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

Hi everyone, first time posting. I have an interview tomorrow for a part time position 2-3 days per week at a private pre-school, I will be meeting with the lead nurse, and the director of child development, wondering what to expect questions wise?

This would be my very first school nurse job. I've been subbing for the last 4 years at my children school, I figured the part time position would be a great way to start the school nurse journey.

Thank you

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Specializes in School Nurse. Having conversations with littles..

Hmmm. The most of my experience with early childhood, is with my kids in our Early Childhood Special Ed. program. Do you know what you would be doing in this job?

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Specializes in Pediatrics Retired.

If you keep in mind they are referring to herding cats regarding every question, you'll be just fine. Good Luck.

Just recall your children at that age and what you did for them...same thing but more of them.

1 Votes
Specializes in School Nursing.

Good luck!

Let us know how it went!

1 Votes

A student was just diagnosed with TIDM. What is your nursing plan of action? I had to write my answer on a piece of paper before I was interviewed in a room with four school nurses and one nurse manager.

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1) see student first bc we know that they have a life threatening emergency-they are a priority 2) teacher with chest pain evaluate 3) fracture .. I feel confident doing the diabetes calculation. The need is a large hs at this time. Thank you for your response. I am

Horrible at interviews! I am a shy person :(

1 Votes

What did you write for you care plan? My interview as far as I know is with the head nurse of the district and the head of people personnel. More nerve wracking with more people to judge you! The Diabetes care plan I've seen is usually very detailed with orders from our children's hospital that I've seen.

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I studied up a ton on Type I Diabetes, seizure disorders, allergies/anaphylaxis, and asthma. Anything peds or first aid that you're rusty on--review it! Be ready to tie in how your past experiences will help you to be a school nurse. Have you worked independently before? Be able to give examples of how you can work well under pressure, feel confident in your assessments, use resources to help you make informed and appropriate decisions. How have you dealt with families or parents? What experience do you have in patient education? If you won't be working alongside other nurses--do you feel you'll be able to run the clinic? If you're working with nurses or techs be ready to talk about teamwork and delegation.

1 Votes

Thanks everyone. The interview went well, I think, they seemed to be more interested about my family/personal life more than anything else, it was very relaxed and comfortable, so I'm not really sure. She said that they would interview a few other nurses, but I should hear back within two weeks. I plan on sending a thank you email to them. Otherwise I will continue subbing at the private school, and start subbing in the public schools in on our district to see if they are a good fit before committing to a full time position.

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If you do a search on here, you will find tons of questions, and I would say they were pretty spot on. Specially the one about " how would you descale an angry parent", and also they will throw a few scenario of different students and ask you which ones would you see first.

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Specializes in ICU/community health/school nursing.

Oh good! High schoolers are great. They will Google their symptoms and will be convinced they have a kidney infection when they really are probably dehydrated....but you can reason with them and they probably won't throw up on your shoes. Good luck!

1 Votes
Specializes in Community and Public Health, Addictions Nursing.

...you review the welcome packet of paperwork at your new job, and the last paper is your state's guidelines for head lice in school.

Just started for my local community's Head Start/Pre-K/Early Head Start and Childcare organization. VERY excited for the new adventure!

1 Votes