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Making the Case for School Nurses

Guest author Jill Patnode is a Kaiser Permanente Community Health Consultant serving the Washington region.

When a child gets sick, it can cause significant disruption. The child might miss school, and the parent or caregiver might miss work. Not to mention, sometimes children don’t get the diagnosis or care they need due to access issues for lower income students and families.

What if there was a better way? What if we could positively impact health and education outcomes without burdening parents, caregivers, or teachers? What if there was a way to help ensure students living in high levels of poverty get the care they need, when they need it?

There is.

School nurses are an often-overlooked solution to many of these challenges. Registered and licensed nurses in school have unique skills. They can treat and help students manage chronic health conditions and disabilities; address injuries and urgent care needs; provide preventive and screening services, health education, immunizations, and psychosocial support; conduct behavioral assessments; and collaborate with health care providers, school staff, and the community to facilitate the holistic care each child needs at the school site and during the school day. School nurses regularly provide stigma-free care which is critically important for the early identification of issues ranging from poor vision to complex chronic diseases or mental health conditions.

Unfortunately, laws requiring or regulating school nurses are inconsistent across the states and lacking all together at the federal level. As a result, school nursing credentials, staffing, salaries and caseloads vary state-to-state and district-to-district, leading to inequities nationwide and within districts. According to the National Association of School Nurses (NASN), fewer than 40% of schools employ a full-time nurse; 35% employ a part-time nurse; and 25% do not employ a school nurse at all.

But there’s a case to be made that among other things, investing in nurses could ultimately save money. According to the Centers for Disease Control, for every $1 spent on school nursing, society saves $2.20. These savings come from preventing costly emergency room visits and parents missing time at work to care for sick children.

It’s important to ask how outcomes in health care and education might improve if every school had a school nurse. In the education setting, students would miss fewer school days, caregivers would miss fewer workdays and educators would have more time to teach. In the healthcare setting, emergency rooms will be less impacted as children are seen in school settings. Also, treatment plans could be co-developed with adults who have knowledge about what is realistic in a setting where children spend the majority of their daylight hours, and care delivery providers could have one point of contact for coordinating each child’s care.

Where do we go from here?  A good starting point is to thank school nurses for their commitment to healthy students. Then, share stories with school and district administrators about how school nurses support individual students and overall attendance and graduation rates. And finally, advocate at whatever level you have access to for school nurses to receive full funding and competitive salaries.

This blog was based on information from a new report from the University of Washington School of Nursing. For more information, visit NASN and review Assessing the Landscape of Washington State School Nurse Services and Health Teams to Advance Health Equity 2023


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