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.
Keeping student health information up to date is an important part of school nursing practice. Knowing your students' current health conditions can help you plan for their needs, identify students who may need an Individualized Healthcare Plan (IHP) or Emergency Action Plan (EAP), and provide appropriate care throughout the school day.
A digital student health history form can provide an easy and organized way for parents and guardians to share updated health information with the school nurse.
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 with an important health update—or had a student casually mention something you didn't previously know?
Those conversations can provide valuable information, but having updated health information documented in writing can make follow-up much easier.
A digital health history form can be shared with families at the beginning of the school year, during registration, when a student enrolls, or anytime a student's health status changes.
If you're using a Google Form, remember to review your notification and response settings so you have a reliable process for knowing when new information has been submitted.
After reviewing a response, follow up with the family as needed to:
Clarify health information
Request additional medical documentation or healthcare provider orders
Discuss school accommodations or supports
Determine whether an IHP, EAP, 504 Plan, or other documentation may be appropriate
Discuss how relevant health information will be communicated to appropriate school staff
Why a Health History Is Important
Accurate student health histories are important. Knowing what to do with that information is even more important.
Digital Health Records
Many schools use electronic student information systems to maintain student records. Determine how health information should be documented within your district's system and whether health conditions can be entered, tracked, and reported.
Taking the time to maintain accurate records throughout the year can make reviewing student needs—and preparing end-of-year reports—much easier.
Health Condition Lists
Many moons ago, I created Excel spreadsheets to track student health concerns because that was the best option I had!
Thankfully, today's student information systems often make this much easier. Depending on your system, you may be able to generate reports by health condition, grade level, graduation year, teacher, or other criteria.
These reports can help you understand the health needs within your school population and provide valuable data when preparing reports for administrators, supervisors, or your school board.
Review each student's individual needs along with your district policies, state requirements, nursing standards, and professional nursing judgment when determining appropriate health planning and documentation.
Emergency Action Plans
Students with health conditions that have the potential to become a medical emergency during the school day may require an Emergency Action Plan (EAP).
The health history can help identify students who need additional follow-up with their parent/guardian and healthcare provider to ensure appropriate emergency plans, orders, medications, and supplies are available at school.
Knowing which medications a student takes can help the school nurse understand the bigger picture of the student's health.
If medication needs to be administered during school hours, follow your state requirements and district policies regarding healthcare provider orders, parent/guardian authorization, medication documentation, and administration.
Nursing Procedures
Health history information may also identify students who require nursing procedures during the school day, such as tube feedings, catheterization, suctioning, dressing changes, or other skilled nursing care.
Follow applicable state requirements, district policies, provider orders, and nursing standards when developing an appropriate plan of care for these students.
One Form Can Be the Starting Point
A student health history form doesn't replace nursing assessment or individualized follow-up. Instead, it gives the school nurse a starting point.
The information families provide can help you identify students who need additional assessment, documentation, healthcare provider orders, emergency planning, accommodations, or other school health support.
And having a consistent system for collecting that information can make the process much more manageable—especially at the beginning of a busy school year.
Looking for an easier way to collect student health information?
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