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Click on the link to learn about Ohio and becoming a school nurse
School Nurse | Ohio Department of Education

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Home - Ohio Association of School Nurses (oasn.org)

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Home - Ohio Association of School Nurses

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Strategic Plan and About the National Association of School Nurses

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Strategic plan, core values, vision, and mission. Find the definition of school nursing and association history.

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School Nursing and the State of Michigan

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School Nursing and the State of Michigan

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Click on the link for becoming a school nurse in Michigan.
School Health Services (michigan.gov)

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The Michigan Association of School Nurses | Nursing Network

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The Michigan Association of School Nurses | Nursing Network

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Employers - Post a job

Job Opportunities

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Position: Part Time Registered Nurse (RN) or Licensed Practical Nurse (LPN) Facility: Grand Traverse County Jail Location: Traverse City, MI Hours:...

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The Michigan Association of School Nurses | Nursing Network

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Follow The Michigan Association of School Nurses to automatically receive news, announcements and priority invites to upcoming events.

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Click on the link to learn more about becoming a school nurse in Nevada.

Home - Nevada State Association of School Nurses (nevadaschoolnurses.org)

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Nevada State Association of School Nurses

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The Nevada State Association of School Nurses supports, strengthens, and unites school nurses to increase collaboration in improving the health, safety, well-being, and academic success of school-age children across the state.

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Click on the link for learning more about working in Texas as a school nurse

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Explore the roles and responsibilities of school nurses in Texas. Take a look at professional school nursing resources that bridge healthcare and education.

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State of Nevada Department of Education

information for School Nurses

School Nursing (nv.gov)

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Click on above picture for article.

This article discusses students and their stress levels, as well as COVID issues, and the importance of having diversity in hiring school nurses.

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The 2022-2023 school year will be the fourth marked by COVID. With schools facing unprecedented challenges, school nurses are preparing for a demanding year.

No one is more familiar with these challenges than Robin Cogan, MEd, RN, NCSN, FNASN, FAAN, who has spent more than two decades of her 35-year nursing career as a school nurse in Camden, New Jersey. She is New Jersey Director for the National Association of School Nurses and faculty at Rutgers University-Camden School of Nursing. Here, she discusses the essential role nurses play in advancing health equity in schools and communities as well as what they need in order to continue caring for children.

Students Have Urgent and Growing Needs

One of my most vivid memories is discovering that a 4-year-old pre-school student wasn't eating her school lunch. Instead, we noticed her stuffing food into her pockets, day after day. Her family was new to our country and had endured a grueling journey on foot from El Salvador to get here. When we asked why she wouldn't eat, the child shared that she felt responsible for feeding her family. Our school came together and provided a food pantry to support the family and other families in similar circumstances.

That is just one example of how school nurses advance health equity within schools and communities. We are the chief wellness officers, the care coordinators, the people who know what resources are available in our communities. We recognize emerging problems and mitigate the struggles children and families face. We eliminate barriers by connecting families to resources. We get eyeglasses for children who can't see well, and do tube feedings for medically-fragile children, which allows them to be in school.

We also deal with life-and-death situations. Twenty-five percent of students with an undiagnosed food allergy have their first anaphylactic event at school. Students have asthma attacks at school that can be deadly. Some are medically fragile. Some are newly diagnosed with diabetes. Up to 30 percent have chronic health conditions. COVID remains with us, and now monkeypox.

Ultimately school nurses are an investment in student wellness and achievement because health happens in the community and at school. So having a school nurse democratizes healthcare. But just 40 percent of schools have a full-time student nurse and 25 percent have no school nurse at all.

Stressed Communities Create Stressed Children

A few years ago, I heard from a former student who I had known when he was 8 or 9 years old. Now a grown man, he reminded me that I had once invited him to sit with me in my office when I noticed that he wasn't having a good day. He disclosed that he had been contemplating suicide that day, and my words and presence saved his life. He is now a thriving adult and father to three boys.

You never know the impact you have. One caring adult in a child's life is a protective factor. Often that caring adult is a school nurse.

We know that no dysregulated child ever calms down because you tell them to, that a stomachache is often a sign of anxiety, depression, or a problem at home. We can encourage a child to identify emotions and connect her or him to a school counselor or psychologist. We can open communication with parents.

