What is a School Nurse?
A Registered Nurse (RN) who works with school children (and their families) and school staff to help keep children as healthy as possible so that they can learn as much as possible.
Does that mean we can’t hire a Licensed Practical Nurse (LPN)?
No, but Tennessee state law requires that an LPN be supervised by an RN, MD, or DDS, so LPNs can’t be the only health staff that you hire. In many school districts, LPNs work with RNs as part of the school health team.
Who hires these Nurses?
In some states or locations, school systems hire the Nurses. In others, Department of Health of other agencies supply the School Nurses and have some type of contractual arrangement with the school system. Legal issues such as medical malpractice insurance coverage, need for protocols or standing orders, and access to consultants or other health care staff may enter into this decision.
We already have a Nurse. She teaches the health Science Ed course at our school. We’re okay, aren’t we?
No. This Nurse has a job teaching students in a set curriculum. She is not available for another full-time set of responsibilities which could interrupt her classes.
We have volunteer parents in our health room. Why do we need a nurse?
Congratulations for having volunteer help! School Nurses do not replace those parents but work with them and supply more extensive services than the parents can provide. Health Room parents usually stay in the Health Room and provide help with tummy aches and minor health problems. School nurses work throughout the school, make home visits, teach classes to students and staff, carry our complex health procedures, and a whole lot more.
All of our kids have their own doctors. We don’t need a Nurse, do we?
All schools – their children and staff – need a Registered Nurse. Doctors usually work in their offices and School Nurses work in the schools, providing two different types of health care. School Nurses work closely with your students’ doctors, especially in the case of children with special health needs.
We have a rescue squad next door to the school. Do we need a School Nurse?
Yes, you do. Rescue squads respond to life and death emergencies. They are not in the business of preventing emergencies through planning for and assessing your students’ health needs. They do not do preventative health teaching. They do not get to know individual children and families. School Nurses can take care of most health issues in a school. Save the rescue squad for 911 calls.
I heard that the only schools that need School Nurses the ones with special education students. Is this true?
No. All schools need School Nurses. All schools have children with special health problems such as asthma, diabetes, seizures, or serious allergies. All schools have teachers who can use help with certain health education topics. All schools could use assistance with access to health care and health resources for their students, families, and staff.
All the attention goes to the kids. What about us poor stressed out principals and teachers?
School Nurses are as concerned about you as they are about the children. Whether it is checking blood pressure regularly, running stress management courses, weight loss, or smoking cessation groups, or educating teachers how to protect themselves with correct lifting techniques or Universal Precautions, School Nurses have a stake in protecting the health of school staff. After all, if you aren’t healthy, you aren’t able to teach as well or be a good role model for your students.
Okay, you’ve convinced me. How many school nurses do we need?
The new state law, adopted in May 1996, states that there must be at least one full-time Registered Nurse for every 3000 students or one for each district if the district is smaller than 3000 students. A ten year old state program suggests a ratio of 1:1500. National Standards for School Nurses recommend 1:750 for a general school population to a ratio of 1:125 for a population with children with major handicapping conditions and/or significant health care procedures. Each school district needs to look at the location of its schools and placement of children with special health problems and health care procedures, as well as other factors when deciding how many nurses to hire.
Now, how can I convince my School Board?
Share some facts with them and point out potential costs averted, dollars to be gained, public relations improvements, and potential for better school performance via this investment:
- School nurses can teach CPR to school staff
- They can monitor blood pressure for staff and help keep staff blood pressure in control so that there are fewer sick days.
- School Nurses can do home visits for incoming students with serious health problems, for children who have been out for three weeks with head lice, and for children with repeated or prolonged “illness” absences. Remember, better ADA’s mean better dollars.
- School Nurses can help improve immunization levels before you get audited
- They can provide on-the-spot advice about typical school health problems such as ringworm, impetigo, pinworms, scabies, and chicken pox and decrease the likelihood for spread of these diseases.
- School Nurses are able to teach the puberty classes of your Family Life curriculum and to assist with the AIDS curriculum.
- They will help you comply with the OSHA Blood Borne Pathogen’s regulations.
- School Nurses work with local Emergency Medical Services to plan ahead for children with potentially life-threatening problems.
- School Nurse programs are a high priority of the national PTA, the American Academy of Pediatrics, and other health and education groups. SACS accreditation looks for evidence of school health services and programs.
- Nurse means “to nurture,” and all of us in this high stress world need more nurturing.
Where can I find out more?
From the Tennessee Nurses Association – the professional association for Registered Nurses in Tennessee – whose mission is to promote and protect the registered nurse and to advance the practice of nursing in order to insure a healthier Tennessee. Contact us!
Information excerpted from the State Department of Education and State Department of Health Guidelines for Health Care Procedures in Schools and the National Association of School Nurses.