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Hey everyone! I'm starting as a school nurse for a middle school and high school next Monday. I am the only nurse in the district. I was told the previous nurse (position has been vacant for a year) would wear scrubs sometimes and sometimes business casual, more like a teacher. Both are acceptable, apparently. What does everyone wear? I don't have set guidelines. Help!
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A school nurse is a licensed healthcare professional who supports student health, safety, and academic success within a school setting. At first glance, the role may seem simple. Many people picture handing out ice packs and calling parents. In reality, school nursing sits at the intersection of healthcare, public health, and education. School nurses often work independently, managing everything from acute injuries to chronic conditions like asthma, diabetes, and severe allergies. The role requires clinical judgment, strong communication, and the ability to make decisions without immediate backup. Key TakeawaysSchool nurses provide both clinical care and public health support Most roles require an RN license and often a BSN Average pay is around $35-$40 per hour in the U.S. The role is more autonomous than hospital nursing Work schedules typically follow school hours -
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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Hello all, I really need help! I am very anxious about starting this school year. I do not feel as though I am prepared enough and am ready to quit! I am a new nurse and I just landed a job with an agency as a substitute school nurse. I went to the school today (just to look through the files, tour the room, and meet the staff, kiddos aren't in school until next week!) and left with even more anxiety! The school nurse prior did not leave me much and I am very confused. I found binders for the 15-16 school year, but that's it. Thankfully, the new nurses are supposed to be mentored and I believe someone is coming to the school, but I have not yet been informed of my mentor and am stressing out about that as well. I have been looking at the posts on here and they have helped me. I have some ideas; however, I feel as though I'm going to be a total pushover and too nice. I really need help being stern and not letting my room become total chaos. Thank you all for reading and any advice will be very much appreciated!
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I looked through the last 10 pages of posts and key word searched the forum but did not see much on the subject of what most school nurses wear. Do you wear scrubs, lab coat, business casual, or something else? I was just hired into a middle/high school position and they said I could wear scrubs, but didn't give much direction. What do you find is most appropriate?
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Have you ever been faced with a situation where you had to make a life or death decision knowing that it could jam up your license or even cause you to lose them? Jennifer Jacobs, a Registered Nurse, working in a public school made a challenging decision last year when a seventh-grade student who had diabetes came to her office during lunch with low blood sugar. When the student entered the school nurse's office, she was greeted by Heather Wengler, LPN who jumped to action. Jacobs was at lunch at the time, but returned and began assisting within a few minutes. The two nurses gave the student food and glucose tabs only for her blood sugar to continue to drop. At one point, the student fell to the floor and went unconscious. Jacobs told the Tri States Public Radio, "[She] wasn't seizing but was tremoring, and her eyes were rolling back in her head….." Jacobs gave a dose of glucose gel. However, because the student was drooling, it ran right out of her mouth. This is when the two nurses conferred with one another and decided to make a difficult decision. They knew the student needed a dose of glucagon, but this particular student didn't have the drug in her supplies. However, another student did. And, in the state of Illinois, glucagon isn't a drug that schools keep in stock for nurses to give following a standing protocol. Jacobs told the news channel that she knew giving the drug might mean losing her license and placing the school district at huge liability risk. She also knew that the other option was to do nothing and risk the student slipping further into the hypoglycemic episode, seizures, breathing difficulty, and ultimately death. She made the split-second decision that was confirmed by Wengler to take the glucagon from the other student's supply and administer it to the student in distress. Paramedics arrived and delivered a second glucagon dose on the way to the hospital. The student made a full recovery, and the school replaced the dose of glucagon to the student for which it was ordered. You might think this story ends here. However, Jacobs knew that she needed to do something about this law that left her placing herself in jeopardy to do the right thing for the student. She contacted her state representative, Michael Halpin of Rock Island to discuss the possibility of changing the law to add glucagon to a list of other drugs that can be given per a standing protocol. These drugs include an EpiPen for allergic reactions, Narcan for opioid overdoses, and an inhaler for asthmatic episodes. Halpin agreed to help with the legislation which has now cleared the house and will soon be heard in the Senate. So far, the proposed law has been met with unanimous approval. The most impressive part of this story isn't that Jacobs gave the medication. It's that she recognized a barrier to care, took the risk, and then refused to sit back and allow this to be another Illinois school nurse's dilemma in the future. She acted with quick and just decision making to see what more she could do. Have you ever been faced with a similar care issue where you had to decide between "right" and "legal"? If so, we would love for you to leave a comment and let us know about the situation, how it turned out, and if you would do it again. If you have never been in a similar situation, share your thoughts on Jacobs' and Wengler's actions. Would you have done the same or do you think they should have acted in another way?
