Quick Facts :
School Nurses


Bureau of Labor Statistics, Registered Nurses, May 2017

info-icon Bachelor's Degree
info-icon $48,506 Annual Wage
info-icon 15% Job Growth
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The Importance of School Nurses

The original role of the school nurse was to routinely check students for illness and determine their potential for having a contagious condition that required immediate treatment and isolation from other students. After the invention and widespread implementation of vaccines and antibiotics, the role of the school nurse evolved. While concerns over communicable diseases have largely abated, today’s school nurse encounters a variety of issues that nurses in the earliest days of the profession could not have foreseen – or understood.

Although today’s children possess conveniences very different from those in the earliest days of education in the United States, in many ways, their lives are more stressful. Schools require skilled nurses to manage students with mental health issues, behavioral problems, chronic illness, learning disabilities, and other common conditions. Because of its focus on a particular population and the skill set required to work in this field, the nursing industry as a whole recognizes school nursing as an area of specialty practice.

What Does a School Nurse Do?

Typically, those who become qualified as school nurses go on to specialize, so they can work specifically with students in elementary, middle, or high school. Additional specialty areas include:

  • Early childhood intervention programs
  • Learning disabilities such as dyslexia
  • Physical or emotional challenges
  • High-risk behavior in children

Most states require that a school nurse acquire and maintain certification through the state’s Department of Health or the Department of Education. Certification at the federal level is available but is not universally required. This option is offered by the National Board for Certification of School Nurses (NBCSN).

School Nurse Roles and Functions

The school nurse fulfills many duties, but his or her primary role is to ensure that all students, regardless of background or ability, receive equal education opportunities. Equality in education can be achieved only when students are physically and emotionally well. They must receive any necessary accommodations and attend school in a safe learning environment. The specific tasks of a school nurse include:

  • Ability to assess injuries and illness and respond with appropriate intervention methods.
  • Become part of the educational team that designs an Individualized Education Plan (IEP) for students with disabilities.
  • Assist students with feeding disabilities by completing gastrostomy tube feedings, catheterization, and tracheostomy care.
  • Conduct vision and hearing screenings as well as other routine health checks.
  • Discuss the prevention of pregnancy and sexually transmitted diseases with older students and implement prevention programs.
  • Create strategies to prevent tobacco, alcohol, and illegal drug use by students.
  • Find resources for students in crisis.
  • Help students manage chronic diseases by teaching them self-care skills.
  • Administer medication.
  • Work with the principal and teachers to create the health education curriculum.
  • Act as the point of contact for parents and the community for health-related concerns.

The school nurse works in a variety of educational settings throughout the United States and on overseas U.S. military bases. In addition to public and private preschools and K-12 schools, colleges, universities, hospitals, and public health agencies also have school nurses on staff.

Steps to Become a School Nurse

The school nurse plays an invaluable role within the education setting. School nurses work closely with teachers, administrators, and parents to accommodate the mental and physical health needs of the student population. School nurses counsel students and staff in an effort to stop the spread of illnesses and diseases, raise awareness about important conditions that affect the school community, and promote healthy working conditions on the school grounds. School nurses also serve as a resource for teachers and administrators who need information about health-related topics. These leaders among school staff help promote good health for students, teachers, administrators, and all the other members of the school community.

Because the nurse plays such an integral role in the school, school nurses must be able to work with a variety of people. School nursing training focuses on improving communication skills, developing organizational skills, performing clinical work, making presentations, and learning the correct methods for teaching health-related lessons to students. Nurses must be self-motivated and dedicated. In addition, they must be able to commit to continuing their education throughout the course of their careers.

A school nurse must undergo extensive training to gain the necessary background to be able to act with confidence. In their position, school nurses usually work independently; therefore, it’s essential that their training prepares them to act as the single resource for an entire student population.

1. Earn Your Bachelor of Science in Nursing (BSN)

The BSN degree is designed to give future school nurses a thorough understanding of the fundamentals of nursing. The core curriculum for a BSN degree spans a range of topics, including caring for populations throughout their lifespan, from newborn through pediatric to adult nursing care. Student nurses often also study psychiatric and gerontological nursing. A nursing degree requires courses in anatomy, microbiology, public health, nutrition, pharmacology, mental health, pathophysiology, and other foundational topics.

Students learn the principles and theories of nursing and how to apply that theoretical knowledge to a range of different scenarios, with patients of different backgrounds. Nursing students are also taught to collaborate and communicate with colleagues and other professionals to help patients meet their healthcare goals. They learn critical-thinking skills and how to analyze and interpret published research to apply the conclusions in a hands-on manner to their patients.

During the BSN course, not only does the student gain knowledge in theoretical-based topics, but also in evidence-based skills. Students receive real-world clinical training, during which they apply their knowledge, gain experience, and see firsthand the full spectrum of what their chosen profession involves.

In addition to this core curriculum, nurses are exposed to a range of innovations in technology that help advance their practice. The nursing science curriculum is typically accompanied with training in computer science to ensure nurses can use the technology required in modern-day nursing to help treat patients. Upon graduation, students sit for the National Council Licensure Examination, which is also known as the NCLEX-RN.

2. Pass the National Council Licensure Examination

All registered nurses seeking employment in the United States must first pass the NCLEX-RN exam, a computerized test that’s scored by the National Council of State Boards of Nursing (NCSBN). To help protect the public in health care settings, the examination contains questions that test nursing candidates to ensure they have received the training and possess the skill set necessary to become a successful school nurse.

