Online RN to MSN
Clinical Systems Leadership

Shortage of School Nurses Poses a Large Problem

Students entering the nursing field have many options when it comes to job opportunities. Some may choose to work in a hospital, while others may opt for travel-based careers. There is one sector that is in desperate need for clinicians: schools.

The American Academy of Pediatrics recommends a full-time nurse be employed at every school in the U.S. Yet, many institutions – around 50 percent, according to NBC – do not have a full-time registered health-care provider on campus, which can cause a number of problems for children with medical needs.

The school nurse shortage poses a major problem for children with chronic conditions.

The benefits of school nurses

While some people’s experience with school nurses meant spending time getting out of class, these clinicians provide a high level of service to the institutions where they work. Instead of simply putting a bandage on an open cut or playground scrape, these health-care providers often distribute important medications and monitor students’ health conditions. These professionals often act as a liaison between educators, doctors and parents to ensure children’s specific needs are addressed.

Having a clinician on staff full-time offers educational institutions the following numerous advantages, according to the National Association of School Nurses:

  • Staff wellness: The presence of a clinician can result in improvement of the general health of the staff, leading to increased attendance and productivity as well as the ability for teachers to focus on education.
  • Accountability: A full-time school nurse can promote compliance with federal and state law, address student mental health as it pertains to academic achievement and advocate for appropriate staffing ratios.
  • Time: Having these health-care providers on campus can save administrative employees the time they would have spent dealing with medical concerns of students.
  • Attendance: Health promotion and disease prevention and management are two ways school nurses improve attendance, as healthier students are less likely to miss classes or days of school.
  • Academics: Reduced absenteeism means more students are in the classroom learning – and healthier children may perform better.

In addition to educating students on their own conditions, school nurses often assist children with disabilities. Furthermore, having these clinicians can lead to increased immunization adherence, better-protecting kids from the outbreak of dangerous diseases.

A deficiency of school nurses could have serious consequences for schools, educators, families and students alike. To fix the problem, it is important to start by understanding what caused the lack of full-time clinicians.

What led to this shortage?

The lack of full-time nurses operating in schools is due to a number of factors. The largest cause was likely individual institutions’ budgets. Depending on the school’s tax revenue and location, it may not be able to employ a clinician on top of managing all of its education costs. As a result, administrators had to find areas of their expenses to reduce or cut completely – and school nurses were often one of the first elements to go.

Retirement is another issue causing the school nurse shortage. Many of these employees consider this field to be a life-long career and the majority of clinicians will stay in these positions until retirement age. Institutions who lose their full-time nurses due to this factor are responsible for finding replacements, yet some schools will choose to forego that responsibility in an effort to save money.

Lastly, the profession of school clinician is one of the lowest-paid registered nurse occupations, making an average annual salary of $55,290, according to the Bureau of Labor Statistics. The average for all RN jobs is around $70,000, on the other hand.

All of these factors play a role in the current nursing shortage schools across the country are experiencing.

Additional duties for educators

The lack of full-time clinicians affects more than just students. As a result of having only a part-time nurse or no nurse at all, teachers become responsible for providing medical care to children who need it.

While tending to schoolyard cuts may not be the biggest issue, educators may also have to distribute prescription medications and monitor food intake for kids with allergies and diabetes. The addition of this duty for teachers can disrupt their ability to instill the level of knowledge necessary for children during their most developmental years.

Nurses are critical to learning, as they provide the care kids need to get them back in the classroom to learn. Clinicians are able to treat children in an efficient and effective manner, returning youngsters to their studies quicker than someone without a health care background. With these professionals employed full-time at schools, teachers can focus on the responsibilities of their own job and continue offering the comprehensive education necessary for children.

The private sector has an influence

A decline in school budgets has played a large role in the school nurse shortage, but that is not the only cause of the issue. On top of that, the private sector can offer these clinicians higher salaries than school districts. Signing bonuses are also an option should health-care providers choose to work in facilities other than educational institutions.

Another cause of the shortage is that nurses feel overwhelmed when operating in schools. Since many are the only clinician on staff, they often have to deal with numerous serious cases on a daily basis. Having too much on their plate – especially to handle on their own – is causing these health-care providers to search for different opportunities within the field.

It is crucial for school leaders to realize the importance of having a nurse on staff. Budget cuts may occur over the years, causing institutions to eliminate the clinician position, but the role should not be removed without a fight. Administrators should make rehiring a school nurse a main priority to ensure students are not only safe but able to focus on their studies instead of their medical conditions.

An ongoing problem

The need for full-time school nurses will not decrease as the years continue. Childhood chronic illnesses like asthma, obesity, epilepsy and food allergies increased 13.8 percent between 1994 and 2006 and is still an issue today.

The scarcity of school nurses poses a serious problem as these health conditions become more prevalent in kids, especially those living in poverty and in rural areas, according to U.S. News and World Report. When these clinicians are the only source of accessible health care, school-based professionals are a necessity to both the educational and physical well-being of children.

In addition to potentially being the only health-care provider a student sees, school nurses are able to spot infectious and communicable diseases before they spread through the institution. This ability can reduce absenteeism, which in turn can improve public school funding, according to Advanced Healthcare Network for Nurses.

Legislation attempts to help

States across the U.S. are struggling with the shortage of school nurses. Some are making fixing this issue a priority by passing laws regarding institutional clinicians.

Pennsylvania, for example, set a nurse-to-student ratio in the state’s public school code. The guideline requires one full-time clinician per every 1,500 children. While this is a step in the right direction, this ratio is outdated. Other states have followed suit, but have enacted a mandate that requires one school nurse for every 750 students – the proportion recommended by the National Association of School Nurses.

It is important to note, however, that this 1:750 ratio is for healthy students only. The NASN recommends the following differentiations based on particular institutional factors:

  • Ratio of 1:225 for schools with student populations that require daily professional school nursing services or interventions such as Special Ed inclusions.
  • Ratio of 1:125 for institutions that contain students with complex health care needs.
  • Ratio of 1:1 for schools with individual students with multiple disabilities.

As of 2008, Vermont had the best nurse-to-student ratio with one clinician for every 275 students, the NASN reported. While states continue to make progress in this area, the proportion may still not be enough, as the duties clinicians must manage vary from monitoring health conditions like diabetes to treating injured students to communicating with parents and other health-care providers. Many school nurses believe even a 1:275 ratio is too high.

Nurses should be aware of the legislation surrounding school nurse to student ratios.

The school nurse shortage is a growing problem in the U.S. today. These clinicians provide valuable care and service to the children they work with to ensure students remain safe while concentrating on their education. School districts and administrators need to make this role a top priority in their institutions as more health-care providers reach retirement age or begin to look elsewhere to continue their careers. Legislators are working to ease the stress of these school nurses, but there is still a long way to go.

The University of Arizona Master of Science in Nursing provides clinicians with the skills and education necessary to handle these sometimes overwhelming situations. Pursuing this advanced degree will offer nurses additional tools to balance multiple patients while gaining insight into current and forthcoming legislation and much more.


Get More Information

Request Information

Which program are you interested in?

Which health-care setting do you work in?

Please complete the form below to receive your program brochure.