How to Become a School Nurse

What is a School Nurse?

School nurses are registered nurses (RNs) who work in a school setting, assessing and treating students' minor ailments. Their presence in the academic setting is vital for maintaining a healthy and safe learning environment.

History of School Nursing

The practice of school nursing began in the U.S. in 1902, when Lina Rogers, the first school nurse, was hired to reduce absenteeism by intervening with needs related to communicable diseases. After one month of successful nursing interventions in the New York City schools, she became a pioneer for school nursing throughout the city. 

Since then, there have been an estimated 132,300 practicing public and private school nurses in the U.S. Beyond caring for a student's health, school nurses address the social determinants of health, such as income, housing, transportation, employment, access to health insurance, and environmental health.

What Does a School Nurse Do?

Students experiencing illness or injury during the school day or at after-school activities will report to the school nurse for further care. School nurses are responsible for assessing these students and determining if they need a higher level of care.

School nurses are "real" nurses, which means they must maintain state-governed licensure at the same level as a hospital nurse. Although they have the same scope of practice as other RNs, school nurse duties differ due to their unique role and environment.

Common school nurse responsibilities include the following:

1. Assess and treat students for injuries and illnesses like scrapes and cuts, or illnesseses like COVID-19 or the flu. If the students illness or injury is severe, a school nurse may send them home or contact emergency services.
   
   
2. Oversee infection control standards at the school, including educating staff and students on proper hygiene and prevention measures. The school nurse also handles communications for communicable illnesses like lice and chickenpox.
   
   
3. Provide annual assessments for sports, scoliosis, and general health, as well as maintain student health and vaccination records.
   
   
4. Daily healthcare services like administering physician-prescribed medication or glucose monitoring.
   
   
5. Provide staff education in emergency response procedures like first aid, CPR, or the hiemlich maneuver.
   
   
6. Assist families who need help finding external healthcare, health insurance, or help enrolling in school programs.
   
   
7. Submit student vaccination records to the state, and maintain proper documentation in accordance with state laws.

School nurses have one of the easiest nursing jobs because they get ample rest time. Unlike hospital nurses, they don't work nights, weekends, holidays, or summers, providing a low-stress environment that avoids burnout.

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Since school nurses are registered nurses, they can work anywhere an RN can. However, being a school nurse requires working in an academic setting. While this typically refers to public and private pre-, elementary, middle, and high schools, they may also find jobs at colleges, universities, and vocational schools.

The following is a list of places you can work at as a school nurse:

Salary.com reports that the median school nurse salary in 2022 is $55,028 annually. ZipRecruiter estimates that as of September 2022, school nurses in the U.S. earn an average salary of $65,048 per year or $31 per hour. 

Salary Factors

The primary element influencing your school nurse income is geographic location and cost of living. However, you'll also notice changes based on your certification. Certified school nurses often have slightly higher annual salaries. Non-certified RNs usually earn an hourly income, often even lower than hospital nurses.

Unlike other nursing jobs, there is little to no chance for overtime in school nursing. Most positions are a yearly salary and do not have overtime built into the contract. There is some increase in earning potential with experience and additional education.

School Nurse Benefits

Regardless of the workplace setting, school nurses enjoy similar benefits. While actual benefits may vary depending on the institution must include the following:

• Health, vision, and dental insurance
• Retirement options
• Family leave of absence
• Maternity Leave
• Discounts
• Tuition, certification, and CEU reimbursement
• Attendance at nursing conferences

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

The first step to becoming a school nurse is attending nursing school. While you can become an RN with either an associate's or bachelor's degree, school nursing requires BSN-trained nurses. Earning a BSN typically takes 4 years.

2. Earn Your Registered Nursing License

Once you graduate, you'll be able to take the National Council Licensure Examination (NCLEX). Passing this nationwide exam and meeting all other state-specific requirements will qualify you for registered nursing licensure.

3. Gain Experience

Earning on-the-job experience allows you to foster your newly learned nursing skills and become more independent. While not always a requirement, many schools prefer nurses with at least two years of clinical experience.

4. Meet Additional Requirements

School nurse requirements can vary by state. For example, school nurses in Arizona must earn a school nurse certificate from the Arizona Department of Education to become eligible for employment.

Additionally, some states require further education for school nurses, which many students pursue in graduate school. California, Pennsylvania, and West Virginia require RNs to complete a credential program to become school nurses.

Finally, nursing school qualifications in certain regions include a graduate education. While you can be a BSN school nurse in New Mexico, you must have at least an MSN to be a school nurse supervisor.

Bottom Line: Research school nursing requirements in your state to understand the additional steps you need to become qualified for this role.

Nurses can pursue a certification in School Nursing. Some jobs will require this prior to applying for a position, while others will want the nurse to earn this certification once hired. It is important to look at all of the job requirements prior to applying. 

The National Certified School Nurse (NCSN) is credentialed through the National Board for Certification of School Nurses (NBCSN). The certification is valid for five years. Recertification is more specific for this certification and strictly based on clinical practice hours. Individuals are required to maintain a current RN license and at least 2,000 hours of clinical practice in school nursing in the past five years, of which 750 hours must be in the past three years. 

To learn more about school nursing and certifications – check out these websites.

• National Association of School Nurses 
• National Board for Certification of School Nurses 
• National Association of State School Nurse Consultants 
• American School Health Association 
• The Journal of School Nursing 

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