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School Nurse

Montana School Nurses
Making the Connection Between Health and Learning

Teacher and student

School nursing is a specialized practice of professional nursing that advances the well-being, academic success, and lifelong achievement of students.  Working with parents, health professionals, and school staff, the school nurses provides services that promote optimal health and prevent disease in the school-age population.

98% of children in the preschool to adolescent age group attend school.  This age group may not typically receive routine medical care and well-child exams on a regular basis.  A great deal of professional medical care in this group occurs as a result of accident or injury.  For many children in Montana, the school nurse is the only source of health care available to the child on a consistent basis.  School nurses conduct routine health screenings, monitor immunizations, provide health counseling and health education, and promote communicable disease prevention.

A student’s health status is directly related to his or her ability to learn.  Children with unmet health needs have a difficult time participating in their educational process.  The school nurse provides the expertise to identify, assess, and evaluate the health needs of children in schools, and to create and carry out individualized health care plans.  The school nurse addresses the physical, mental, emotional, and social health needs of students, and provides for the safety and care of students in the educational setting (National Association of School Nurses, NASN 2011).

The number of children that have a chronic (long-term) health condition has increased dramatically over the past 40 years.  Long-term health conditions such as asthma, diabetes, epilepsy, life-threatening allergies, and mental health concerns may have an impact on the student’s ability to be in school and ready to learn.  In addition, students with special health care needs are coming to school with increasingly complex medical problems, technically challenging medical equipment, and complicated treatments (Robert Wood Johnson Foundation, 2010).

Research has shown that school districts with adequate nursing coverage have fewer absences, a decreased drop-out rate, and higher test scores.

Role of the School Nurse

The American Academy of Pediatrics (AAP 2008) identifies the following core roles of registered professional school nurses:

  • Provide direct care to students with injuries and acute illness, as well as those requiring long term management of chronic and special health care needs.
  • Develop and carry out the individualized health care plan.
  • Serve as a health expert on multidisciplinary teams.
  • Provide case management where needed.
  • Provide leadership for health policies and programs, and for the overall system of health care in the school, ensuring that health needs are met.
  • Conduct health screenings and referrals.
  • Help assess and promote a safe and healthy school environment.
  • Provide health promotion and health education.
  • Serve as a liaison between school personnel, families, health care professionals, and the community.

Professional Preparation of School Nurses

School nursing is a specialized practice of professional nursing.  It is the position of the National Association of School Nurses (NASN 2011) that the registered, professional school nurse is the leader in the school community to oversee school health policies and programs.  The American Academy of Pediatrics (AAP 2008) supports the goal of professional preparation for all school nurses including licensure as a registered nurse and a baccalaureate degree from an accredited college or university, as well as additional certification on a state or national level.

Does Your School Have a School Nurse?

School nurses are not mandated by Montana Law.  Montana has one of the highest school nurse to student ratios in the country: 1 school nurse to nearly 2,000 students.  26 of 56 counties have no school nurse at all, and 98% of Montana students have no registered professional school nurse or too few school nurses in their county.  Many school nurses serve more than one school and spend precious time travelling between campuses.

Access to an interactive map showing the school nurse ratios in all 56 counties of Montana

For more information, see the report  Montana Association of School Nurses, The State of School Nursing in Montana, 2015