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I am a substitute school nurse. I love the job. I love the students. All around, it's just great! But I have come across an issue that is baffling me, and I'm wondering if anyone else has had this issue. So when I came onboard I received a letter stating that I would get paid $28.71/hr because I have my BSN. But as I've been getting my paychecks, the amount paid out is significantly lower than I estimated. So I checked the public school web address and found a Misc. Salary pay for a bunch of groups, and sub nurses were there. It says 190.32/day which adds up to the gross amount being paid. I have emailed my supervisor to clarify what is going on. Again, has anyone else had this happen? What was the resolution? Any advice on what to do or what can be done?
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Hello!! This is my first time posting I have read so many posts on here about this topic but I decided I would would ask it again anyway LOL! I am a new grad and I am scheduled to take the NCLEX in one week! My dream job is to be a school nurse, it's what I've wanted to do for as long as I can remember (and really what pushed me to finish nursing school!) I know ideally that I should have some hospital experience before applying but I have talked to the recruiter for my local hospital and she said very rarely do they have open positions in their peds unit. She suggested that I take a job in another area to "get my foot in the door" and that I could transfer when/if a job opened on the peds floor. I agreed to an interview for an opening on the mother/baby floor but every time I start thinking about it I start dreading it more and more. One of the school systems in my area just posted a job listing for substitute school nurses. I really want to apply after I take the NCLEX (if the job is still open) but my question is, is it possible to transition from nursing school to a sub school nurse position or is that just asking for trouble? On the previous post that I have read the few people that said they started out as a new grad suggested starting as a sub first. I did work as a medical assistant in a busy pediatric office for 3 years prior to nursing school but that's the only medical experience I have besides my clinical experiences in nursing school. Sorry if my thoughts sound jumbled.. it's late and my eyes are crossing from studying and answering practice questions! Thanks for your time and any input is appreciated. - Taylor
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If you watch the news or TV shows, you might be led to believe that there is a high risk of firearm homicide. Researchers from Northeastern University, University of Washington, and Harvard University conducted a study into the perceptions of gun violence and the leading cause of death in the United States. They found that the presence of a firearm in a home increases the risk for suicide, which is more common than firearm homicide. So, what's behind our misconception about gun violence and how do you educate the community about the real dangers? Looking at the Numbers According to the Brady Campaign, the oldest organization in the gun violence prevention movement, 96 people die every day in the United States from gun violence. Of these 96, 34 are murdered, and 59 die from suicide. That means nearly twice as many people die from firearm suicide compared to firearm homicide. There are also 246 people shot daily who survive - 183 are injured in an attack, 49 are shot unintentionally, 4 are shot in a legal intervention, and 11 survive a suicide attempt. A 2014 study published in the Annals of Internal Medicine reported that access to firearms in the home increases your risk of violent death by suicide, homicide, or unintentional injury. There was a direct correlation to the risk of suicide among people who had access to firearms compared to those without access. The study also reported that the US has one of the highest rates of access to firearms in the world. Could impulsivity and the ease of access to a gun place some people at a higher risk of committing suicide or homicide? The study suggests that it's possible. Yet, there are no hard data to support the claim. States with the highest rates of firearms, also have a higher percentage of firearm violence compared to non-firearm violence. Is it a Public Health Issue? According to the American Public Health Association (APHA), gun violence is an issue that is deeply rooted in our culture and must be addressed through a public health approach. Violence research should be conducted to ensure that guns don't fall into the wrong hands. APHA also believes that access to mental health services must be expanded to those who need it most to decrease the number of suicides by firearms. Do Nurses Have a Role In the Firearms Debate? Every day nurses in Emergency Rooms across the country come face-to-face with the gun violence issue. They might deal with victims of homicide, suicide, and unintentional shootings. Nurses who work in schools have become far too familiar with the issue over the past few years. The National Association of School Nurses released a Position Brief in which they state that school shootings in the US are an urgent public health crisis. The NASN advocates for safe school environments for all children and recognizes the emotional and physical effects that gun violence has on our students. This doesn't account for nurses in the ICU, rehabilitation units, and many other settings that might care for gunshot victims. Unfortunately, healthcare workers can fall victim to gun violence, too. Recent research has highlighted the prevalence of suicide among nurses. And, gun violence in hospitals and other healthcare facilities seems to happen at an alarming rate. In fact, just a few weeks ago, a young doctor was killed in the parking lot of Mercy Hospital in Chicago at the hands of her former fiancee. What Can You Do To Help? Gun violence is a hot political debate these days. No matter which side of the aisle you stand on, as a nurse there are a few things you can do to help keep patients safe: Educate patients about the risks inherent in having a gun in their home. It's particularly important to speak to parents of young children about safe storage of all firearms. Connect patients with mental health concerns to services as quickly as possible. Many patients have mental health needs that if left unattended can quickly lead to violence towards themselves or others. Participate in violence prevention and intervention programs at your hospital or facility. None of us want to discuss or consider that a shooting could happen at our workplace, but unfortunately, the risk is real. Write to your elected officials to make your viewpoints on the issues known. Advocate for more research to be done to increase our understanding of homicide, suicide, and those who commit both. What are your thoughts on the firearm statistics? Do you feel that nurses have a place in the firearm debate? Let us know your thoughts in the comments below.
