Protecting children

Today’s school nurses have new roles, responsibilities

While school nurses are nothing new — they have been playing important roles in school settings since the early 1900s — their roles and responsibilities have evolved signifi cantly in recent decades.

When Lina Rogers Struthers was hired on a trial basis by New York City schools in 1902, her goal was to keep the city’s schoolchildren healthy and to boost attendance. The experiment was a success, and now, more than a century later, school nurses are still making a difference in schoolchildren’s lives. However, the scope of a school nurse’s job has expanded considerably over the years.

Today, despite the budget challenges of placing nurses in every school, school nursing is considered a specialty, and school nurses play key roles in promoting and maintaining the health of a school community. No longer merely dispensers of bandages and ice packs, school nurses are also responsible for assessing individual students; tracking health trends; dispensing prescribed medications; treating children with asthma, allergies and other medical complications; and providing counseling and mental-health interventions for students and staff.

Beyond working directly with students, today’s school nurses function as a school’s chief health offi cer. They provide health education in key areas such as nutrition, physical activity and general wellness. School nurses are responsible for maintaining and promoting a healthy school environment and for promoting parent and community involvement in the health and well-being of the students. School nurses also perform a broad range of assessments; provide education to prevent drug abuse, teen pregnancy and sexually transmitted diseases; and serve as a liaison between the school and the community.

In the United States, laws passed over the past 50 years have also helped to transform the roles and responsibilities of school nurses. Since the mid-1960s, nearly every state and U.S. territory has enacted mandated reporting laws that require school personnel — including school nurses — and other professionals involved with children to report suspected child abuse and neglect. Nurses are not only responsible for identifying students whose physical ailments may be indicators of maltreatment, but also for educating and supporting school faculty and staff in the identification and reporting processes as well.

The second ruling — the 1975 Individuals With Disabilities Education Act — increased the number of students considered physically and mentally challenged in public schools and regular education classrooms. As a result, school nurses have increasingly been called on to not only assist in assessing special-needs students, but also to provide nursing services, such as tube feedings and assisting children with devices like catheters and breathing tubes.

Despite the fact that the United States currently has no federal or state mandate requiring a registered nurse in every school district, there is growing recognition of the important role school nurses play in keeping students and schools healthy. In recent years, organizations such as the National Association of School Nurses have begun to call for a comprehensive and standardized approach to ensuring that every school district in the nation has access to a school nurse.

In addition to dispensing medication and bandages, school nurses play an important role in keeping children healthy and safe.