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Why do we need school nurses?

School nurses save lives, increase student attendance and decrease early dismissals. Here's what school nurses do. They:

  • are the first line of defense against epidemics and disease outbreaks, monitoring the health of the overall population and connecting with public health officials;
  • are the first responders to critical incidents on school property;
  • provide direct health services for students;
  • identify threats to health in the school community (peanut butter, dogs, traffic, broken equipment and facilities, bullies, lack of clean water or hand soap) and work to elimate those problems as a cause of ill health;
  • provide leadership for the provision of health services, health policies and programs;
  • provide a critical safety net for the most fragile students;
  • provide screening and referral for health conditions such as vision, hearing;
  • promote a healthy school environment;
  • enable children with chronic health conditions to attend school;
  • promote student health and learning;
  • serve as a liaison between school personnel, family, community, and health care providers.


Important information from the National Association of School Nurses:

"The Role of the School Nurse"

School nursing services in the U.S.: Where are we? Where do we need to go? (ppt)

Student-to-School Nurse Ratio Improvement Bills

NASN Radio

RWJF Charting Nursing's Future on School Nurses

Many others

Also see:

"Unlocking the Potential of School Nursing: Keeping Children Healthy, In School, and Ready to Learn," by the Robert Wood Johnson Foundation.

See some of our analyses on school nurses:


Little voices

Why every school needs a full-time registered nurse

school nurse 1903May 19, 2014 -- Over the past year, news items have continued to highlight the importance of school nurses to the health and education of U.S. children, often with a focus on reversing the widespread staffing cuts that threaten students. On August 20, 2013, the Associated Press put out a good general overview by Carolyn Thompson. That piece gave readers a sense of how school nurses help ensure that the next generation is healthy enough to learn. It discussed the independence required of school nurses and the great range of duties involved, including annual health screenings, counseling and mental health services, and chronic care for conditions like diabetes and ADHD, ending with a note about pending federal legislation that would help schools get closer to safe nurse-to-student ratios. On October 18, 2013, Salon published a long, powerful piece by Jeff Bryant about cuts in school nurse staffing. In particular, Bryant pointed to the death of Philadelphia 6th-grader Laporshia Massey from an asthma attack, a tragic event that is hardly an outlier. Bryant argued forcefully that the prevailing political environment has often meant a short-sighted focus on adding security guards at the expense of health and social services, resulting in the criminalization of relatively minor student misconduct. And today, Reuters ran an excellent report by Genevra Pittman on a new study in JAMA Pediatrics by researchers at the Centers for Disease Control finding that a Massachusetts program placing RNs in schools had "more than paid for itself by averting medical costs and lost work for parents and teachers." The study authors noted that the actual savings were likely much greater, since averted emergency department visits and hospital admissions were not considered. We thank all those responsible for these pieces, which provide more compelling arguments for ensuring that all schools have nurses available to protect the nation's children. more...


Crucial, but not consulted

Nurse vaccinating childSeptember 2, 2009 -- Today the New York Daily News published a very good report by Juan Gonzalez about the reaction of New York City school nurses to the city's plan to vaccinate elementary students for H1N1 flu in the fall and winter. The article includes substantial comment from local nursing union leader Judith Arroyo. She reportedly liked much of the plan but urged the city to consider having special traveling teams perform the vaccinations, in order to avoid overwhelming school nurses who already have their hands full with their usual case load. The piece might have noted that the critical shortage of school nurses will likely make the situation even harder. But the piece does give a good sense of the role school nurses will play in the city's flu plans. And perhaps the best part of the report is Gonzalez's pointed statement that "the front-line nurses--who were not consulted by the city--will be crucial this fall and winter to containing the epidemic and keeping schools open." We thank Gonzalez and the Daily News. more...


Always remember to help ladies on with their coats!