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Does your state/district have a mentoring program for new school nurses? Have you been either a mentor or mentee? Our district is looking into starting one, with me as the person in charge of spearheading this ?. I actually LOVE teaching and mentoring but I also know that one of the main reasons we have this forum is because in real life and in our day to day we don't have the luxury of an actual orientation or mentorship. I am hoping to change that in my district. It is sadly stemming from a current school nurse within the district who has been doing this for many years and we are only now aware at how ineffective and at times putting herself and students at risk, but somehow has just been VERY lucky. The new principal brought it to light after several new parents called in the first week of school and shared they were uncomfortable and nervous. It's a long story. So....here I am being volunteered to come up with a way to mentor someone set in her ways, but also focus on a more widely used mentorship program to new nurses within the district. I would love any feedback from those who have BTDT.
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Hi! I've been approved to be a substitute school nurse at my children's school. It's a private school with infants through 12th grade. I have 6 years of experience as a level III NICU nurse, but no school nurse experience. I'm looking for any resources and tips to help me prepare. I've joined the National Association of School Nurses. Thank you in advance for your help!
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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
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Hello all! I am fairly new grad (end of August 2012 and passed boards a week later) and I am just past the one month period of my orientation being a BSN-RN on a medical-oncology floor. I, like many other new grads, am questioning my desire to continue working at the bedside. My reasons aren't because of the novelty of work and the periods of uncertainty that I have for what am I doing, but it is because I have some physical health issues that is making working 40hrs a week on my feet fairly difficult. I knew of this health issue prior to starting nursing school and thought that I would be able to work full-time for a period of time- 2 or 3 years-without much issue. Those thoughts appear to be inaccurate. As a result, I been looking into other specialties that may be more accomodating. One of the nursing specialities I am considering, and have actually applied to already, is a school nurse position. The one I applied for is managing 350 students for grades 5-8. While I remain excited about the potential opportunity, I am concerned that I may be passed over due to my gender status of being a guy. I am aware that there are male school nurses out there somewhere and that it would illegal for the potential employer to discriminate me because of my gender, but I have to talk to and/or meet a male school nurse. Plus, I am thinking about the issues that can present itself at the middle school issue, in particular the female side and the potential avoidance of seeking help from me (assuming I got the position) if they felt like they needed it. Does anyone have any insight for me? I my reply is fairly vague and I havent provided specific questions to be answered, but any response, either specific or general from anyone would be greatly appreciated.
