School Nurse

Students’ ability to excel in school and retain what they learn is influenced by many factors including their mental and physical wellbeing. Students whose health is impaired or put at risk are less able to focus on their lessons and are more likely to miss school. That’s why school nursing is an important aspect of primary and secondary education.

A strong school nursing program at an elementary, middle or high school may improve the health of the student population. This, in turn, helps students learn, achieve good grades, graduate and move on to further education, training and careers.

If you’re interested in the nursing field and have a strong desire to advocate for the health, well-being and educational success of students, you may want to consider a career as a school nurse.

What Is School Nursing?

The purpose of school nursing is to advance students’ health, well-being and academic success. School nursing is, in part, about directly providing health care services to children enrolled at the school. It also plays a greater role. School nursing focuses on community health, care coordination and quality improvement, according to the National Association of School Nurses.

School Nurses Are a Vital Community Resource

In many circumstances, a school nurse is the only health care resource students have. About 4.3 million children did not have health insurance in 2018, the U.S. Census Bureau reports. Access to consistent and preventative medical care influences their physical and emotional health and their capacity to reach their full potential as adults, according to a report published by the National Center for Biotechnology Information.

School nurses are essential in providing students with much-needed care, advocating for students’ mental, physical and social needs, and connecting students and their families with additional resources.

School Nursing Is Unique from Other Nursing Practices

School nurses encounter different problems than nurses in traditional hospital settings or private practices. Before moving into this field, understand that your role will be both medical and educational. A school nurse is a leadership role, and it may be up to you to drive physical and mental health care education and programs.

The National Association of School Nurses advocates for school nurses playing a vital role in promoting positive behavioral health among their students. School nurses often work with school psychologists and counselors to provide holistic support and care for physical and mental health.

It’s important for school nurses to be aware of the social and economic factors that affect the student population. You may need to address the many issues outside of school that can harm students individually and as a whole.

Because school nurses communicate with teachers, administrators, parents and other medical providers, strong written and oral communication skills are important. You’ll also have to understand the students’ communication skills and create messages students can understand and implement.

How To Become a School Nurse

1. Earn a Bachelor's Degree in Nursing

You must first graduate from an accredited nursing program or with a bachelor’s degree and become a registered nurse.

The National Association of School Nurses recommends schools and other facilities hire registered nurses with a four-year Bachelor of Science in Nursing degree or higher, such as a Master of Science in Nursing degree, and the National Board for Certification of School Nurses requires a bachelor’s degree to be eligible for its school nurse certification.

2. Become a Registered Nurse (RN)

To become licensed, you must apply with your state’s board of nurses. The board will inform you if you are eligible to take the National Council Licensure Examination, which is proctored and graded by the National Council of State Boards of Nursing. All nurses are required to pass this exam in order to become a registered nurse.

3. Meet Your State’s Requirements for Becoming a School Nurse

The next step depends on your state’s requirements. Each state governs the requirements for school nursing. Some have specific certification or licensing requirements beyond obtaining your RN license. To determine your state’s requirements for school nurses, you can contact your state’s affiliate of the NASN.

You may be required or wish to obtain certification by the National Board for Certification of School Nurses. According to NBCSN, you must acquire at least 1,000 hours of clinical experience or three years of full-time academic experience to be eligible to take the School Nurse Certification Exam. The test has 250 multiple choice questions, and you have four hours to complete it.

What Do School Nurses Do?

On a daily basis, school nurses perform assessments, screenings, referrals and follow-ups with students. They can diagnose and treat mild conditions or ensure students move on to appropriate medical treatment for more serious mental health conditions or physical injuries, according to the article “Role of the School Nurse in Providing School Health Services” in the academic journal Pediatrics.

However, a school nurse’s day is not solely focused on medical care. Nurses continuously focus on community and public health initiatives. According to NASN, community health encompasses many factors, such as educating students about:

  • Physical, dental, mental and social health
  • Alcohol and substance abuse
  • Risky versus risk-reducing behaviors
  • Preventative care
  • Sexual health and pregnancy
  • Sexually transmitted infections
  • Reducing the risk of communicable diseases
  • Healthy lifestyles

Care coordination is essential to many students and a significant part of a school nurse’s role. There will always be students with conditions who need medical care or advocacy throughout the school year.

Common issues include:

  • Students might need to receive medications, such as insulin, at certain times during the school day.
  • Students might need to avoid certain foods or substances due to severe allergies.
  • Students might need to receive additional educational tools or assistance due to dyslexia or autism.
  • Staff needs to be aware of any student’s increased risk of a medical event, such as seizures, anaphylaxis or cardiac arrest.

School nurses coordinate essential care with the students, parents, medical providers, teachers and staff. They often help develop individualized education plans or Section 504 plans to ensure students’ health and medical needs are not barriers to their education. Nurses also create and implement individualized health care plans.

Social issues, including household income, housing instability, transportation issues, food insecurity, access to health insurance and other environmental factors impact student health and education. School nurses must identify relevant issues and ways to address them at school to improve students’ health, academic outcomes and career opportunities.

Nurses also play a role in connecting students and their families with health care services, shelter, food, financial services and other social resources. They are critical in informing families about Medicaid and the state’s health insurance programs for children and low-income families.

A fundamental aspect of school nursing is continuous quality improvement. Nurses are expected to assess their populations, identify issues, develop action plans, implement action plans and evaluate outcomes. This process entails collecting measurable data, analyzing results and making improvements.

Where Do School Nurses Work?

School nurses work in a variety of settings, including:

  • Daycare centers
  • Pre-school and kindergartens
  • Public elementary, middle and high schools
  • Private and parochial schools
  • Charter schools
  • Alternative schools
  • Hospitals
  • Colleges and universities
  • Local health departments
  • Vocational schools
  • Overseas military bases
  • Summer camps

School Nurse Salary

The Bureau of Labor Statistics on registered nurses reported the national median salary for registered nurses in educational services was $61,850 as of January 2019. Given that this is the median pay, nurses may make more or less than this salary. It often depends on the location, work environment and nurse’s years of experience.

Employment for registered nurses is expected to grow 12% from 2018–2028. This is much faster than the projected growth for all occupations.

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