The intent of this position statement is to clarify the role and declare the value of the registered professional nurse in the health and wellness of the students, staff and community.
The National Association of School Nurses (NASN) (1999) 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. (American Academy of Pediatrics, 2008, p. 1052)
It is the position of the New York State Nurses Association that:
Changes in society such as the provision of health care, education, and the family have increased the need and demand for school health services. New paradigms are evolving for school health services as school systems develop comprehensive school health programs to address the diverse and complex health problems of today’s students. The school population is no longer homogenous; it represents a more diverse population. “Students today may face family crisis, homelessness, immigration, poverty, and violence which increase both their physical and mental health needs. School nurses perform a critical role within the school health program by addressing the major health problems experienced by children…by providing preventative and screening services, health education, and assistance with decision making about health, immunization against preventable disease” (American Academy of Pediatrics, 2008, p. 1052). The school nurse functions as a leader and the coordinator of the school health services team…the American Academy of Pediatrics (AAP) supports having a full time school nurse in every school as the best means of ensuring a strong connection with each student’s medical home” (AAP, 2008, p. 1054).
“The school nurse is likely to be the only healthcare provider in the educational setting. Unlike other healthcare workers…the school nurse is responsible for all students in a given school, district or region. The school nurse collaborates with other health professionals to provide successful interventions for positive client outcomes” (American Nurses Association, 2005, p. 1).
To ensure that “quality services to students and staff should be assured through appropriate education, licensure and certification… it is the position of the National Association of School Nurses that every school aged child deserves a school nurse who is a graduate of a baccalaureate degree program form an accredited college or university and license by the state as a registered nurse” (NASN, 2002, Rationale and Conclusion).
In an effort to capture the extensive role of the registered professional school nurse, the NASN (2002) created seven roles to describe their practice. The NASN states that the school nurse: (1) provides direct healthcare to students and staff, (2) provides leadership for the provision of health services, (3), provides screening and referral for health conditions, (4) promotes a healthy school environment, (5) promotes health (6) serves in a leadership role for health policies and programs, and (7) serves as a liaison between school personnel, family, community and health care providers (Role of the school nurse).
Marx, Wooley, and Northrup, 1998 (as cited in American Nurses Association and National Association of School Nurses, 2005) explain that the school nurse is responsible for providing a broad range of services, including the following eight components of a coordinated school health program:
The ultimate outcome of practice for the registered professional school nurse is to assist students to be successful in the learning process. The ability to learn at school is directly related to the status of a student’s health. The multi-faceted role of the school nurse supports the physical, mental, emotional and social health of each student in the school setting. The school nurse serves as the health advocate for all school children, focusing on the promotion of healthful living styles and the prevention of illness and disability (NASN, 2002).
There have been significant legislative changes that have impacted on the role of the school nurse. The Rehabilitation Act of 1973 and the Individuals with Disabilities Act (IDEA) of 1975/1997 had the greatest impact on the school nurse’s scope of practice by expanding the definition of a “student” and requiring schools to provide services. Section 504 of the Rehabilitation Act prohibits discrimination on the basis of disability and mandates access to public schools for children with disabilities. This law mandates that accommodations be made and barriers removed so that children with disabilities have access to public programs, including schools and services (Wolfe & Selekman, 2002).
The New York State Nurses Association recommends that:
Approved by the Board of Directors on March 18, 1988; September 15, 2004; and January 12, 2011. Reviewed and revised by Council on Nursing Practice on August 13, 2004; and December 6, 2010.
American Nurses Association and National Association of School Nurses. (2005). School nursing: Scope and standards of practice. Silver Spring, MD: Authors.
American Academy of Pediatrics. (2008). Policy statement: Role of the school nurse in providing school health services. Retrieved from http://aappolicy.aappublications.org/cgi/reprint/pediatrics;121/5/1052.pdf
American Nurses Association. (2007). Public health nursing: Scope and standards of practice. Silver Spring, MD: Author.
American Academy of Pediatrics. (2001). The role of the school nurse in providing school health services. Pediatrics, 108(5), 1231-1232.
National Association of School Nurses. (2002). Issue brief: Role of the school nurse. Castle Rock, CO: Author.
U.S. Department of Health and Human Services. (2010). Healthy People 2020. Proposed Objectives. Retrieved from
http://www.healthypeople.gov/hp2020/Objectives/TopicArea.aspx?id=19&TopicArea=Educational+and+Community-Based+ProgramsWolfe, L. C., & Selekman, J. (2002). School nurses: What it was and what it is. Pediatric Nursing, 28(4), 403-407.
For more information on nursing practice, contact NYSNA's Education, Practice and Research Program at 518.782.9400, ext. 282 or by e-mail.