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This article is featured in the July 2018 edition of our allnurses Magazine... Download allnurses Magazine School nurses have always been one of the most diverse and unique subspecialties in nursing throughout the decades. While the specific job responsibilities and pay may have changed some, the mission and purpose of the job remain constant. The National Association of School Nurses defines school nursing as " a specialized practice of nursing, that protects and promotes student health, facilitates optimal development, and advances the academic success" of its population. First and foremost I want to stress the many areas in which school nurses serve the community, the vital roles they play with our youth today, and the challenges that come with those roles. As we dive into the 2018 allnurses.com salary survey results we can see trends in the field of school nursing such as salary comparisons, full or part-time hours, years of experience etc. Are school nurses compensated for their responsibilities appropriately? I will let you decide. Let me start by saying that I am not a school nurse. I am a nurse that has worn many hats in my 20+ year career, but school nursing is not one of them. I will say, however, that I have ALWAYS wanted to be a school nurse. As a child, they were the nurses that I had the most exposure to on a daily basis. They seemed to always play a huge role in the school's day-to-day function. I was awed by what school nurses knew, the fact that they teach AND practice medicine to hundreds of students, staff, and visitors. They were so organized, knew who to call and when and what was a true emergency. At the end of the day, they knew that sometimes we just needed a hug, a listening ear, and some TLC. I decided to be a nurse because of my school nurses. After nursing school, it was apparent that I needed to get experience before applying to work as a school nurse. So I did. When the "right time" in my career came to jump in, I realized that school nurses love what they do! They don't leave their jobs until they retire and I can't say I blame them. So my career and calling as a nurse went in different directions. Then, my admiration for school nurses was taken to a new level when I became a mother to three little hooligans, who, despite my best efforts grew up and started school. I was about as much of a wreck as any other mom on our first child's first day of school. He is still to this day, at 12 years old, our clumsiest child, peanut allergy laden, and asthmatic. This added to my anxiety by sending him to school, epipen and all. No joke, on the FIRST day of school, I got a call from his teacher to tell me that my son had walked into a wall and had a large goose egg on his head. I was then asked by the teacher what did I want her to do with him. What? I said...well, if you think he needs attention, send him to the school nurse. That's when I found out that, in our school district, a school nurse visits each school only one day a week and serves up to 4 or 5 schools! During that day, the nurse's job consists of managing paperwork and teaching teachers how to give kids their medicine's, perform CPR, manage seizures, anaphylaxis etc., until emergency personnel arrives. SAY WHAT??!! Since that day, I have become a school nurse advocate extraordinaire. I believe in my heart of hearts that school nurses serve as one of the most important members of our community. Their job is so broad, ever-changing, and wide-reaching, that it cannot be compared fairly to any other in the field of nursing. They work as health educators and medical and mental healthcare professionals. One would think that school nurses would be one of the most valued members of a school system and the community as a whole, which would then lead to appropriate compensation, respect, and funding. Boy, was I wrong..... I was shocked with several statistics that I discovered in writing this article, but this is one of the most profound to me. According to the Centers for Disease Control 2017, 18% of schools have NO school nurse at all or serve in a part-time capacity, and over 55% of schools have nurses responsible for 2 or more schools at a time! As parents, we send our kids to school entrusting that they will be in a safe, cared for environment. If, in the worst case scenario, they need medical attention for a chronic illness or an emergency such as injury or life-threatening condition that the school would be staffed to handle the situation. Obviously, this is not true for many of us. How are teachers and school administrators expected to care for these needs? Teachers are educated in teaching. Administrators are educated in administration and education. Nurses are educated in healthcare, health education, and medicine. Simply put, teachers and administrators are not nurses and should not be responsible or accountable for that role. According to the U.S Health Resources and Services Administration (2016), over 20% of students that are enrolled in school, enter with a chronic health condition. Such chronic diseases as diabetes (with complicated glucose management systems), seizures, asthma, and of course allergies, (the dreaded food allergies included) are just a few examples off hand. School nurses are able to trend patterns seen with these conditions and can play a major role in student's disease management through collaboration with pediatricians, specialists, parents, pharmacies, and community health staff. They can safely administer prescribed medication and assess and intervene if necessary. When/ if an emergency arises, they can communicate effectively with other medical personnel and start care immediately which can be crucial in many situations. Let's talk about mental health in children. Many mental health disorders are not "officially" diagnosed until children are school-aged or older based on patterns in behavior, grades, and social situational responses. Collaboration with teachers, school nurses, pediatricians and mental professionals is pivotal in providing quality outcomes for these kids. School nurses participate, initiate and intervene in the treatment and management of ADD, depression, bullying, suicidal behaviors and autism, just to name a few, common mental health issues seen in schools today. Roughly â…“ of visits to the school nurses are mental health related. School nurses get to know the children and family situations they serve. From a community health perspective, think of the impact they have on children who may be abused, neglected, malnourished or lack adequate healthcare. Early intervention can prevent further mental health crisis down the road. Nurses are trained in the management of factors that come with mainstreaming children with mental health disorders. This is one area of education that is ever changing and can be very challenging for teachers and staff. Education is a key job responsibility for school nurses. They educate staff regarding health care issues of students and other staff. They participate in producing policies and procedures for environmental safety emergencies both outside and inside the school building. They educate students about maintaining their