How to Become a School Nurse
A school nurse works closely with school administrators to create a learning environment that meets the physical, mental and emotional needs of students. Nurses have been working in schools since the 1800s, when their main job was to identify and quarantine people with communicable diseases. Today their primary responsibility is to provide nursing care and health counseling to students and staff, a community that includes those with chronic illnesses, disabilities and mental health conditions such as ADHD and autism spectrum disorders.
According to federal law, schools must develop individualized education plans that establish learning goals and guarantee appropriate accommodations for students with disabilities. School nurses are the professionals who develop and implement these health plans, dispense medications and show teachers how to administer the necessary care.
School nurses also play an important role in curriculum development. They work with educators to set developmentally appropriate learning standards for health and physical education programs and serve as resources for faculty who are teaching health-related content. As valued members of the educational team, they work in close, collegial relationships with teachers, administrators and community stakeholders to improve learning and increase access to counseling and health care services. Because students in emotional distress often present with complaints of illness, nurses are in a unique position to note patterns of conflict and other stressors that impact school life. Often, they initiate or participate in the creation of anti-bullying campaigns and other programs that promote students’ social and emotional well-being.
School nurses serve as health care leaders within their communities. They are important resources not only for students but also for parents, administrators and community leaders. They enjoy frequent, meaningful contact with students and families that often develops into close, caring relationships. A career as a school nurse provides the rare opportunity to serve the individual student as well as the community at large as both caretaker and consultant.
School nurses practice at public, private, vocational, alternative and early childhood schools across the United States. Some practice overseas at international schools or Department of Defense schools located on US military bases.
Nurses spend most of the workday in school health offices. Depending on funding, these may be spacious and well-equipped or cramped and understocked. School nurses also move about campus to assist students, attend meetings, give presentations and observe learning. They occasionally meet outside the school setting with health care providers, public health professionals, politicians and parent groups.
Some school nursing positions require frequent travel among schools. Only 45% of public schools had a dedicated, full-time nurse in 2011. Due to funding cuts, more and more nurses are covering several public schools within a district. Most school nurses work regular, daytime hours. In some districts, they enjoy the same summer and holiday vacations as students and faculty.
While some schools still employ licensed practical nurses, the National Association of School Nurses (NASN) recommends a four-year bachelor’s degree (BSN) and registered nurse (RN) certification as the minimum standard. Each state board of nursing maintains a list of approved RN training programs. Nursing education covers classroom instruction in the life and social sciences as well as extended clinical experience in a variety of health care settings.
Most schools prefer to hire nurses with at least two years of experience in an acute care setting.
Licensure of registered nurse is mandatory in all states. While standards vary, candidates must usually hold a degree from an approved training program and pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN). Additional training and background checks may be required in some states.
School nurses may pursue voluntary national certification, which is jointly administered by NASN and the National Board for Certification of School Nurses. Candidates must meet education and experience requirements and pass an exam.
Necessary Skills and Qualities
School nurses must possess a broad knowledge base that covers pediatric, public health and mental health nursing as well as school law and policy. Leadership qualities and the ability to work both independently and collaboratively help these professionals to manage health programs effectively and advocate for needed change. Candidates should have strong interpersonal skills and enjoy working with children, teens, family members, educators and administrators of diverse backgrounds.
Opportunities for Advancement
Experienced school nurses may advance to positions of greater responsibility in which they coordinate school health programs at the district or state level. Others go on to work for public health agencies. Nurses who hold a doctorate may conduct research in the field of school nursing or teach classes at the university level.
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School nurses enjoy competitive salaries and benefits as well as flexible hours. The average annual salary for a school nurse is $43,856. Some of these professionals supplement their income by working temporary positions during the summer months.
According to the US Bureau of Labor Statistics, employment of registered nurses (including school nurses) is expected to grow by 26% between 2010 and 2020—faster than the average for all occupations. However, federal accountability legislation, which emphasizes math and reading achievement on standardized tests, has led many districts to divert resources away from health programs. Many schools are therefore consolidating or eliminating school nurse positions due to budget concerns. On a more positive note, school nurses whose positions are cut will find ample opportunities for their talents elsewhere.