School nurses focus on students’ overall health. They may work in one school or in several, visiting each for a part of the day or week. They may also assist the school physician, if the school employs one. They work with parents, teachers, and other school and professional personnel to meet students’ health needs. School nurses promote health and safety, work to prevent illnesses, treat accidents and minor injuries, maintain students’ health records, and refer students who may need additional medical attention. School nurses may also be responsible for health education programs and school health plans. They are also in charge of administering medication to children and for seeing that special needs students’ health requirements are met. School nurses are employed at the elementary, middle, and high school levels. There are about 57,000 registered nurses employed as school nurses in the United States.
The Job of School Nurse
“Many people think school nursing is simply putting bandages on skinned knees, but it is much more than that,” says Sue Schilb, RN, a school nurse at an elementary school in Iowa. “Of course, we take care of injured and sick children, but what most people don’t realize is the amount of paperwork, planning, and record keeping that is involved in the job.”
Schilb adds, “We must assess every child entering kindergarten and make sure the child has had all the required immunizations. In addition, we must maintain records on all the students, including state-mandated immunizations. We take the height and weight of each student every year, check their vision, and work with an audiologist to conduct hearing tests.”
In addition to all their record-keeping tasks, school nurses are frequently a resource for parents or staff members. “We often interact with parents when their children are ill or if they have questions about their child’s health,” says Schilb. “If children with special needs attend our school, we must develop a care plan for them to make sure that their needs are met.”
School nurses are also health educators. Teachers may ask the school nurse to speak to their individual classes when they are covering subjects that deal with health or safety. School nurses may also be required to make presentations such as disease prevention, health education, and environmental health and safety to the student body, staff, and parent organizations.
School nurses may be employed on a full- or parttime basis depending on the school’s needs, their funding, their size, and their state’s or district’s requirements. Some school nurses may also be employed in private or parochial schools.
School Nurse Career Requirements
State requirements for school nurses vary. Some states have a certification requirement. Others require that their school nurses have bachelor’s degrees while some do not require a bachelor’s degree but do have specific educational requirements. There are some states that require their school nurses to be registered nurses.
There is no special program for school nursing; however, most nursing programs have courses geared to the specialty such as health education, child or adolescent psychology, crisis intervention, community health, and growth and development.
Many school nurses are graduates of practical nursing programs, which involve about one year of classroom instruction and supervised clinical practice, which usually takes place in a hospital.
There are three basic kinds of training programs that you may choose from in order to become a registered nurse: associate’s degree, diploma, and bachelor’s degree. Which of the three training programs to choose depends on your career goals. A bachelor’s degree in nursing is the most popular method, however, as such a degree is required for most supervisory or administrative positions, for jobs in public health agencies, and for admission to graduate nursing programs. Diplomas are offered by three-year programs at schools of nursing and hospitals, and an associate’s degree is obtained from a two-year college.
Certification or Licensing
Both licensed practical nurses and registered nurses must pass an examination after they have completed a state-approved nursing program. This is required by all states and the District of Columbia.
Currently 19 states have certification requirements for school nurses, and five states have certification programs but they are not required in all circumstances. National certification is available through the National Board for Certification of School Nurses.
In addition, some state education agencies set requirements such as nursing experience and competency in specified areas of health and education. Local or regional boards of education may also have certain qualifications that they require of their school nurses.
School nurses must have patience and like working with children and teens. They must also be able to work well with teachers, parents, administrators, and other health personnel. School nurses should be able to work independently since they often work alone.
Exploring School Nurse Career
This is one area of nursing for which you don’t have far to travel to talk to someone in the career; of course, you should visit your own school nurse. Ask about his or her daily responsibilities and workload and how he or she prepared for this line of work. Ask for suggestions on nursing programs and other tips on starting your career.
See if your school or local institution offers first-aid programs to learn some basic emergency medical procedures such as CPR. Another way to gain experience is through volunteer work at a hospital, nursing home, or other medical facility.
School nurses are employed by private and public schools at the elementary, middle, and high school levels.
Many new nurses gain practical experience in a nonschool setting before they apply for employment as a school nurse. Nurses can apply directly to hospitals, nursing homes, and companies and government agencies that hire nurses. Jobs can also be obtained through school placement offices, by signing up with employment agencies specializing in placement of nursing personnel, or through the state employment office. Other sources of jobs include nurses’ associations, professional journals, newspaper want ads, and Internet job sites.
Administrative and supervisory positions in the nursing field go to nurses who have earned at least a bachelor of science degree in nursing. Nurses with many years of experience who are graduates of the diploma program may achieve supervisory positions, but requirements for such promotions have become more difficult in recent years and in many cases require at least the bachelor of science in nursing degree.
Some school nurses may advance to the position of registered school nurse. These professionals manage and oversee health aides employed in the schools.
According to the U.S. Department of Labor, registered nurses had median annual earnings of $52,330 in 2004. Salaries ranged from less than $37,300 to more than $74,760. Licensed practical nurses made a median salary of $33,970 in 2004. The lowest-paid 10 percent made less than $24,480, and the highest paid 10 percent made more than $46,270. School nurses’ salaries may differ from these figures, however.
School nurses’ salaries are determined by several factors—the financial status of the school district, the nurse’s experience, and the scope of duties.
Schools are found in all communities, cities, and rural areas, and learning institutions can vary greatly. School nurses may work in an environment that is a state-of-the- art educational institution in an affluent community, or they may work in a rundown building in the inner city. By the same token, some school nurses may have up-to-date equipment and adequate resources, while others may find that they have restricted funds that inhibit their ability to do their jobs.
School nurses usually work days and may have some time off during the summer months when school is not in session.
The increase in school violence impacts the school nurses’ working environment since it is evident that acts of violence can occur in any institution and in any community. School nurses must be prepared to deal with the physical results of violence in their schools.
School nurses may come in contact with infectious diseases and are often exposed to illnesses and injuries. All nursing careers have some health and disease risks; however, adherence to health and safety guidelines greatly minimizes the chance of contracting infectious diseases such as hepatitis and AIDS.
School Nurse Career Outlook
Nursing specialties will be in great demand in the future. In fact, according to the Bureau of Labor Statistics, Nursing will rank as the second-highest career for growth through 2014. However, according to the National Association of School Nurses, even though school enrollments are projected to increase, school nurse positions are being eliminated in a greater proportion than other positions within the educational system. As educational systems try to find ways to cut costs, professionals such as school nurses may be eliminated. Since cuts may vary by region and state, school nurses should be flexible and willing to relocate or to seek other nursing opportunities, if necessary.