own health and wellness, diseases, social pressures, mental health, and community health concerns. They educate parents and caregivers on issues affecting their children such as diseases, immunizations, and concerns noted by school staff. This of course, is just a broad overview of some of the vital roles school nurses play in schools and the community at large. With the amount of responsibility placed on these nurses and the number of "patients" they serve each day, lets venture into some of the statistics from 2018 allnurses.com survey such as salary versus hourly pay rates per state/ regions, number of years as a nurse and years of experience in current job title (school nursing). OK...shocking statistic #2 for me....according to results from the 2018 allnurses Salary Survey, the average pay for a full-time school nurse is only $37,164 for hourly employees and $51,043 for salaried employees. The hourly pay per year feels very low to me given the responsibilities of a school nurse at large. Keep in mind with the next set of values, that for some states only a handful (sometimes only 1), school nurse answered the survey representing their respective state. Some of the highest paid school nurses reside in the states along the west coast and northeast coast. For example, New Jersey hourly paid school nurses make an average salary of $50K per year and salaried nurses make an annual salary of $67K per year. The Texas nurses that responded to the survey were all annual salary based and average $50K per year. This is a sharp comparison to Montana (who only had 1 nurse take the salary survey) making $20K as an annual hourly salary and Georgia with a few more responders making an average hourly salary of $25K per year and an annual salary of $15K per year! This made my brain spin and my stomach upset! I began to think about how much experience school nurses have and whether this plays into the average pay rates. As I suspected most of the respondents have 5 to 35+ years of career-long nursing experience. As far as the number of years in their current job, those numbers were pretty evenly spread over the span of less than one year to more than 10 years. I wonder whether this number spoke more to years as a career school nurse or years in their present job as a school nurse. Of the school nurses that responded, 99% were women. I further polled the allnurses' school nurses and asked about whether they work year-round or have the summers off. The majority of school nurses do keep their summers off to vacation or spend time with families etc. Some work part-time at their schools and other work in the hospital or as camp nurses during the summer. In wrapping this up, I have come full circle to where I began with how much I love school nurses. I admire them now more than ever, knowing how much they balance and the grand scope of their practice. I am grateful beyond words for the people who watch over our children as though they are their own. Those who put bandages on our children's wounds both internal and external. Those who watch, listen and truly hear our children and their needs. Those who advocate for our kids individually, school-wide, statewide, and nationally. School nurses are vital to our children and the community's health and welfare. So do we compensate them fairly based on those roles and responsibilities? For those states and counties where schools either don't have nurses or have them part-time or less, we need to look for creative ways to fund full-time nurses in our schools. We need to advocate and speak up for our children. As our nation's healthcare needs evolve and change over time, we have a responsibility to provide a voice for those without one......just as school nurses have done for our children for decades! As a side note, there are so many more aspects to the discussion of school nursing as a career in terms of roles, challenges, more pertain thought-provoking questions regarding the number of hours worked per day, degrees most commonly held, whether CNAs or LPNs can fill some of the gaps, continuing education requirements etc. Please add more to the conversation! by Sarah Matacale RN, BSN, CCS
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Hi all! I am an LPN with almost 4 years clinic and urgent care nursing experience and have an interview for a substitute school nurse position this Friday. what does a typical day ( if there is such a thing as typical 😜) look like. From my understanding I will be a sub for the entire school district, all age groups. I am looking forward to it. Thanks in advance! freesia29
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Good morning, So to give some background, I am currently working part-time and am in the beginning of my second year at a new school. Our school last year only had Kindergarten (125 kids). They moved to first grade this year and now we have K and First, so 250 kids. I only work 9-1:30 which has been a great schedule since I have two kids (in 3rd and 5th grades). With this schedule I am able to take them to school in the morning, come to work, then get home to be there when they arrive home from school. With the doubling of the number of kids, I have been a lot more busy with paperwork and am already feeling the struggle of getting through files, documenting immunizations, sending letters home, screenings, etc. in those 4.5 hours. It is extremely likely that for the 2017-2018 school year, they will ask me to increase my hours to 8:30-3 (doable but not something I would love), as well as now have 375 kids, one grade of which might be on a different campus, meaning I would have to travel mid-day to another site (not something I am excited about). If things next year would stay just as they are this year I wouldn't even be considering leaving. I LOVE the staff here, feel totally supported to do my job as I see fit and the admin staff pretty much are happy and eager to help me in any way they can. The teachers are all amazingly dedicated and just a great bunch. I get 6 weeks off in the Summer and three weeks vacation (Dec/Feb/April). In my home school district, as well as the neighboring town school district, they are eagerly looking for School Nurse substitutes. I am considering leaving at the end of this school year and subbing instead so I can decide when I work, and be more involved in my own kid's school activities (their school welcomes parents for lunch, help teach, etc. and I have not been able to do this with my current job). Sub nurses are paid a LOT more in my district ($35/hr vs. $26/hr) but of course hours are not consistent. For those of you who sub, what is it like subbing? Are you getting a call early in the morning on the day of, asking if you can work? Are you functioning like a regular school nurse or are you doing mostly admin tasks? I am sure this varies from school to school, but overall I am curious. Obviously I would ask all of these questions in an interview, but I don't want to interview unless I am already pretty much decided I am not coming back next year (people talk and news gets around). I have to make a decision by March 1st when I re-sign my contract for 2017-2018, or tell them I am not coming back. Thanks for any advice.
