School Nurses: Helping Students Stay Healthy

Depending on the size of the school, the job of a school nurse can become very demanding – especially when you start taking on multiple students at once when a school has a large population. According to the National Association of School Nurses (NASN), school nurses wear many hats while on the job. In fact, the NASN has defined the role as:

“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. Adopted by the NASN Board of Directors February 2017.”

Although it’s typically common to find a school nurse working among the public school system in the United States, you can also find them working in private schools and even in college or university health centers. It’s also not uncommon to find a school nurse on a local board of education, focusing on healthcare education for their school district and communities. More recently, the NASN reported a significant shortage of school nurses with only about 40% of schools having a full-time RN on staff. They also reported that 35% of schools employ a part-time nurse and roughly 25% do not even have a nurse on staff.

Have you ever wondered how school nurses got their start working in the school system? It all dates back to around 1850 when a report was produced by the Sanitary Commission of Massachusetts, which indicated that school health had become a vital part of public health.

The History of School Nurses

As part of a public health initiative, per American Nursing History, it was believed that it was important for each child to learn how to “preserve his own life and his own health and the lives and health of others.” Headed by Lemuel Shattuck, this initiative was brought to life during the times when disease was widespread and he believed that everyone had a duty to be knowledgeable about what caused diseases, how they spread and how students could be safe and try preventing the spread.

By 1894, according to American Nursing History, “medical inspections” began when Boston appointed several “medical visitors” to make visits to school campuses to review how well the students were doing. Roughly three years later, similar health inspections were conducted in Chicago, Philadelphia and New York. New York City, in 1897, hired 150 physicians to examine students for common contagious diseases such as lice, impetigo and tuberculosis and sent students home with a note that explained why the student could not attend school.

As students were sent home, however, they played with other children that also couldn’t attend school and began to spread contagious diseases even worse than before. After this situation escalated, nurses were sent to the families’ homes where the nurse would treat the child and educate the family on how to stay healthy, which prompted the role of the school nurse. American Nursing History states:

“The advent of the school nurse brought a radical change in methods of dealing with diseased children. Instead of excluding and neglecting them, they were treated by the school nurse. School nurses visited their homes to instruct parents and caregivers in care for the child’s problems as well as how to protect the other children.”

Later on, school nurses became a big influence in advocating for health by creating “wellness and illness-prevention” programs, which encourages teachers to teach children about good hygiene, nutrition and physical development. In the early 1900’s they also began to implement dental and hearing screenings in schools, and the first textbook for school nurses was published in 1917.

School nurses continue to this day to be major influences on keeping good health and wellness in the school system. In fact, school nurses help start student health initiatives to promote healthy eating and healthy habits for students to continue through life. It’s important that each school has a nurse on duty, but unfortunately, that isn’t always the case. Lately, school systems have seen a shortage of school nurses so the demand for filling the role is high. But what does it take to become a school nurse?

How to Become a School Nurse

As you should know by now, a school nurse does more than tend to injuries on the playground – they are the backbone of keeping a school healthy and thriving. Not only do school nurses provide direct care to students – including students with chronic conditions and disabilities – they also oversee immunizations and screening clinics. They typically assist with developing health-related emergency action plans, such as dealing with a pandemic. School nurses also promote healthy school environments through programs and health initiatives, as well as contribute to health policies and may act as a liaison among the school and parent.

Although it may vary by state and different regulations, school nurses typically hold a Registered Nurse license, as well as a bachelor of science in nursing (BSN).

In order to achieve this status, usually you have to follow this type of educational career path:

• Step #1: Graduate with a BSN
  • Although there are some exceptions, typically you would first need to complete a four-year BSN program and then qualify for the National Council Licensure Exam.
• Step #2: Pass the NCLEX-RN
  • The National Council Licensure Exam (NCLEX) is where you receive your licensure to become a RN; you must apply to your state licensing board for authorization to get approved and take the exam.
• Step #3: Train and gain experience
  • Depending on where you live and what the state and local regulations may be, you might have to have additional clinical experience or even a national certification before becoming a school nurse; if you decide to become nationally certified as a school nurse, the certification requires several hours of professional experience.

Just like any job, there are pros and cons to being a school nurse. One of the downsides to becoming a school nurse is that typically you have to depend on the school district's budget in order to work full time or you might even end up working part-time at multiple schools. The benefits, however, may outweigh the cons and it might be something you are interested in pursuing.

As a school nurse, you tend to leave a measurable difference in the lives of the students and their families at the school. You also get to help with creating initiatives to improve community health, work hours that are consistent with the school calendar and the demand for school nurses is high, so the likelihood of getting a job in this area is full of potential.

So the next time you see a school nurse, thank them for all they do for our schools and our children. And who knows, maybe you are interested in pursuing a career in this field and join the ranks of school nurses making an impact around the country.