School Nurses: Frontline for Student Health, Safety

Salary is lower but school nurses enjoy many perks not available to private practice nurses

By Deborah Jeanne Sergeant

The shortage of nurses in the hospital setting represents a longstanding concern for the healthcare industry. It has also affected school nursing positions.

A 2017 survey by the National Association of School Nurses states that fewer than 40% of public schools have full-time school nurses, likely because the pay rate is considerably lower. According to the Bureau of Labor Statistics, the median annual wages for hospital nurses is $78,070; school nurses make only $61,780. But school nurses enjoy a few perks.

Central Square Central School District listed only one substitute school nurse opening online as of July 2023, as staffing has not been challenging for the district.

“A lot of them like the teacher’s calendar, to work 180 days,” said Tom Colabufo, superintendent of schools at Central Square Central School District.

Hospital nurses usually work irregular shifts and hours and are often called upon to work longer shifts.

The school employs a chief medical officer who oversees six nurses and six nursing assistants, a team of one of each in each of its six buildings, along with substitutes available as needed.

“They play an invaluable role,” Colabufo said. “It’s a requirement to have a nurse at the middle school and high school, but not elementary. But I don’t know any schools that don’t have them.”

In addition to these medical issues, school nurses also provide a “safe space” for children’s social and emotional needs beyond the school counselor, psychologist and social worker.

“The nurses always build a strong relationship with the students,” Colabufo said. “It’s another trusted adult to have.”

Children evidence their trust in nurses by asking health questions or bringing up concerns that they may not want to with teachers or at times with their parents such as when a girl begins menstruation during the school day.

Marquis Youmans, the school nurse coordinator with Greece Central School District near Rochester, said that her district has openings like everywhere. “There is a need for school nurses. It’s not a profession a lot of people look at. It’s also hard because it’s such a different type of experience. You have to work with kids. The triage skills are different than a hospital,” she said.

The summers off can be challenging because that’s two months’ less pay than elsewhere and the district typically does not have enough seasonal summer positions for everyone. Some nurses work short-term nursing assignments elsewhere during the summer.

The school nurse’s duties are manifold and in many ways are quite different from hospital nursing tasks.

“It’s past applying ice packs and Band-Aids,” Youmans said. “There are complex needs for all kinds of things.”

She listed Type 1 diabetes, propensity for seizures and children who take maintenance medications as a few of the issues that school nurses help manage every day.

“A lot of kids need medication,” Youmans said. “Nurses are responsible for getting orders through the doctor and making sure their paperwork is up to date and being a liaison with the family about the amount of medications they take at the school.”

School nurses also help track the state-mandated immunizations and required physician screenings for school athletes. They perform hearing and vision screenings. For children whose families cannot meet these needs, school nurses work to find resources like clinics.

“Over the years, I think the role of a school nurse has changed a lot,” Youmans said. “They’re a part of the team within the school system to help students, faculty and staff to help make the whole experience a positive one. They’re there to provide support and help these students in any way they can, not just medically. I’ve been doing it seven years and I love it.”

Previously, Youmans worked at Rochester Regional Health.