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The Role of the School Nurse

The National Association of School Nurses defines school nursing as: A specialized practice of professional nursing that advances the well-being, academic success, and lifelong achievement of students. To that end, school nurses facilitate positive student responses to normal development; promote health and safety; intervene with actual and potential health problems; provide case management services; and actively collaborate with others to build student and family capacity for adaptation, self-management, self-advocacy, and learning (NASN, 1999).

The National Association of School Nurses identifies 7 core roles that the school nurse fulfills to foster child and adolescent health and educational success. 

  1. The school nurse provides direct care to students. The school nurse provides care for injuries and acute illness for all students and long-term management of students with special health care needs. Responsibilities include assessment and treatment within the scope of professional nursing practice, communication with parents, referral to physicians, and provision or supervision of prescribed nursing care. An individualized health care plan is developed for students with chronic conditions, and when appropriate, an emergency plan is developed to manage potential emergent events in the school setting (diabetes, asthma). The school nurse is responsible for management of this plan and communication about the plan to all appropriate school personnel. The school nurse has a unique role in provision of school health services for children with special health needs, including children with chronic illnesses and disabilities of various degrees of severity. 
  2. The school nurse provides leadership for the provision of health services. As the health care expert within the school, the school nurse assesses the overall system of care and develops a plan for ensuring that health needs are met. Responsibilities include development of plans for responding to emergencies and disasters and confidential communication and documentation of student health information.
  3. The school nurse provides screening and referral for health conditions. Health screenings can decrease the negative effects of health problems on education by identifying students with potential underlying medical problems early and referring them for treatment as appropriate. Early identification, referral to the medical home, and use of appropriate community resources promote optimal outcomes. Screening includes but is not limited to vision, hearing, dental and scoliosis (for grades 5th -9th grades). 
  4. The school nurse promotes a healthy school environment. The school nurse provides for the physical and emotional safety of the school community by monitoring immunizations, ensuring appropriate exclusion for infectious illnesses, and reporting communicable diseases as required by law. In addition, the school nurse provides for the safety of the environment by participating in environmental safety monitoring (playgrounds and potential hazards). 
  5. The school nurse promotes health. The school nurse provides health education by providing health information to individual students and families. Health education topics may include nutrition, exercise, smoking prevention and cessation, oral health, infectious diseases, substance use and abuse, and immunizations. 
  6. The school nurse serves in a leadership role for health policies and programs. As a health care expert within the school system, the school nurse is a leader in the development and evaluation of school health policies. These policies include health promotion and protection, chronic disease management, coordinated school health programs, school wellness policies, crisis/disaster management, emergency medical condition management, acute illness management, and infectious disease prevention and management.
  7. The school nurse is a liaison between school personnel, family, health care professionals, and the community. The school nurse also works with primary care physicians to make the community a healthy place for all children and families.

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