June 29, 2009 -- Tonight's episode of Showtime's Nurse Jackie highlights the expert psychosocial care Jackie Peyton and her nurse colleague Mohammed (Mo-Mo) de la Cruz give to ED patients and families. ... At the same time, the episode features a remarkable scene in which a school nurse goes head to head with Jackie about whether Jackie's daughter has a potentially serious anxiety disorder that may require medication; both of them seem to have valid points. ... This fourth episode, "School Nurse," was written by Christine Zander. more...


Take Action!

Post-Its and other priorities

July 9, 2009 -- In the June 4, 2009 premiere of USA Network's new hit summer drama Royal Pains, the brilliant and heroic physician character Hank Lawson was fired and blackballed by a New York City hospital for treating all patients equally. Afterwards, Hank lamented that he could not even find a job as a school nurse! (See the Quicktime clips at broadband or dialup speed.) The message for the episode's 5.6 million viewers was that there could not be a more trivial and unskilled job for a health worker than that of school nurses, who presumably spend their days placing band-aids on scraped knees. But in fact Hank could not get a job as a school nurse because he has not spent years in nursing school, has no nursing license, and knows little about nursing. While the contempt in this episode continues to infect the mass media, it's no surprise that real school nurses struggle for the resources they need to save lives and improve student health. Ryan Blackburn's May 8, 2009 story in the Athens Banner-Herald (GA) explained that school nurses manage chronic health issues like allergies, diabetes, and seizures so students can continue learning. Anemona Hartocollis's April 28 New York Times article described the work of New York City school nurse Mary Pappas. She became "a sort of folk hero to nurses" for setting in motion the governmental response to the October swine flu outbreak, identifying and managing hundreds of students' symptoms in a way that might even impress Hank Lawson out in the Hamptons! And today the Associated Press ran an excellent item by Lauran Neergaard about Pappas's "riveting" performance at the Obama Administration's swine flu summit. There the nurse explained how she handled the huge triage challenge in October, and her plans for the coming flu season, offering this pointed advice to the government: "Every school needs a nurse." Kris Sherman's March 8 article in the News Tribune (Tacoma, WA) offered a tragic example of what happened in that same October at a local school with no nurse:   A fifth-grader died from a massive asthma attack, even though she was taken to a school health room where materials were reserved specifically to save her life. No one with significant health training was there to use them. These recent press pieces paint a picture of a vital professional specialty worthy of more than the undervaluation that has strained its members beyond the breaking point--and that continues to take our children's lives. We urge everyone to help change that situation. Join the National Association of School Nurses in the effort to pass the student to school ratio improvement act and ask your organization to join their list of supporters. more...and take action to support school nurses!


Salon: "No school nurses left behind"

September 29, 2005 -- Today Salon posted a lengthy, generally good piece by Laurie Udesky about the denursification of U.S. public schools, which has come at a time when the number of children attending with serious, chronic health issues like asthma continues to grow. Udesky's story includes harrowing anecdotes illustrating the "often tragic results" as non-nurse school workers try to care for sick children. Part of the problem, Udesky reports, is the tremendous financial pressures that the No Child Left Behind program and local budget demands have placed on public schools. The piece might have focused more on the views and experiences of the nurses themselves, but it still provides a good sense of the value of nurses and the gravity of the problem. more...


"If there's ever an emergency, don't even bother trying to find me -- just call 911"

                                         -- A school nurse responsible for 7,200 students

December 13, 2005 -- Today USA Today ran a massive and influential report on the shortage of school nurses, including a very good main story and five shorter related pieces. The main ideas are that U.S. school nurses are vital but severely understaffed, and that given the serious health issues today's students confront, their health is at risk. The report covers much of the same ground as Laurie Udesky's Golden Lamp Award-winning September 2005 piece in Salon, even using some of the same anecdotes. The earlier article seems likely to have been a strong influence on this one. But the USA Today piece, while less probing in some ways, surpasses the earlier one in giving readers a better sense of what it's like to be a school nurse confronting this short-staffing, and in showing the different ways school nurses affect patient outcomes. The new report appears to have led to recent coverage by NBC's "Today Show" and other prominent news entities. We commend authors Bruce Horovitz and Kevin McCoy, contributors Paul Overberg, Tom Ankner, and Bruce Rosenstein, and USA Today for bringing these important issues to a broader public. more...


