School Nursing Resources

Resource documents to support maintaining school nurse positions that may be reduced or eliminated due reduction in school budgets

Recent News Articles or Blog Posts regarding School Nurse Staffing

Reference Documents

  • School Nurse Workload: Staffing for Safe Care [NASN; June 2020, Position Statement]
  • Student Access to School Nursing Services [NASN; January 2022, Position Statement]
  • Standards of Practice: School Health Services Manual [Vermont Department of Health]
  • Massachusetts Department of Public Health School Health Services Unit [Mass.gov; March 2023]
    • The 1998 legislative report Options for Developing School Health Services in Massachusetts recommended the school nurse to student ratio be 1.0 fulltime equivalent (FTE) professional school nurse (RN) in each building with 250 to 500 students. In buildings with more than 500 students, an additional 0.1 FTE is recommended for each additional 50 students. For buildings with fewer than 250 students, the recommended ratio is 0.1 FTE: 25 students. 
  • Implementation and Evaluation of a School Nurse Toolkit to Reinforce Best Practices for Asthma Care in Schools [CDC; August 22, 2024] 
    • School nurses fill the gap between health care and education, provide both acute and chronic care, treat and assess behavioral health concerns, and connect students and families to community resources (6). Although school nurses are well positioned in their role to support students with asthma, inadequate time to devote to asthma management, due in part to competing student needs and multiple roles, impedes completion of these activities (7). Additionally, school nurses in Michigan practice in various models, and they may be responsible for covering more than 1 building or an entire school district. As such, a medically qualified person may not always be available to meet the emergent needs of students, and the oversight is shifted to school staff, teachers, and administrators (7).

Infographics

Tools

  • Acuity Toolkit [Oregon School Nurses Association]
    • Although there was little evidence to support the identified ratios, many states and the National Association of School Nurses recommended one school nurse to 750 students in the general student population; 1:225 for student populations requiring daily professional nursing services; 1:125 for student populations with complex healthcare needs; and 1:1 for individual students requiring daily continuous professional nursing services.
  • Instructions and Tools to conduct a "local" Cost-Benefit Study of School Nursing Services [NASN; 2016]

Vermont Department of Health

Vermont Agency on Education

National Association of School Nurses