Helpful School Nurse Tip: Did you know school nursing began as an experiment? One nurse. Over 8,600 students. A 90% reduction in absenteeism. Read the remarkable story of how Lillian Wald helped shape the profession we know today.
How did it become that a nurse was needed to work in the school setting so many years ago?
Lillian Wald was a public health nurse who believed healthcare should reach people where they lived, learned, and worked. Through the Henry Street Settlement in New York City, she focused on prevention, health education, and improving the well-being of underserved families.
As schools became recognized as important centers of community life, Wald saw an opportunity to improve children's health by bringing nursing directly into the school setting. She advocated for hiring Lina Rogers, who became New York City's first school nurse in 1902.
The results were remarkable. During the first year of the program, student absenteeism dropped by nearly 90%, proving that school nurses could make a meaningful difference in both student health and school attendance. Because of the program's success, New York City quickly expanded school nursing services.
More than 120 years later, Wald's vision continues to shape our profession. School nurses still promote health, remove barriers to learning, and help students stay healthy, in school, and ready to learn.
the history of school nursing
School Nursing Started As An Experiment
It's hard to imagine today, but school nursing began with a simple experiment.
In 1902, New York City hired one school nurse, Lina Rogers, to care for 8,671 students in four public schools. Lillian Wald believed that many children were missing school because of preventable or manageable health concerns, and she wanted to see if having a nurse in the schools could make a difference.
The nurse's responsibilities were straightforward:
Assess students who became ill or injured at school.
Exclude students when necessary to help prevent the spread of illness.
Follow up with families to make sure students received the care they needed.
Help students return to school as soon as it was safe to do so.
The results exceeded everyone's expectations.
Within just one school year, student absenteeism decreased by nearly 90%. The experiment was so successful that New York City quickly hired 25 additional school nurses, forever changing the future of school health services.
More than 120 years later, our responsibilities have expanded tremendously. Today's school nurses manage chronic health conditions, respond to emergencies, support student mental health, coordinate care, promote public health, and collaborate with families, educators, and healthcare providers.
But the heart of our profession hasn't changed.
We're still helping students stay healthy, in school, and ready to learn.
Helpful School Nurse Tip: Did you know that school nurses are responsible for making sure their students have met the compliance for the health requirements required by their state?
What health forms are required for school?
One of your first responsibilities as a school nurse will be collecting, reviewing, and tracking your students' required health forms. Depending on your state, these may include physical examinations, immunization records, vision and hearing screenings, dental examinations, sports physicals, and other required documentation.
At first, it can feel like a lot.
The good news? Every experienced school nurse has learned this process one step at a time—and you will too.
One of the first things I recommend is becoming familiar with your state's school health requirements. Every state has different laws, forms, deadlines, and exclusion requirements, so it's important to know what applies where you work.
A great place to begin is with your:
State Department of Health
State Department of Education
State School Nurse Organization
School district's health services handbook or procedures
Most of the required health forms are completed by a licensed healthcare provider before being submitted to the school. But why are these records so important?
History of School Health Forms
Since the early days of school nursing, one of our responsibilities has been helping ensure students are healthy, safe, and ready to learn. Collecting and reviewing required health forms may not be the most exciting part of the job, but it's one of the most important.
These records help identify students with chronic health conditions, verify required screenings and immunizations, and ensure students receive the care and accommodations they need throughout the school year.
Why are health forms required for school?
Parents and students often ask why these forms are necessary.
The short answer is simple: they help protect both individual students and the entire school community.
State laws and local school policies establish health requirements to help prevent the spread of communicable diseases, identify health concerns early, and ensure students are healthy enough to participate safely in school activities.
These requirements also provide school nurses with the information they need to plan care, coordinate services, and respond appropriately when health concerns arise.
Handling Non-Compliance
If families don't submit required forms, it's important to have a clear follow-up process. This might include reminder letters, phone calls, or working with school administrators to ensure compliance.
Always follow your district's procedures, as requirements and exclusion policies vary from state to state. Taking time to understand your school's expectations early in the year will help make the process much smoother.
Staying Organized with Required School Health Forms
Find out your state’s specific requirements and create a plan to track compliance. For me, that means using a Google Sheet alongside Skyward reports. I also keep non-compliant health charts in a labeled plastic banker’s box for quick access.
What works for one nurse might not work for another—try different systems until you find what fits your style and your school’s needs. Pre-COVID, I consistently reached 100% compliance; the pandemic has complicated things, but persistence is key.
Remember to protect student health information by following HIPAA and FERPA guidelines. Keep records secure and only share health information with authorized staff or parents.
Tip for Efficiency
One of the biggest time-savers I've discovered is using Google Email Templates for routine communication with families. Instead of writing the same emails over and over again, I simply customize a saved template and send it.
