School Nurse Job Description: Duties and Skills

A school nurse is a registered nurse who keeps students healthy and safe enough to learn: running the health office, giving medications, managing chronic conditions such as diabetes, asthma, seizures and severe allergies, handling emergencies and working with families and staff. Many school nurses work as the only health professional in the building, or cover several schools, so independent judgment is central to the job. The schedule follows the school calendar.

What a school nurse does

School nursing is a specialized practice that supports students' health, safety and ability to learn. The National Association of School Nurses (NASN) is the specialty's professional organization. You practice under your state's nurse practice act, state education and health laws, and your district's policies, which together decide what you can do and what you can delegate.

A typical school day

1. Before the bell. Check messages from parents, review students with new orders or care plans, and confirm emergency medications and supplies are where they should be.
2. Scheduled medications. Give medications per district policy with the required parent and provider authorization, and document each dose.
3. Health office visits. Assess students with injuries, illness, headaches, stomachaches or anxiety, decide who returns to class and who goes home, and call parents. Watch for patterns too, such as frequent visits that may point to anxiety, bullying or problems at home.
4. Chronic condition care. Blood glucose checks and insulin per a student's diabetes plan, asthma treatments, and procedures such as catheterization or tube feeding for students who need them.
5. Emergencies. Respond to allergic reactions, seizures, injuries and other emergencies, using emergency medications per policy and calling 911 when needed.
6. Paperwork and planning. Update health plans, track immunizations, follow up on screenings and attend meetings.
7. Training staff. Teach teachers, bus drivers and aides to recognize emergencies and, where your state allows, train them for delegated tasks such as giving emergency medications.

Few days go exactly to plan. A field trip needs medications packed, an insulin pump fails, or several students arrive at once with the same stomach bug.

Core duties

• Writing individualized healthcare plans (IHPs) and emergency action plans for students with health conditions
• Taking part in Section 504 plan and IEP meetings when health affects learning
• Medication administration, plus safe storage and accurate records
• Screening programs such as vision and hearing, as your state requires
• Reviewing immunization records and reporting compliance
• Communicable disease surveillance and reporting to the health department
• Health education for students and staff
• Supporting students' mental health and connecting families to resources
• Emergency preparedness planning for the school

Skills that matter

• Independent assessment. There is no provider down the hall, so you decide who needs care now. The principles in how nurses prioritize care apply in a busy health office as much as on a hospital unit.
• Pediatric knowledge across ages and developmental stages, including students with complex medical needs.
• Delegation and teaching. Under your state's rules you may train unlicensed staff for certain tasks while staying responsible for oversight.
• Communication. With anxious parents, teachers, administrators, outside providers and students themselves. Short, plain teaching works best; the teach-back method is a simple way to check understanding.
• Organization and documentation. Health records, medication logs and compliance reports all need to be accurate.
• Basic knowledge of education law, such as Section 504 and the IDEA, which shape how schools accommodate health needs.

Settings and schedule

School nurses work in public, private and charter schools, from preschool through high school. Some are employed by the district, others by health departments, hospitals or staffing agencies. Many cover more than one school. Some states also use LPNs in school health under RN supervision.

Hours follow the school day, with summers, holidays and breaks usually off. Pay arrangements vary: some districts pay only during the school year, others spread pay over twelve months, and some school nurse jobs are hourly. Read the offer closely; how to compare nursing job offers explains what to check, including benefits and paid time off.

Education and certifications

Requirements vary by state and district:

• An RN license is standard, and some states and districts require a BSN
• Some states require a school nurse certificate or credential through the state department of education
• Pediatric, emergency or community health experience is valued
• BLS is usually required

The national credential is NCSN (Nationally Certified School Nurse), from the National Board for Certification of School Nurses. Eligibility includes school nursing experience; check the board for current requirements, and check your state's education department for any state credential.

Questions to ask before you accept

School nurse jobs vary more than most nursing roles, so ask:

• How many schools and students will I cover, and is there a health aide?
• Which students have complex needs, such as diabetes, seizures or tube feedings?
• Who supervises me, and is that person a nurse?
• What do the district's medication and delegation policies say?
• Is there a substitute nurse when I am out?
• Is pay spread over twelve months, and what happens to benefits in the summer?

Covering several schools with no backup is a very different job from one building with a health aide, so get the details in writing.

Career path

School nurses can move into lead nurse or coordinator roles for a district, district health services director, school-based health center work or public health nursing. Some pursue graduate education to become pediatric or family nurse practitioners. Others pair school nursing with summer camp or per diem work.

Where to see pay

School nurse pay depends on the district, the state, the schedule (school year or full year) and whether the district uses a salary schedule. For real ranges from jobs posted on NurseTide, start with registered nurse pay, then use the free pay calculator to compare a school-year salary with year-round hospital pay. School and pediatric nurses swap ideas in the pediatric nurses group.

Next step

Browse nursing jobs for school nurse openings near you; every posting on NurseTide shows the pay.

General information for nurses, not medical, legal, tax or financial advice. Follow your facility's policies, your state board of nursing and the terms of your employer or contract.