What Does a School Nurse Really Do?

The position of the school nurse is perhaps one of the most misunderstood in all of nursing -- people simply don't think about all the roles that school nurses take on to care for students. As a National Education Association article pointed out, "For some students, the school nurse is the only health care professional they ever see."

As the article noted, a school nurse's "typical" day can include an array of duties. School nurses may be called on to handle a number of routine elements of preventive care like immunization and healthcare screenings. Hearing and vision tests may also fall under the purview of a school nurse.

If a student has an accident at home before coming to school, the school nurse may be the first one to attend to that student. If a student has an allergic reaction, the nurse is best positioned to diagnose it and administer epinephrine. (Though, as a Washington Post article pointed out, Virginia state law requires schools to carry epinephrine but not staff schools with nurses, meaning that in some schools, it's left to school secretaries to administer the doses.)

The school nurses' duties can also go beyond just the physical. For students with mental health issues, or students who are homeless or whose parents are in jail or otherwise absent from their children's lives, the school nurse is often the primary (and sometimes only) school official coming in contact with them.

Given those realities, school nurses are vital not just to the schools where they work, but they are also important as a community resource for children who might otherwise not receive needed care.

And there simply aren't enough of them to go around.

In May 2016, the American Pediatric Association recommended at least one nurse per school in every school across the nation -- a step up from their earlier recommendation of one nurse for every 750 students.

As Sallie Jimenez noted in a Nurse.com article, the reality is unfortunately far starker than that. While there are about 50,000 school nurses nationwide, more are needed to get to the recommended ratio. She noted that in some school districts, the ratio can be as lopsided as one nurse for 4,000 students.

The aforementioned Washington Post article -- titled "You have no clue what school nurses do"-- describes schools with a ten-deep line of students by 8 a.m. Monday, many of them exhibiting physical signs of anxiety.

It also describes students who don't know how to manage their conditions, students asking for drugs that nurses can't administer without a doctor's permission, and parents who aren't truthful on health forms.

In other words, a school nurse dealing with a single school's population has to make multiple judgment calls each day, and the more he or she knows the students, the better job he or she can do in making those calls. With multiple schools to attend to, a school nurse is tested that much more.

An RN with a BSN -- especially one from a program that emphasizes community health and the role of a nurse as educator -- can take on the challenges of school nursing. While it is one of the most demanding sectors of nursing, it is no doubt one of the most rewarding, too.

Learn more about LSUA's online RN to BSN program.


National Education Association: School Nurse Day

The Washington Post: You Have No Clue What School Nurses Really Do

NURSE.com: Academy Recommends One Nurse Per School

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