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In response to this comment from a previous thread: Give out Bandaids and ice packs, that's it. Just kidding! Although that's what the majority of the general public thinks we do. What school nurses do varies from school to school, depending on student populations, state laws or district policies, etc. I'll get the list started with just a few things I personally do at work and my fellow school nurses can chime in! Things School Nurses Do 1. I personally cover only 1 school and see 30-40 kids a day, and I know I'm one of the lucky few with such great numbers! It's not unusual for school nurses to see 60, 70, even more on a daily basis---from multiple schools or even the entire district. I assess, monitor, treat students for quite a variety of things: wounds minor and severe, sore throats, headaches, stomachaches, N/V, SOB r/t asthma, menstrual cramps, head injuries that may or may not turn out to be concussions, sprains, strains, nosebleeds, chest pain, many more. You name it, a school nurse has probably seen it. 2. Ensure students with chronic conditions (most commonly asthma, severe allergy, seizure, diabetes---but many school nurses also see students with more specialized needs such as those with cystic fibrosis, spina bifida, etc.) have plans in place that ensure the safety AND success of the student while at school. For example, a diabetic student would have emergency meds/supplies/a plan for hypo- or hyperglycemia. That's in addition to their day to day maintenance plan (e.g., checking in with the nurse before lunch for a blood glucose check and any necessary treatment.) 3. Administer daily and PRN medications, making sure all necessary forms are on file, calling parents when meds expire or run out, monitoring for any adverse effects, etc. 4. Educate students on self-care, healthy lifestyle choices, puberty, or more specific info related to their particular condition or situation. 5. Educate and train staff on common chronic conditions present in our school, s/s to look for, step-by-step response to emergency situations (anaphylaxis, hypoglycemia, etc.) Many school nurses also do CPR training for staff. 6. Working with administration to develop policies/protocols related to school health that ensure all students are safe and have equal opportunities to thrive and succeed. 7. Managing the occasional "special cases"---post-op student for example might need to learn how to use crutches/wheelchair to get around school, pain management plan, special accommodations in class (sitting near the door, needing a way to prop a limb up, etc.) 8. Document thoroughly on EVERY SINGLE STUDENT I see. That alone takes up a chunk of my time. 9. Annual vision, hearing, height, weight, acanthosis nigricans, scoliosis screenings for certain grades as mandated by state law. 10. Being the "safe place" for students with anxiety, other mood/behavioral disorders, and all students really. I'm fortunate to have counselors AND social workers but many schools don't so the school nurse plays that role. 11. Connecting students/families in need with community health resources. 12. Navigating the tricky world of teachers and education. You're the ONLY "medical person" in the entire building, nobody understands your job (but thinks they could do it since you just sit around handing out ice packs and Bandaids all day), if you're lucky another nurse is nearby or a phone call away but sometimes not, you are SOLELY responsible for your students' health needs and outcomes during school hours. It's tough being a nurse in a "teachers' world." Anyway, I could go on but I know the other school nurses have plenty to add. TGIF!
