School Nursing: Education and Career Opportunities

school nurse checking temperature of young student at desk
school nurse checking temperature of young student at desk

School Nurse At a Glance

What you’ll do: Promote the physical well-being of students so they can succeed academically. School nurses conduct student assessments; administer first-aid, medication, and treatments; and educate students about their health.

Where you’ll work: K-12 public, private, vocational, and alternative schools; health departments, military bases, and community, state, and federal organizations

Degree you’ll need: Depending on state and school requirements, an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN)

Median annual salary: $77,600


School nurses provide a bridge between students, parents, and teachers to address the physical, mental, emotional, and social health needs of students so they can thrive in the classroom.

Steps to Become a School Nurse

Use these steps as a guide to pursue a career as a school nurse.

Find the Right School

smiling nurse walking on college campus

ere are many factors to consider when choosing a nursing school. While you’ll want to find a program with a location, cost, student-to-faculty ratio, and programming to meet your needs, you’ll also want to look for:

Accreditation: A degree from an accredited nursing school meets requirements for state nursing licenses and professional certifications. It also ensures that your credits are transferable to other accredited institutions toward advanced degrees and that you’re eligible for federal financial aid.

Job placement and career counseling: These services can help you set career goals, network, and find your first role.

Online programs: Many nursing programs offer online courses for the classroom-based portion of your education. This flexibility is important if you must work or juggle family responsibilities while you complete your education.

Choose a Degree

nurses discuss their continuing education progress and requirements

While you can be a school nurse with an Associate Degree in Nursing (ADN) and a registered nurse (RN) license in some states, the National Association of School Nurses (NASN) recommends that schools hire nurses with a Bachelor of Science in Nursing (BSN). A BSN is also required to qualify for professional certification as a school nurse, though this credential isn’t always required for employment.

“The additional education is always beneficial so if one does not have a BSN, it is important to get one as most employers are requiring it for work anyway,” says Emily Hunter, BSN, RN, CSN, a certified school nurse and founder and author of Your Favorite School Nurse blog.

Apply to School

admission form being displayed on laptop computer

Admission requirements for BSN programs vary by school. If you already have an ADN, you may be able to reduce the time you’ll need to finish a BSN with an RN-to-BSN bridge program.

Depending on the BSN program you choose, you may have to meet some or all of the following admission requirements:

• High school diploma or GED
• Advanced math, biology, and chemistry prerequisites
• Professional and/or academic recommendations
• Personal statement of purpose
• In-person or virtual interview
• Standardized test scores from the SAT or ACT
• Passing score on HESI Admission Assessment (A2) Exam

Decide if School Nursing Is Right for You

Like any new career journey, you’ll need to decide if school nursing is right for you. Talking to current school nurses and potentially shadowing them while they work is one way to get a firsthand perspective of the role before you invest time and money in training.

“I have found that this role is much like being an ER nurse in that you have often very little information and supplies and have to make do with what creativity you can come up with,” says Hunter. “You never know what’s going to come in your office—is it a bellyache because we hate math or is it a kid who punched glass and needs stitches? A pregnant teen or a kid that fell and maybe has a broken bone?”

In addition to being able to respond in any situation, it also helps to have certain personality traits. “I think the personal characteristics needed for this role would include organization skills, time management skills, and the ability to be flexible and adapt,” says Hunter. “You have to be able to see through some stories and get to the real issues at hand.”

What You’ll Do

While your role may vary depending on the size and type of school, here are some common responsibilities and duties of a school nurse:

  • Administer medication and treatment for chronic conditions such as asthma, diabetes, seizures, and sickle cell disease
  • Conduct annual vision, hearing, health, and mental health screenings
  • Oversee school infection control standards
  • Respond to health emergencies involving children and staff
  • Maintain student health records, including immunizations
  • Develop educational plans for students who need accommodations due to their ability to learn
  • Identify child abuse, bullying, and drug abuse
  • Connect students and families with social services related to healthcare, food, shelter, and other support

“School nursing can be extremely rewarding. There is so much more than giving out band-aids and ice packs—that’s the easy part!” says Hunter. “We have to be ER nurses, special ed teachers, mommies, counselors, and even teachers.”

Pros and Cons to a Career as a School Nurse

There are many reasons to pursue a career as a school nurse, including:

  • Regular work hours, generally 8 a.m. to 3 p.m. Monday through Friday
  • Opportunity to be home on snow days, holidays, and during summer break
  • Autonomy to do things your way since most school nurses work alone
  • Rewards of helping children in need
  • Potentially less stressful environment versus working in a hospital
  • Opportunity to make an impact and develop relationships with students

And as with any job, there also are challenges to being a school nurse:

  • Potentially lower salary than other nursing specialties
  • Sometimes heavy workload if you’re the only school nurse on staff
  • Lack of recognition as an important part of the school community
  • Little administrative help with forms and paperwork
  • Less opportunity to interact with other healthcare professionals
  • Responsibility to make potentially life-saving decisions without oversight
  • Potential to be assigned across multiple schools
  • Likelihood of dealing with the messiness of vomiting, colds, lice, and other common childhood health issues

Work Environment

School nurses serve as an important link among students, teachers, coaches, and parents. This requires effective communication and collaboration.

In addition to handling everyday injuries and illnesses, you’ll work to prevent a student’s medical issue from interfering with their ability to learn.

“If the student also has educational issues in addition to the medical issues, then the nurse will be on the IEP (individualized education program) team to help manage the medical accommodations,” Hunter says.

In addition to handling everyday injuries and illnesses, you’ll work to prevent a student’s medical issue from interfering with their ability to learn.

On a broader level, a school nurse contributes to the school environment by educating staff and students on a range of health care issues, including infection control, recognizing signs of distress, and first-aid.

Elementary School vs Middle School vs High School

While many of your duties will be the same no matter the school, elementary, middle, and high school students can present different challenges. “Those are three totally different jobs!” says Hunter.

Here’s a look at responsibilities that can differ by age.

Elementary school

  • Address issues affecting proper growth
  • Coordinate medication and treatment for chronic conditions
  • Handle a higher number of bumps, bruises, and common conditions like stomachaches and fever than likely at older grades

Middle school

  • Address issues related to physical and emotional bullying
  • Deal with more complex behavioral issues
  • Identify and educate students and staff about the dangers of fads like TikTok challenges

High school

  • Less hands-on care for chronic conditions like diabetes since teenagers can often manage on their own
  • Address issues related to sexual activity, including STDs, date rape, and teen pregnancy
  • Provide alcohol and drug education and identify substance abuse

Salary

According to the BLS, the annual median salary for RNs is $77,600, with those in the lowest 10% of the profession earning $59,450 and those in the top 10% making $120,250.

Annual Median Salary for RNs:

$77,600

While the BLS doesn’t report salaries by specialty for RNs, earning a BSN and certification may increase your salary potential and help you stand out among job candidates, especially in a field that values advanced education. Where you work, your experience, and other factors also can influence your salary.

Job Outlook

Pursuing a nursing career may be a wise investment of your time and money. The BLS predicts 9% growth in jobs for nurses from 2020 to 2030, slightly above the average rate for all occupations.

Your employment opportunities as a school nurse will vary depending on the school districts in your area. While some districts hire nurses part time and pay lower salaries, others employ nurses as part of their teachers’ union and pay them on a scale that aligns with teacher salaries, Hunter says.


anna giorgi

Written and reported by:

Anna Giorgi

Contributing Writer

emily hunter

With professional insight from:

Emily Hunter, BSN, RN, CSN

Certified School Nurse and founder and author of Your Favorite School Nurse blog