex students to maximize all students' time in the classroom. I stress that sometimes, the school nurse may be the only medical person in the building and if the poop hits the fan, they're the ones everyone will look to.
Is there anything else that I can tell my students or use to maximize their clinical experience?
We have students at the middle and high school campus of my school (I am at the elementary campus). The nursing students are very helpful with screening students for State Mandated Screenings (Hearing, Vision, BMI). They are also taught to take vitals and do assessments. It is a great time to make sure they are comfortable with basic health assessments. Also they get to learn a lot about asthma management, Type 1 and 2 diabetes, etc. Students can gain a lot of useful clinical experience in the school setting. I WISH we could have students here and I am working on making that happen :)
Hi all! I am a brand new school nurse fresh out of nursing school. Just looking for some guidance as to how to build relationships w/ staff at the schools. Seems the relationship between the school nurse and others has been strained in the past so I want to be sure I ask the right questions to start off on a positive note. I was thinking i'd meet w/ the principles at the schools (I am in a district w/ TK-8 spread over 5 schools), the health aides and school secretaries.
Any and all suggestions about how to best start are appreciated. It's quite overwhelming!
Specializes in ICU/community health/school nursing.
Peruse the threads here. It is really tough. Listen to everyone; take everything with a grain of salt. Follow all procedures (even if "Nurse X didn't do it that way.") Try your best to educate. Grow a thick skin. They will learn to appreciate who you are when they need you. Best of luck!
Thank you so much. I am a people pleaser at heart so I know I will be taken out of my comfort zone as I won't be able to please everyone. I appreciate your advice!
Thank you so much. I am a people pleaser at heart so I know I will be taken out of my comfort zone as I won't be able to please everyone. I appreciate your advice!
Yes, people pleaser here as well and it can make for difficulties for sure. I am VERY fortunate that I not only was the first nurse here, but also to have a very supportive admin and staff. It can take time for them to trust that you are trying to do your best to keep the kids safe and healthy so that they can be their best to learn and succeed in school.
Specializes in Community and Public Health, Addictions Nursing.
Just started my current job in April, and I completely hear you on wanting to start off on the right foot. Learn your policies, state regulations, etc. inside and out- it shows you know something to the other staff, plus it helps a whole ton when you're trying to make decisions. Remember that change can be very hard, and staff might be resistant to some of what you try to do in the beginning for that very reason. Roll with it if you can, and see what you can be flexible on so folks can adjust accordingly. Other than that, enjoy! I've been in peds my whole nursing career so far, and those kids still make me smile every darn day.
Hey everyone! New school nurse here! The district I just started working for requires that we obtain initial DESE certification within the first year of employment. My question is, for my state, this process costs close to $500... I fronted the cash for the "educator" licensing as that was required prior to the start of the school year, but the remaining courses required through my state will cost a whopping $320.. Now my question is, based on your experience, will the school district pay for these or will I be expected to fork over the cash for these trainings? Something tells me I'm going to need to come up with the money, so if anyone has any leads or ideas about school nurse scholarships, please include them in your response!
LikeTheDeadSea, MSN, RN
654 Posts
CSNs in my state are the same as teachers in the state system. "professionals"
RNs in my state are on the same as "paraprofessional" staff, which have their own system within the state.
^^ This is if the district hires nursing staff directly. Many contract, so it's whatever the agency gives to employees.