Playground scrapes, tummy aches, and terrorist attacks

AP logoFebruary 21, 2005 -- Today the New York Times ran an AP story by Joe Milicia under the headline "School Nurses Want More Terror Preparation." The relatively brief piece does a good job of stressing the importance of school nurses as first responders to potential terrorist attacks in the post-9/11 era, even as many of the nurses now face serious short-staffing and a lack of resources. However, even though the piece actually mentions "lack of respect" as a barrier to school nurses getting training, a few of its elements may subtly reinforce regressive stereotypes about the nurses' work. In fact, school nurses provide vital preventative and other care, as students attend with more serious chronic conditions and less access to other care. more...


"I'm here full time, thank you God for that"

September 2, 2005 -- Today the MetroWest Daily News (Framingham, MA) ran a short but very good piece by Norman Miller about local school nurse Mary Lou Rivernider, who saved a six-year-old student's life after he had a severe reaction to a bee sting. The story, "School nurse praised for quick thinking," does not just offer the standard "hero" comments. Instead, in an era in which school nurses have been cut back despite the increasing complexity and importance of their care, the piece includes powerful quotes from Rivernider and a fire lieutenant that stress how critical it is that nurses be available at school. The article, unlike many, tells us several of the specific things Rivernider did for the boy. And we can't resist any piece whose headline includes the words "nurse" and "thinking." more...


Crazy school kids insist on staying alive, Part I

February 22, 2004 -- Today the Boston Globe published a powerful letter from 10-year-old Anthony J. Delmonaco protesting the plan of Massachusetts Governor Mitt Romney to cut the state's school-based health program, which would reportedly mean layoffs of hundreds of school nurses. more...


Crazy school kids insist on staying alive, Part II

February 24, 2004 -- Today the Boston Globe published a very effective editorial opposing the plan of Massachusetts Governor Mitt Romney to cut the state's school-based health program, which would reportedly mean layoffs of hundreds of school nurses. more...


Quick! To the Breathmobile!

August 16, 2006 -- Today WYPR, the Baltimore National Public Radio affiliate, had a very good report by Taunya English about the Breathmobile. The Breathmobile is a nurse-staffed "asthma and allergy clinic on wheels" that visits the city's elementary schools. The piece relies on audio quotes from two nurses. It explains how valuable the program is in keeping asthmatic kids in school and out of the ED. The report might have briefly explored the relation of the Breathmobile to school nurses. To what extent could school nurses help these kids manage their asthma if they weren't so short-staffed? But the piece does bring out important specifics about the clinic nurses' holistic care. We commend Ms. English and WYPR. more...


Baltimore Sun teaches readers about today's school nurses

May 12, 2003 -- Today's Baltimore Sun includes a generally helpful article by Jonathan Rockoff, "Tending bruises and deeper ills," about how much more complex the work of the United States' 58,000 school nurses has become in recent years. The piece is built around profiles of several busy Baltimore school nurses, who now handle everything from headaches and muscle pulls to asthma, diabetes, pregnancy, drug abuse, domestic abuse, rape and psychiatric problems. Sharon Hall, RN, a profiled nurse who works at Baltimore County's largest high school, notes that her office is sometimes like a clinic, other times like an ER. more...

Also see the following articles:

"Another Philadelphia student dies at a public school with no nurse" by Trymaine Lee for MSNBC. May 22, 2014

"A Day with a School Nurse" by Chris Gullick for the Chico Enterprise Record.

"Minnesota School Nurses Are In Short Supply" by Emily Johns for the Star Tribune. .

"Bay State Schools Experiencing Nurse Shortage" for The Boston Channel - WCVB 5. .

"Education Advocates Call for Better School Health Care" by Whitney Jackson for Medill Reports. .

"Managing Asthma" by Casey Bortnick for Capital News 9.

"Schools Unite to Duel Diabetes" by Jessica Jordan for The Gainesville Times.


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