Collaboration Is Key
You don't have to do it all yourself.
Building strong relationships with your office staff, administrators, attendance team, counselors, teachers, and families can make collecting health forms much easier. School nursing is truly a team effort, and working together often leads to better outcomes for everyone.
New to School Nursing?
If you're just getting started, this article is actually one chapter in a much bigger picture.
The Ten Hot Topics: New School Nurse Guide brings together ten of the most common topics new school nurses encounter during their first year, including:
✔ Student health requirements
✔ Office visits
✔ Medications
✔ Communication
✔ Health screenings
✔ Organization
✔ Emergencies
✔ Special services
…and more.
Instead of searching for answers one topic at a time, you'll have practical guidance and direct links to additional resources all in one place.
Each state has rules listing the minimum health requirements students must meet in order to attend school.Try searching your state + school health requirements to locate your specific state school health requirements.
Helpful School Nurse Tips: Knowing the health conditions of your students will prepare you to be able to provide appropriate care for all of your students. In addition, you can use this information to calculate the % of your students who have chronic health conditions, create Individualized Healthcare Plans, and other health related Action Plans.
Health History Purpose
The purpose of this digital student health history form is to provide an easier, yet formal way, for the school nurse to gather (collect data) on medical conditions for current students. Although this digital form is 100% editable, it currently offers parents a way to inform the nurse of the following:
Current health concerns
Explanation of the health concern
Description of how the health concerns impacts the student's school day
Requested accommodations the might benefit the student throughout the school day
Doctor contact information
As you can see, this digital health history form provides parents a chance to subjectively provide the school nurse with an overview of their child's current health conditions. The school nurse can then ask for needed / required follow up information from the student's parents and/or physician.
How To Collect A Student Health History
Have you ever had a parent call you with an update or have a child give you a verbal update? Those are great, but usually you prefer to have something is writing too. This digital student health history is a great initial data collection tool. Use this form within a follow up email - just make sure your Google settings are set so you receive notification when the form is completed. Follow up emails give you a chance to recap information from the conversation, review discussed accommodations, ask permission to share information with staff on a need to know basis, and ask any questions that you might have thought of since the conversation.
Why A Health History Is Important
Accurate student health histories are great!
Knowing what to do with the information from those health histories is even better!
Digital Health Records-Many schools use some sort of digital school management software; such as Skyward, SASI, PowerSchool etc. What program does your school us? IS there is a way to incorporate health history information into your school management software system? If so, use it :) It might seems time consuming at the moment, but you will save time in the long run.
Health Conditions Lists- Many moons ago, I used to create Excel Health Concern lists- this was my only option at the time and so it worked for me. I would create a column filled spreadsheet and sort and organize as needed! Thankfully now, I can use my school's school management software (Skyward) to organize this same information! Skyward allows the ability to add health concern information as a "Health Condition". Then, "Health Condition" reports can be created by grade level, graduation year, teacher, etc. These reports also provide an overall school summary including the number of students with each health condition. This information is very valuable for your end of the year (EOY) report for your school administration, school board, and/or supervisor.
Healthcare Plans- Use the gathered health history information to create individualized healthcare plans for your students. There are many FREE and paid examples of healthcare plans all over the Internet- just Google what you are looking for. Maybe you don't think you have enough time to create a healthcare plan for every student who might need one- that is OKAY! You can always create a generic plan to put in place for specific health conditions- asthma, seizures, food allergies etc. Then, you can decide which students need their own specific emergency action plans from their private physicians and use your time to encourage parents to provide those completed emergency plans to you.
Emergency Action Plans- Emergency Action Plans (EAP) are needed for students with known acute or chronic health conditions which have the potential to turn into a medical emergency while attending school or a school sponsored even and/or the health condition has the potential to negatively impact the student's learning process. There are many free and paid examples available online- again, just search what you are looking for many examples should appear.
Medication Forms- Knowing what medications a student is prescribed is nice to know. This knowledge can help you see the "bigger" picture. Many times students only take medication at home, but sometimes at school too. If medication is needed during school hours, then most districts require a physician's order and sometimes even have a specific form that needs to be completed. You can view medication form examples HERE. If a specific medication is included on an EAP then a separate medication form is typically not required.
Procedure Forms- As you filter through your student health history forms, you might find that a student requires a nursing procedure completed during school hours. These procedures might consist of: dressing change, g-tube feed, suctioning, catheterization, etc. Just like a doctor's order is required to administer medications in the school setting, a doctor's order should be on file in order for the nurse to complete any sort of nursing procedure in the school setting. Years ago in Illinois there was a "yellow manual" full of nursing procedures that may need to be completed in the school setting. I don't remember who published the manual and I don't have it available at the moment, but I will update this blog post if I find it! In the meantime complete an Internet search and I'm certain many examples will be available.
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