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Did you know that only 39% of schools in the US employ full-time school nurses? Did you know that in a recent study it was reported that "nearly half of 5- to 17-year-olds have experienced trauma in the form of at-school victimization. Exposure to trauma increases students’ risk for mental health disorders and school failure." This was in a published article in the Journal of School Nursing. This is just one issue that school nurses encounter. In-school bullying is known to cause trauma that lasts much longer than the school year. School nurses are on the front lines of education from pre-school age thru college-aged students. Some of the issues that school nurses deal with include: Asthma which can be a chronic issue with episodic flare-ups requiring Falls Other acute medical complaints Chronic illness Communication with parents, staff and others in the community Assessment of social issues Administer medications Coordinating screening of hearing, eyesight, weight Provide healthcare education Many other duties So, what skills should a school nurse possess? Ability to listen and also to be inquisitive Very familiar with developmental milestones The ability to explore sensitive issues with tact, understanding and patience. Ability to stay calm in an emergency. Record-keeping and organizational skills. School nurses wear many hats during a day. They must have great communication skills and the ability to get along with many types of people in sometimes very stressful situations. These nurses face many challenges doing their job including: Students that come from non-English speaking homes Students that have grave social situations I.e., poverty and food-insecurity Homeless students Parental discord Mental illness in students Students with severe physical disabilities The school nurse supports the students in an environment where they spend many hours of their day. As parents, our children are our greatest asset and some of our most vulnerable citizens. The school is often the only supportive place where these children go. The National Association of School Nurses (NASN) is the organization who provides school nurses with continuing education, conferences, jobs and “is the leading worldwide expert in providing opportunities and programs for school nurses.” The NASN also tasks school nurses to be advocates. Only school nurses have the insight to educate stakeholders so they know the role of the school nurse role and the different school nurses make in the lives of children. Stakeholders need to know why school nurses are important. School nurses serve students and families and should proactively engage their school community. They encourage school nurses to attend PTO/PTA meetings and engage in the community via their local elected officials. It takes some very special people to be school nurses. allnurses.com has a very active School Nurse Forum - come and share some of the reasons you are a school nurse. Some of our recent threads have discussed nosebleeds, diabetics in the school, questions about time off/PTO, and essential oil diffusers. Current news is also a hot topic. Happy School Nurses Day! References: Study Reviews At-school Victimization In Middle And High School Students National Association of School Nurses
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Hello, Can anyone tell me if a school nurse (LVN) has to give vaccines to the students? Ever since the covid vaccine came out, my whole view on vaccines changed. After doing research, I am against the covid vaccine and now other vaccines as well. I am interested in applying for a school nurse position but I would not want to be expected to give vaccines to the kids. I would appreciate any feedback.
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Where are We Now? Here we are rounding the bend of October 2021. About 20 months into a global pandemic, healthcare has been in a strange place. While many in healthcare have worked tirelessly caring for COVID-19 patients, those with other health issues other than COVID have been put on the back burner. Although some practices have been open to all or most patients for a while, there are still some areas where finding a physician who will see you in person has been a feat. From my own personal experience, I have not been able to see my PCP for almost two years, as he is still concerned about the number of COVID-19 patients he has been treating and how many have died. He has been seeing me remotely only. When an issue arose last year with my blood pressure, which I had never had an issue with before, I was told to go to the Emergency Room at my local hospital. I was much more concerned entering an ER full of sick people than I was seeing my primary care physician in his office fully masked, seeing the risk of getting infected much lower than sitting amongst a room full of sick people. Needless to say after over two hours I called my PCP and asked him to “just call me in a prescription for something” because I could not handle another minute in this ER where no one was leaving, yet more people kept coming in. That’s typical of course in any Emergency Room, but the idea of being less than six feet from sick people in an indoor space during a second wave of the pandemic, well, that was just unnerving, to say the least. People have put off getting the medical attention that they really have needed in the past two years because of fear of contracting COVID-19. It’s a tragedy that cancers have gone undetected, heart attacks and strokes ignored, and life-saving surgeries put on the back burner. Preventative care has been just about thrown out the window. School Children and COVID-19 I am a school nurse in the city of Boston. When our students were able to return to school at least a few days a week in cohorts last year, some medical practices were still seeing pediatric patients only remotely, so a physical exam consisted of not much more than subjective data. There were no vital signs performed and vaccines were given out at separate nurse visits only. Many of these separate appointments were missed. Some students were still not being seen at all. Parents were afraid to bring their children anywhere, including to medical or dental appointments, even if they were available. So far this school year, most students have been in school full-time and mostly uninterrupted. When schools reopened, the Delta variant caused many worries about how it would play out with crowded classrooms and minimal social distancing. According to the New York Times October 7, 2021, a majority of the nations’ 50 million public school students have been in classrooms full-time and mainly uninterrupted this fall whether students are masked or unmasked, teachers vaccinated or not. Infection rates have actually declined 35 percent nationally through the month of September (NT