School nurses play a vital role in promoting school-age children’s health and emotional well-being. The American Academy of Pediatrics recommends that school districts provide a full‐time school nurse in every school building. Check with your child’s school about health services available to support chronic or short-term health needs.
Does every school have a school nurse?
There is wide variation in health services offered at schools. For example:
- In some schools there is a full-time certified school nurse. They handle acute and chronic health problems. This may include administering medications and performing health assessments and screenings, as well as special procedures ordered by a child's doctor. They also refer children to their pediatrician for physical exams, diagnosis and treatment.
In some communities, a full-time school nurse is responsible for several schools and spends only a limited time in each one. They are responsible for training other staff members (teachers, administrators, secretaries, health aides) to handle acute health situations when the nurse is not on-site.
A full- or part-time nurse practitioner is available in some schools. They often work with consulting physicians, school nurses, social workers or health educators in a school-based health center where routine medical care is delivered in the school. This has been an important and successful way to provide care to students in areas where care has been limited because of a lack of health-care providers, insurance or adequate transportation options. The American Academy of Pediatrics believes that all children deserve a "medical home" and supports the implementation of school-based clinics, especially in areas where children do not have access to health care.
Bumps, scrapes & headaches
Most illnesses and injuries that arise during school are minor (bumps, scrapes, headaches) and can be cared for by the school nurse. In many instances the child can return to class. Parents should be notified if a child has a head injury so they can monitor for symptoms of concussion at home.
When the problem is more serious, a parent will be called to come and take the child home. If the situation is extremely serious or life-threatening, the child will be transported by ambulance to the hospital emergency room or nearest doctor. In many but not all schools, one or more staff members have been trained in CPR (cardiopulmonary resuscitation) and first aid. Parents should know how these situations are handled at their child's school.
Short-term health problems at school
Sometimes your child may have a health condition that does not last long but still interferes with how well they can function at school. This kind of problem should be brought to the attention of the school nurse, the teacher or the principal. For instance:
Hearing loss related to an ear infection could require a temporary change of seats to the front of the classroom.
Some infections—especially an ear infection, strep throat, bronchitis, and sinusitis—may need administration of medication for a week after your child is well enough to return to school. Ask your pediatrician if a medication can be prescribed that can be given before and after school and then at bedtime, so there is no need to take it at school.
Ask about your school's policy about medication before your child's first illness. Your school may require a written order from the doctor before it will administer the medication. They may also require that the medication be in its original, labeled container. It will be easier to take care of this during the visit to the doctor's office. Many school districts have the forms you need on the district website so they can be downloaded at home.
If your child has a readily visible problem that has already been evaluated by your pediatrician let the school staff know about the doctor's diagnosis and treatment. This will help avoid further evaluation of your child at school, which may disrupt their classroom work and unnecessarily concern them.
If your child has an injury or illness that requires immobilization—wearing a cast, for example—or limitations on physical activity, ask the school about alternative activities available during physical education classes and recess. When a child is unable to participate in PE for months or even years, a formal adaptive PE program—one that is appropriate and safe—needs to be designed for them. Discuss this with the school principal. When you get a note from your pediatrician, ask that it specify which activities your child can or cannot do. For example, a student recovering from a broken arm can still walk laps around the school track during PE class.
Seeing the school nurse
Most students can go to the school's health office and speak with the nurse whenever they need to during the day, usually just by asking their teacher. If you would like your child to consult with the nurse, send a note to school with them or call the school early in the day. Let your child know the reason for the visit so that they will not be confused or surprised when they are called to the office.