Prior to COVID, we were spending up to 34 percent of our time on mental health issues. These mental health needs escalated with COVID and the resulting isolation. We even faced a divisive election season and may be heading for another. All of this turmoil seeps into what happens at school. Children observe adults and absorb stress and conflict within communities which ultimately affects their ability to learn.

I sometimes say that school nurses are population health gold. We are the epicenter of every concern a child brings to school, be it racism, hunger, homelessness, threats to undocumented families, opioids, or something else.

COVID Exacerbated Challenges

For school nurses, COVID added a second full-time job on top of the full-time job we already had. Many of us became the de facto community health department, engaging in intense COVID-related duties. We conduct contact tracing and testing; we track students who are quarantining. We put mitigation strategies in place in schools. We monitor outbreaks, run school-based vaccine clinics, and are responsible for reporting new cases, which is complex and time-consuming when it involves a city, county, and state. We inform parents when their child is symptomatic or exposed to contagion.

Many school nurses have been so preoccupied with protecting children from COVID that we are terrified we'll miss a more typical health problem.

As challenging as facing COVID has been, it's also transformed public perceptions of school nursing. Suddenly, headlines acknowledged our role on the frontlines of the pandemic. That has been gratifying.

Diverse School Nurses Deliver Culturally Sensitive Care

I am inspired by the remarkable trailblazer, Charity Collins -the first Black school nurse. She served a segregated, underserved Black Atlanta school community in the early 1900s. Still, today, school nurses are currently 90 percent white and trend older. We need school nurses who reflect the communities they serve.

I work in a community that is largely Black and Brown, and I am White. My urban school district is 13 miles from my house, but there's a 10-year life expectancy gap between where I live and where I work. That's the difference between privilege and poverty. I don't reflect the community I serve, so I walk in cultural humility.

We don't just have a shortage of school nurses; we have a diversity problem among school nurses and a failure to pay a livable wage. Some school nurses are paid on a teacher scale, starting at an entry level that may ignore decades of nursing experience in another, non-school setting. It varies from locality to locality, but nearly all school nurses take a huge pay cut when they leave the acute care setting. One school nurse told me she donated plasma twice a week to make up for it.

And we don't have an infrastructure for upward mobility for school nurses. I've been in the same job for 22 years. We need a place to grow.

We need more diversity, better pay, better mobility-and making that happen starts with doing a better job sharing the true story of who we are and what we do. School nurses care for other people's children. It doesn't get more consequential than that.

Explore stories about school nurses from across the nation on Robin Cogan's blog, The Relentless School Nurse.

About the Author
Robin Cogan is a Nationally Certified School Nurse (NCSN) and has been a school nurse in New Jersey's Camden School District for over two decades.

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Four Reasons We Need School Nurses Now More Than Ever

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With schools facing unprecedented challenges, school nurses are preparing for a demanding year.

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Promoting student health and helping with academic success.

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Healthy and Ready to Learn: School Nurses Improve Equity and Access | OJIN: The Online Journal of Issues in Nursing

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Healthy children learn better; educated children grow to raise healthier families advancing a stronger, more productive nation for generations to come. School nurses work to assure that children have access to educational opportunities regardless of their state of health. Challenges…

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School Nurse Salary in Michigan | Salary.com

School Nurse Salary in Ohio | Salary.com

Salary estimates are for Michigan and Ohio and are from salary.com

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Naloxone Education for School Nurses Toolkit | NASN
Learning Center

Discusses how:

to establish a program for your school.

to administer Naloxone.

how to present it to your school.

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Video about being a school nurse

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A Day in the Life - Sheila (School Nurse)

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CDC Recognizes the Importance of School Nurses

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CDC Recognizes the Importance of School Nurses

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The CDC discusses the importance of school nurses, and they role they play in schools

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Centers for Disease Control and Prevention

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It’s National School Nurse Day! Celebrate the work of school nurses! Learn how they keep students healthy and ready to learn. https://bit.ly/37CNPpg

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Vanquishing Vaping Toolkit | NASN Learning Center

Creating a plan for your school

Prevention and Cessation program

How to communicate with parents and students about vaping

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Click on the above picture.

