Healthy Children Learn Better,

School Nurses Make It Happen!

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Helpful School Nurse Tip: Nurses have been working in schools for over a century! And although there have been many changes since then, the goal remains the same. The goal is to keep children in school through health promotion, education, and disease prevention. Remember- Students must be healthy to be educated and educated to be healthy.

What is school nursing?

School nursing as defined by the National Association of School Nurses (NASN) is “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) The vision is that “all students are healthy, safe, and ready to learn” and their mission is to “optimize student health and learning”. It is a big undertaking, but with adequate staff and a team collaboration it is possible. Keeping this definition, mission, and vision it is clear to see why school nurses are needed in schools!

Why are school nurses needed?

Healthy Children Learn Better, School Nurses Make It Happen

Most school nurses have heard the above phrase before and I'm not 100% certain who said it first, so it is difficult to give credit. However, it seems true, right? Healthy children learn better and school nurses make it happen. I bet you're not surprised that over 98% of US children attend school (National Center for Education Statistics, 2019). However, you might be surprised to know that 40% of those children have been diagnosed with a chronic health condition (CDC, 2019). Having a school nurse on campus can help those children attend school safely while remaining in the least restrictive school environment.

Compilation of Some Common Physician Verified Student Health Diagnoses

This chart is just a partial list- Add diagnoses you have dealt with in the school setting in the comment section below. The severity of each health condition is specific to each child. So, the responsibilities and duties of school nurses changes from one semester to the next and one school year to another school year. Regardless, school nurses must be prepared to care for students with mild health conditions to severe, life threatening health conditions (not to mention health emergencies in the school setting too).

Attention Deficit Disorder	Allergies	Anxiety
Asthma	Bleeding Disorders	Brain Defects
Celiac Disease	Cerebral Palsy with Partial Limb Paralysis	Diabetes- Type 1
Gastrointestinal Issues	Gilbert’s Syndrome	Hurler Syndrome
Headaches/Migraines	Autoimmune Hepatitis	Hypothyroidism
Heart Conditions	Rheumatoid Arthritis	Ehlers-Danlos Syndrome
Scoliosis	Seizure Disorders	Vision Impairments- partial and total blindness

How many nurses are employed by your school district?

How many students are at your school? How many schools do you cover?

These are very common questions among school nurses and the answers seem to vary greatly! Using the recommended ratio provided by NASN- is your school overstaffed, understaffed, or perfectly staffed? Please use the comment section to leave your answer and let us know if you're surprised by your answer? If you feel as though your school and/or school district is understaffed then come up with a plan of action on how you can promote school nursing positions and advocate for more nursing staff within the schools of your school district. Keep in mind that the number of nurses needed could change from school year to school year depending on the required health needs of your students.

Having a full-time nurse in every school building is a recommendation by the National Association of School Nurses AND the American Academy of Pediatrics (link in the resource section below). School nurses are capable of caring for student health needs while at school. In addition, (when time allows) school nurses can:

Become certified to screen vision and hearing
Conduct drug testing for your high school athletic department
Teach coaches & other staff/students basic first aid and CPR skills
Support the monthly AED checks
Provide health education lessons and demonstrations in classrooms
Complete health reviews as part of the Special Education IEP team
Collaborate with community professionals to host school wide immunization clinics, physical exams, and dental exams and restorative dental treatment

Benefits of Hiring a Full Time School Nurse

There are countless benefits to hiring a school nurse for every school. Let's list 5 here that were pointed out by the CDC in their School Nurses Help Keep Students Healthy article:

School Nurses can actually save a school district money!
School Nurses may be the first health provider to identify a chronic health condition in a student.
School Nurses can help students manage their chronic health conditions.
School Nurses help protect the health and safety of both students and staff.
School Nurses play an important role during public health crises.

Some people might find it hard to believe that hiring a school nurse could actually save their community money, but it's true. Wang et al (2014) utilized standard cost-benefit analysis methods to estimate the costs and benefits of an essential health services program compared with a scenario involving no school nursing services. They found for every dollar invested in full-time registered nurses, there was a gain of $2.20 for the society. This gain occurred because school nurses and the services they are able to provide offer a "benefit to schools, families, the health care system, and the community at large through increased student attendance, improved teacher and worker productivity, and reduced health care costs." Wang et al (2014)

PS- As you can see, the Wang et al study was completed in 2014- it would be very interested for someone to replicate this study for 2022 and compare the results! Who is looking for a research project?

PSS- Not touched on in this post is Medicaid Reimbursement for schools when nurses perform medication administration and other required and/or prescribed nursing services for students with IEPs who qualify for billing and reimbursement. I will save that detailed topic for it's very own blog post!