Before taking the NCLEX exam, students must first apply for a nursing license from the board of nursing in their home state. Only students who meet the criteria for state licensure can take the NCLEX examination. After applying for the license and receiving the examination test information, the student is eligible to register for the exam.

The NCLEX-RN exam selects questions based on how each individual test-taker answers the questions, so the scores are based on predetermined standards, not on the abilities of others who also have taken the test. The exam focuses on the critical-thinking skills that help nurses perform better in the workplace and in healthcare settings.

The test incorporates questions that test the candidate in patient management, basic care and comfort, prevention and early detection of disease, growth, and development, infection control, safety, pharmacological topics, and others.

A minimum of 1,000 hours of clinical experience or a total of three years of full-time academic experience is required to become eligible to seek certification as a school nurse. The experience helps nurses acquire the background necessary to perform independently in a school setting. A registered nurse with a bachelor of science degree who passes the national exam may practice in a variety of settings, from hospitals to doctors’ offices. After achieving this milestone, the candidate must pass the certification exam.

3. Pass the School Nurse Certification Exam

The School Nurse Certification Exam, which is administered by the National Board for Certification of School Nurses, is a multiple-choice, 250-question exam. Test-takers are given four hours to complete the exam. The purpose of the test is to measure a nurse’s understanding of the type of health concerns typically encountered in a school setting and in the interventions that help keep student populations healthy. Nurses are also tested on their understanding of the types of ethical issues unique to this type of setting.

To prepare for the exam, nurses may form study groups, review textbooks, and attend workshops. For each sitting, the exam questions are compiled from a variety of different topics, so the exam is always different. Nurses must retake it every few years to maintain certification, depending upon the state in which they reside. Additionally, school nurses are required to complete a set number of hours of continuing education, the number of which varies by state as well.

This exam helps prepare nurses for the many challenges they will experience as school nurses. It also ensures that nurses who get jobs in schools are qualified to meet the requirements of their position.

4. Enter the Workforce/Search for Jobs

Once the student has passed the exam, the newly certified school nurse must find a job.

The criteria that may qualify a candidate for an entry-level position vary from one state and county to the next and even between one school and the next. Jobs are typically made available through the school district or local public health department. Typically, private schools hire their nurse directly through the school. In some cases, a nurse will be assigned to multiple schools, and they may supervise health aides who work full-time in each individual school.

School nurses are responsible for implementing their own multi-disciplinary approach to health care within their school. To achieve these goals, a school nurse must be self-motivated, organized, a critical thinker, and a problem-solver. Working independently is important for school nurses. Primary duties include:

  • Wellness counseling
  • Emergency management
  • Sex education
  • Communicable disease management
  • Illness assessment
  • Preventative healthcare

Nurses also must work closely with students, parents, teachers, and administrators to promote good health and increase awareness of important issues at the school. In addition, nurses are expected to maintain and organize accurate health records. To obtain a job, a nurse must be able to demonstrate skills in these areas and discuss his or her unique strengths that are applicable to the position.

A newly certified school nurse who is seeking a position should research districts in which he or she would like to work. Geography, commute, community compatibility, and job availability are all factors that may influence the decision to apply for a position.

Many nurses find that one good way to gain experience and develop a good reputation is to apply for work as a school nurse substitute. This experience helps school nurses adapt to school culture and the responsibilities of a school nursing position.

School nurses must understand that the role of a school nurse encompasses not one, but two fields: health care and education. The candidates who stand out during a job interview are those who can speak knowledgeably about their experience in both areas. Before going into a school district for the first time, nurse candidates should familiarize themselves with the nursing requirements of that specific district. Nurses who can speak knowledgeably about educational outcomes and who can demonstrate their ability to present lessons to small groups will have an edge over candidates who focus exclusively on health care.

School nurses must also have the ability to work inside and outside the school nurse office to help students. Nurses should be able to provide examples that demonstrate their adaptability and flexibility as well as their ability to stay organized and clear-headed in any situation.

A good school nurse takes a proactive approach in promoting and implementing school-wide wellness plans. In addition, a good candidate can establish specific plans for promoting wellness.

To prepare for interviews, role-play a mock interview with a friend who plays the part of a school administrator. Thorough preparation and practice can lead to a fulfilling role in a highly regarded school.

School Nurse Salary and Job Outlook

According to Salary.com, the median wage for a school nurse was $46,213 annually in May 2016, the average for all school nurses across the United States. Salary varies considerably according to the city and state where the school nurse finds employment. The U.S. Bureau of Labor Statistics reports that demand for all types of RNs is expected to grow by 16 percent between 2016 and 2024, which is approximately 10 percent greater than the projected growth for all types of occupations combined.

The demand for school nurses as a specific profession is difficult to predict in advance. Schools districts must occasionally make the choice to close a school because of budget cuts and lower numbers of registered students throughout the district. Since every school needs a school nurse on staff, those who can’t find employment in their immediate area may find a position outside their own district in a neighboring system.

Effective school nurses possess a genuine love for children. A school nurse typically works fewer than eight hours a day, a time frame that corresponds to the length of the school day. Those who work in a traditional school environment also have summers and typical school holidays off, although many work a temporary job in the summer or have their paychecks divided over 12 months instead of nine. 

Compared to a nurse who works in a hospital, a school nurse never has to work weekends, holidays, 12-hour shifts, evening shifts, or overnight shifts. For many people, the benefits enjoyed by school nurses offset the lower annual pay as compared to nurses who work in other health care environments.