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 School Nurse, past Med Surge.

Not required for me. I had considered it doing it just for myself, but it won't benefit me ($$) so I decided I'm good without it.

Specializes in NCSN.

Not required where I am but I am taking it this summer because our district bumps up your salary when you do :)

Specializes in School Nursing.

It's required for CSN positions in PA. While obtaining mine I was flat out told by districts that "we don't do contingencies, apply once your certification has processed with the state."

Otherwise, you can be a staff nurse as an RN, but that is considered paraprofessional.

Specializes in ICU/community health/school nursing.

The NCSN certification requires 3 years' experience as a school nurse. For state certification, you'd have to ask the nurses in the individual states, but it seems like some states allow you a certain amount of time to become certified, while others don't.

Specializes in CPN.

As a peds acute care nurse and pediatrician nurse turned school nurse, I wholeheartedly agree with the above comments! School nursing has a TON of perks. Kids are awesome, you get the opportunity to do a little bit more holistic care, definitely heavy on the admin/paperwork side of things through about October then it's day to day stuff, intermittent "emergencies" to spice up the day, and a schedule you can't beat.

There is definitely a learning curve though! Working in the education industry is definitely different than the healthcare industry. Also, your experience in school nursing will have a lot to do with the district and principal you work for. After two years in my current district with a central admin who varies from unsupportive to incompetent, I'm really looking forward to a new district this fall!

Hello,

I am curious as to what retirement options those of you who are school nurses receive/are eligible for? Are you eligible for the 457(b) like most teachers are?

Any info would be great!

Thanks,

Specializes in School nursing.

In my state, school nurses that work in public schools qualify for the teacher's retirement system. I pay into it and can pull for it after at least 20 years of service (those I get more if I work 30 years). It is nice retirement package and part of the perk of this job :).

Specializes in kids.

We are in the NH state retirement system

Specializes in Pediatrics, school nursing.

I am in the TX state retirement system, the same as all of the teachers.

Specializes in ICU/community health/school nursing.

I would also add (after talking to one of our nurses who worked in a hospital, came out to work as a school nurse, and is going back to the hospital after a year) - this may be a profoundly uncomfortable position if you're used to having a "cookbook" worth of standing orders and a doctor behind you. Because in most cases, we don't. You need a lot of autonomous nursing judgment and seriously good assessment skills (and the willingness to use them). Based on your history, you have what it takes! I'd just say give it more than the first year to decide if it fits. Your year is really only 10 months!

JenTheSchoolRN said:
In my state, school nurses that work in public schools qualify for the teacher's retirement system. I pay into it and can pull for it after at least 20 years of service (those I get more if I work 30 years). It is nice retirement package and part of the perk of this job :).

I am the same! In Illinois, Certified School Nurses (CSN) are considered educators (and have the EXPENSIVE license to back it up) and are on the teacher contract. Building nurses are considered support staff and on that contract with the Illinois Municipal Retirement Fund pension (same as firefighters, police, and other state govt employees)

Specializes in School Nursing, Pediatrics.
JenTheSchoolRN said:
In my state, school nurses that work in public schools qualify for the teacher's retirement system. I pay into it and can pull for it after at least 20 years of service (those I get more if I work 30 years). It is nice retirement package and part of the perk of this job :).

DITTO. I pay a percent every pay check into the system.