School Nursing

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. Specialties School Article

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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.

Certification

National Board for Certification of School Nurses (NBCSN)

The NBCSN offers the Nationally Certified School Nurse (NCSN) certification examination.

Eligibility  (not all-inclusive)

  • Graduate from accredited RN Nursing program with BSN or higher degree
  • Successfully pass NCLEX-RN
  • Current, unencumbered RN license in U.S. state of practice
  • Minimum 1,000 hours worked within the 3 years prior to taking the test
  • RNs enrolled in MSN programs that do not confer BSN may not apply to take the examination until completion of the graduate program

Publications

The Journal of School Nursing

NASN School Nurse

NASN Weekly Digest

Job Outlook

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.

A Day In The Life Of A School Nurse

Resource/Reference

National Association of School Nurses (NASN): Definition of School Nursing

Specializes in kids.

My guess is you will have to pay, teachers have to pay for their certification.

I was reimbursed through tuition reimbursement because in IL, we have a full grad level program to become certified. Maybe look into that through your district?

Specializes in School Nursing, Pediatrics.

I am in MA, and I paid for mine. I did get reimbursed for my NSCN certification exam, but not the DESE stuff.

Specializes in Telemetry, Gastroenterology, School Nrs.

I paid for mine initially and then used tuition reimbursement. In my State, classes are post-graduate classes through a University. I took over 30 hours before all was said and done, and that was on top of the BSN that I already held.

Specializes in pediatrics, school nursing.

Good to know! Its tough when some districts require the certification and others don't. Very frustrating..

jhunting said:
Good to know! Its tough when some districts require the certification and others don't. Very frustrating..

What district are you in? I know most MA districts require nurses to ether be DESE licensed, or eligible for DESE licensure. But I don;t know of any that require the National Certification Exam. Or are you referring to the rest of the trainings when you say certification? What have you already completed for licensure by DESE? I paid up front for the MTELs but got reimbursed. My school then paid for the three other trainings (Medication administrations, the 2 day intro to school nursing one, and the mandated screening trainings. If your school is requiring you to be DESE ceritifed, I would ask about reimbursment. Once you have the "initial licensure" you can pay $25 more for "professional licensure" but that takes either 3 years of FT work as a school nurse, or the National Certification Exam.

Specializes in Peds.

In my district of NC, we are required to have our NCSN. We have to pay out of pocket to take the exam and any prep but we do get compensated in our salary when it is completed after year 3.

Specializes in School Nursing.

To work in a CSN position, you must already have your CSN to even apply - so out of my pocket. We need graduate-level courses to be certified, so I was able to apply general nursing scholarships from my previous employers to help the cost.

This used to be deductible from your Federal income tax, but I think that changed.

Specializes in NICU.

Unless you have a union contract stating that they pay ,sorry but you will have to pay.

My first certification I had to lay out all the money,books,conference,and test-much more than you are paying.No reimbursement at all back then.

I had a secondary certification also all self paid but they wanted to make use of my

knowledge but refused any payment....so I kept it all to myself.

Today there is a contract,you pass they pay.

Hello everyone! Very interested in one day becoming a school nurse.

Wondering in general-- what type of nursing/how much experience is best to have before making the switch to school nursing?

Thank you all for any advice, it is much appreciated! :)

I think you might get better results posting this to the School Nurse forum. It's under Specialties.

Good luck!