The Changing Role of School Nurses

In a recent edition of the monthly newsletter I receive in the mail from my family’s HMO, a letter from a reader asked, “Do we even have school nurses anymore? And, what do they do?”

School nursing has evolved from the temperature-taking, bandage-applying friendly face we remember from our childhoods, and not all for the positive. While the responsibilities of school nurses have expanded to include things like nutrition counseling, crisis intervention and developing special education programs, nurses are now often very limited, due to liability, on how much hands-on care they can provide to injured or ill students. School nurses are pressed for time as the nursing shortage combines with dwindling education budgets to affect staffing. Schools may have only part-time coverage as one nurse rotates among many schools in a district, leaving office staff or paraprofessionals to handle routine and emergency care.

Most states have Nurse Practice Acts which govern the scope of nursing practice and spell out the services school nurses can provide. These may be basic, such as applying ice packs and administering prescribed medications to students, or they may include training school staff in CPR, developing and implementing Individualized Health Plans (IHPs) for students who require them and working with the city or town Board of Health to address health issues such as communicable diseases.

School nurses can be RNs or LPNs.

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