Article address staffing shortages and other issues associated with schools and nursing

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School nurses, psychologists, and other health workers are experiencing a daunting dilemma: They have a rapidly growing workload, but many don't feel like they have enough support or resources to effectively meet the demands.

Results from a new nationally representative survey from the EdWeek Research Center paint a picture of a helping profession overwhelmed with student needs, both physical and mental. The volume of work-coupled with salaries lower than they could get outside of the school system-has prompted some school health workers to consider quitting, even though many feel a responsibility to the children in their care.

"People who go into education want to do everything they can to support students, so they'll work themselves to death to provide that support," said Jason Pedersen, a school psychologist in the Derry Township district in Hershey, Pa.

But, he added, "the expectation for additional job functions has increased. We're typically asked to do more with less. We are trying to do the best we can in all the helping professions. ... There are people who are drowning-they burn out."

The EdWeek Research Center surveyed 3,480 school health workers in March. The sample included about 2,300 school nurses, 350 social workers, and 245 school psychologists, among other health-related job titles.

Most of the school health workers surveyed said that since 2019, the number of students struggling with anxiety, depression, vaping or smoking or chewing tobacco, marijuana use, and obesity has increased-and are challenges for their school or district. Anxiety was the largest health challenge, with 59 percent of school health workers saying it was a "major" challenge.

And the survey results indicate that they're having trouble keeping up: Relatively few school health workers said their school or district did an excellent job meeting students' health needs.

Twelve percent of school health workers said their school was "very" or "somewhat" insufficiently able to meet students' physical health needs, and nearly a quarter said the same about meeting students' mental health needs. (About 30 percent said their school or district wasn't sufficiently meeting students' sex education needs, and 7 percent said their school or district did not try to meet those needs at all.)

Staff shortages create 'overwhelming' conditions

One major obstacle to meeting students' health needs: staff shortages. Many school districts don't have enough psychologists, counselors, or nurses on campus to appropriately respond to the mounting needs, leaving these health workers with oversized caseloads.

Adrienne Floriano, a school nurse at a large, urban school district in southern California, said her district has two vacant nursing positions right now. As a result, she is responsible for three sites-a preK-8 school, a high school, and the health clinic at the district office, where she administers vaccines and gives physical exams.

She is constantly running between locations. At one school, two students have diabetes and need her to give them insulin injections a couple times a day. She's also responsible for special education assessments, attending individualized education plan meetings, devising care plans for students with conditions like asthma, and conducting screenings for height, weight, and vision, along with making referrals to counselors as needed.

"It's so overwhelming," she said.

And when school health workers are stretched thin, they're not always able to provide the full complement of supports for students-especially since the priority is typically special education services, which schools are federally mandated to provide.

"Usually, if you're stretched really thin, your administrators are going to say, 'Focus on making sure we're in compliance with special education laws,' and help address different mental health needs or systems-level interventions or preventative services second or third or fourth," said Eric Rossen, the director of professional standards for the National Association of School Psychologists.

The catch is that providing those things help to prevent the need for special ed. compliance in the first place, he said: "It is a bit of a nasty cycle."

Pedersen, who was named the 2023 School Psychologist of the Year by NASP, said he's heard from school psychologists who are tasked with conducting as many as 150 special ed. evaluations in a 180-day school year-putting them in a "reactionary role," he said, and leaving them little time to focus on anything else.

"That's not why people go into school psychology," he said. "It's something we're committed to, and want to do, ... but oftentimes that ends up being the only mechanism they have to provide support for students."

Pedersen added: "They're asked to do the same function over and over and over again with no end in sight. They don't feel like they're making a difference."

Some school health workers will quit

About 20 percent of school health workers said they were likely to leave their current job in the next two years to pursue the same type of work for a different employer, and about 30 percent said they were likely to leave their current profession entirely in the next two years to retire or pursue a different line of work.

Not all employees who say they intend to quit will actually end up doing so, for financial and logistical reasons. And the percentage of school health workers eyeing the exit door is lower than the percentage of teachers who say they intend to quit within the next two years -that figure is 35 percent, according to another EdWeek Research Center survey earlier this year.