Times, October 7, 2021). Most students have resumed in-person physical exams and routine vaccine administration. Many of our students 12 and over have received COVID-19 vaccines as well. Mitigation Strategies In Boston, Massachusetts schools, our mitigation protocols have included mask mandates for all staff and students, continued weekly pooled testing for all students whose parents have consented as well as “test and stay” for students who have been determined to be close contacts of a COVID-19 positive person. Test and stay consists of rapid antigen testing daily for one week at school for all students who are either part of a positive pool or who have been determined to have been in close contact with a positive person while in school. This has omitted the need for entire classes to be quarantined and keeps kids in school and learning. All staff working in the school must provide proof of vaccination for COVID-19 or proof of a negative PCR test weekly to stay at work or be placed on unpaid administrative leave. It is surprising to me how many staff working in schools are hesitant to vaccinate, even at the risk of losing their jobs or the need to go through the hassle of weekly testing and documentation of proof of negative COVID-19 status. Even more startling is the fact that staff are willing to risk their health and the health of others in a setting where social distancing is next to impossible. Schools are now at 100% enrollment with all restrictions lifted except masking. Persistent online disinformation has been one of the biggest obstacles throughout the vaccine rollout including unproven claims of infertility, altering of one’s DNA, and microchips being added to the vaccine. Some have religious beliefs and many just completely distrust the government or don’t believe in the science of vaccines. Let History Do the Talking Edward Jenner began his successful use of cowpox material to create immunity to smallpox in 1796. Louis Pasteur’s 1885 rabies vaccine was next to make an impact on human disease. Antitoxins and vaccines against diptheria, tetorifice, anthrax, cholera, plague, typhoid, tuberculosis and more were developed throughout the 1930s. By the mid-twentieth century, methods for growing viruses in the laboratory led to rapid discoveries including the creation of polio vaccines. This was followed by vaccine development for other common childhood diseases such as measles, mumps and rubella, which greatly reduced the burden of disease. Here we are now in 2021, still battling this pandemic. People are still dying. Some are wishing to change their minds about getting the vaccine once they become very ill, but by then it is too late. The miracle of science has given us a vaccine to prevent and even eradicate COVID-19, yet so many in America are hesitant to receive the life-saving vaccine. In a national climate fueled by politics, conspiracy theories, social media and other fears about the seemingly rapid development of a vaccine, we have become a divided nation. Why can we not look to history and science to make decisions about our health rather than seek out misinformation and folklore on the internet to keep us ever doubting this miracle of medicine? A lot has changed since the 1930s when technology was not where it is today. We never doubted the validity of vaccines then when many childhood diseases led to debilitating deformities and abnormalities or even death. School Nurses in the Spotlight of COVID-19 School nurses have been working hard and overtime consistently to make COVID-19 testing and contact tracing a success in schools while state guidelines for reducing transmission in schools have loosened. School nurses are the primary site facilitators for COVID-19 testing including symptomatic, routine pooled testing and Test and Stay. Massachusetts school nurses are reporting concerns about the health and safety of students with nurses working two jobs simultaneously possibly causing the potential for medication and treatment errors and missing acute health conditions or emergencies. This causes physical and emotional stress and burnout, resignations, early retirement, leaves of absence and taking sick days. It has become difficult to find substitute nurses willing to work with these new responsibilities in place. Some districts are even having difficulty hiring qualified school nurses who have mandatory Department of Elementary and Secondary Education licensure requirements. As a school nurse in Massachusetts, I feel the burden of this responsibility. It can be draining and exhausting. Needing to take a mental health day has been deemed nearly impossible by the lack of substitute staffing. Anxiety levels are high among many students in my K-8 school. For our most vulnerable kids already experiencing anxiety, continued mask-wearing and adherence to school protocols regarding COVID-19 are pushing their stress levels even higher. I want to be there for every one of them. I teach them stretching exercises to do in class to reduce headaches and neck and back tension, which affects every grade level. We do deep breathing exercises next to the open window outside of my office. We talk about the importance of drinking lots of water, eating breakfast and lunch, getting enough sleep, spending time in nature and staying away from screens as much as possible. These are things we talk about every day, even without a pandemic. Sometimes the conversation turns to how COVID-19 has affected us during the past almost two years. But what is always evident to me is that our youth are living in and accepting a pandemic and doing it with more grace than many of their adult counterparts. I’ve watched my four-year-old granddaughter (now 5 and in kindergarten) don a mask every day without a single complaint other than why she couldn’t have chocolate doughnuts for breakfast. An Autumn of Hope As school nurses, we need to stand strong. This is our time to show how important our jobs really are. Many of us have felt unappreciated by the medical community. We are the ones who sit in our offices waiting to put on a bandaid or take a temperature. Or so it seems to some. We have always had to justify our purpose in school buildings, particularly when nurses have been required to cover multiple schools. Now we are on the cutting edge of turning the tide on COVID-19 through educating the youth that we care for. Let’s give them the knowledge and tools they need to affect a change in the direction of this disease. Let’s persevere with confidence in the work we do every day to keep students healthy, at school and learning. They are our future and change truly starts with them. Resources: National Association of School Nurses Massachusetts School Nurse Organization New York Times The History of Vaccines / An Educational Resource by the College of Physicians of Philadelphia.
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