Still, the numbers are cause for some concern, given the pipeline challenges in recruiting new school health workers to the field, experts said.

When asked why they were planning on leaving their current position, 35 percent of school health workers said they could get a higher salary elsewhere. Since the pandemic, many hospitals have increased their salaries for nurses, given workforce shortages and market pressures.

"I'm content to be where I'm at, I love what I do, but it's hard knowing that, gosh, I could go somewhere else to work and earn another $30 to $40 an hour," said Julie Light, a school nurse in a rural area outside of Cedar Rapids, Iowa.

In open-ended responses to the EdWeek Research Center survey, many school health workers indicated plans to retire. Others said they were feeling overwhelmed and drained from the burdens of the job.

"We have been overworked, and I am burning out," said one school health worker.

"Too emotionally draining," said another.

"Is education my job, or is it supposed to be my life?" another school health worker said. "The entire profession is unrealistic right now, but for some reason I stick with it because I feel SO bad for the students who are stuck in the middle."

Psychologists cite too much work and not enough help

Twenty-one percent of school health workers said they are considering leaving because they don't have enough support from district or school leaders, and 18 percent said their workload is too high.

School psychologists were significantly more likely than other school health workers to say that they were considering leaving because their workload is too high-44 percent, compared to 15 percent of nurses and 27 percent of social workers. They, along with health and sex education directors, were also the most likely to say they don't have enough support from district and school leaders.

Rossen said school psychologists often feel like they have "a bunch of work dumped on them without sufficient support." The message from administrators, he said, seems to be: "We are asking more, but giving you the same or less to do that 'more' with."

"It's a lot of those little things where there isn't a sense of appreciation, there isn't really a sense of being seen," Rossen said. "It creates this sense that it's a bit of a grind, and it creates this churn in education."

One form of support could be adequate time and opportunity for professional learning. School health workers overwhelmingly said they could benefit from professional development in a handful of areas. The top of the list: helping students cope with anxiety.

But oftentimes, many districts don't provide PD that's specific to school health workers. Instead, district-provided trainings are typically tailored to classroom teachers.

School psychologists are "forced to sit in on 6th grade reading pedagogy, versus learning about something like how to deal with suicide threat or risk," Rossen said.

School nurses, for instance, need training on how to be health leaders in their school districts and communities, and how to use and collect health-related data, said Kate King, the president-elect of the National Association of School Nurses and a middle school nurse in Columbus, Ohio.

They also need to understand the "gamut of mental health diagnoses, treatments, and evidence-based practices," she said, since many students often show up to the nurses presenting physical symptoms of mental health challenges. (Frequent stomachaches, for example, could be a sign of anxiety.)

Yet many districts don't have school nurse administrators overseeing health services programs, she said, leaving school nurses largely on their own.

"If as a school nurse, your boss is the principal or the person in charge of special ed. or-maybe a little better-a counselor, those folks don't always know how to advocate for professional development specifically for nurses," she said.

School health workers said in interviews that the bulk of their professional development came from state and national professional associations. But districts don't always cover the registration fees and travel costs associated with that training, said Pedersen, the school psychologist in Pennsylvania.

A 'plea' for more support

School health workers say they hope states and districts will invest more into the helping professions, especially as student mental health needs continue to rise.

"There's a lot we can do to support teachers," Pedersen said. "My plea is that people recognize that. These are highly trained people and they're on your staff, and you can use them to greater effect to support your goals-[which can] keep them engaged and [wanting] to stay."

After all, many school health workers say they care deeply for their students and feel passionate about the work.

"It's a great job," said Floriano, the school nurse in California. "It has been hard, and there are a lot of challenges-obesity, mental health, the drug problems are all issues-but what a great place to be able to combat those and make a difference."

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'It's So Overwhelming': Demands on School Health Workers Are Making Them Want to Quit

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A new national survey sheds light on the working conditions of school nurses, school psychologists, and other health workers.

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School Nurse Workforce Study - National Association of School Nurses (nasn.org)

Facts and Figures on School Nurses

Only 65% of all schools in America have access to a school nurse.

Just under 50 percent of a school nurses day is devoted to care coordination.

Many nurses are assigned to multiple schools

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School nurses discuss their role they play in student's lives.