School nurses care for kids who suffer bumps and bruises or need a quiet place to recover when stomach upset, headaches and other ailments hit. Important as they are, these everyday services barely begin to describe the central role school nurses play in child, family and community health. For many families, the school nurse is the first person they think of when a child gets a bump, scrape or headache during the school day.
Today's school nurses manage increasingly complex student needs, including chronic health conditions, communicable diseases, mental health concerns and medical emergencies. They also help create safe, supportive school environments where students can learn and thrive.
Why every school needs a full-time nurse: AAP policy explained
The American Academy of Pediatrics (AAP)
recommends that all U.S. schools have at least one full-time nurse for every elementary, middle and high school campus. Yet many schools still lack this important resource. Here's why school nurses are so essential for student health, safety and learning, and how parents can support their presence in local schools.
More than a century of supporting children’s health
The first school nurse helped New York City schools deal with contagious diseases that spread through neighborhoods in the early 1900s. Public health leaders saw that school-based care and family outreach could reduce absences and help students stay on track academically. The approach was so successful that it became a model for schools across the country.
What do school nurses do today?
Today, school nurses remain at the heart of family and community health. They serve as crucial resources during public health emergencies, including disease outbreaks, wildfires, tornadoes and floods. Every week, school nurses also:
Safely give medications to students who need them during the school day
Respond to health emergencies such as seizures, allergic reactions, breathing difficulties, bleeding, broken bones and other urgent situations
Coordinate care with pediatricians, hospitals, specialists, therapists and families
Help create written care plans for children with asthma, food allergies, diabetes, heart conditions and other chronic health needs
Support health screenings and help families connect with community resources when follow-up care is needed
Most illnesses and injuries that happen at school are minor and can often be treated by the school nurse, allowing students to return to class and continue learning. When a child experiences a more serious illness or injury, school nurses assess the situation, contact parents and coordinate next steps. In an emergency, school nurses help activate emergency response plans and work alongside trained staff and emergency medical services to get students the care they need.
Helping students manage short-term health issues
Children don't need to have a chronic health condition to benefit from a school nurse's expertise. Temporary health problems can also affect a child's ability to participate and learn at school. For example:
A child recovering from an ear infection may have temporary hearing difficulties and benefit from sitting closer to the teacher.
A student who returns to school with a cast, brace or other injury may need special accommodations for physical education, recess or classroom activities.
A child taking medication while recovering from an illness may need help following treatment plans during the school day. If a student has a head injury, for example, parents should be notified so they can monitor for signs of concussion after school.
School nurses help families and schools make these adjustments so students can continue learning safely while they recover. They can also explain school medication policies, help families complete required medical forms and make sure medications are stored and given safely when needed.
A trusted link between home, school and health care
School nurses also work closely with families, school staff and health care professionals to support students' physical and emotional well-being.
They help coordinate care for children with conditions such as:
Because they interact with students regularly, school nurses may be among the first adults to notice when something is wrong.
For example, a school nurse might recognize that a student's frequent stomachaches tend to occur before tests and suggest evaluation for anxiety. Signs of bullying, cyberbullying or social stress also may be more visible at school. Repeated visits to the health office for fatigue, headaches or other concerns sometimes reveal an underlying health issue that families were unaware of.
Full-time nurses have the time and training to talk with students, identify concerns and connect families with appropriate resources. For many families, they serve as an essential bridge between home, school and the health care system.
How budget pressures threaten school nursing positions
Schools across the United States continue to face difficult financial decisions. Tight budgets and competing priorities can make it challenging to maintain full-time nursing positions.
As of 2024, only about 65% of U.S. schools had a full-time nurse. Schools serving larger numbers of students from lower-income families are less likely to have full-time nurses. Private schools are also less likely than public schools to employ full-time school nurses.
Many schools now rely on part-time nurses who divide their time among multiple schools. When this happens, it becomes harder to provide consistent care and coordinate with families and health care providers.
Without enough nursing support, schools may be more likely to:
Miss warning signs of physical or mental health concerns
Delay health screenings
Have less time to support students with chronic medical conditions
Struggle to coordinate care with families and medical teams
Have fewer opportunities for emergency preparedness training and planning
Face challenges implementing new systems for health records, referrals and communication
Leverage your "parent power" to advocate for school nurses
AAP policies place school nurses at the center of childhood health, safety and learning. Every child deserves access to a full-time nurse who can provide care, support and guidance throughout the school day.
Here are some ways parents can help advocate for full-time school nurses.
Find out what's happening in your schools
Do all schools in your district have full-time nurses? Are nurses assigned to one building or required to cover multiple schools? If your child attends a private school, ask whether a full-time nurse is available and how health services are provided.
Attend school board meetings
Ask school leaders how they are supporting student health and whether staffing levels meet students' needs. Speak up if funding cuts could affect school nursing positions.
Share your perspective
Engage with local media outlets and platforms, community publications or school newsletters. Explain why school nurses are an important investment in children's health, safety and academic success.
Contact elected officials
If a school nurse has helped your child or family, consider sharing your experience with local or state policymakers. Personal stories can help decision-makers understand why school nursing services matter when education and health funding decisions are being made.
Remember
School nurses do far more than treat bumps, scrapes and headaches. They help manage chronic health conditions, respond to emergencies, support mental health, identify health concerns early and help students stay healthy, safe and ready to learn. Every child benefits when a qualified school nurse is available throughout the school day.
More resources
About Dr. O'Leary
 Sonja O'Leary, MD, FAAP, is an Associate Professor of Pediatrics at the University of Colorado School of Medicine. She is currently the Chair for Ambulatory Pediatrics and School and Community Programs and previously served as the Medical Director of Denver Health Pediatrics at Denver Public Schools. She recently served as the chair of the Council on School Health (COSH) for the American Academy of Pediatrics (AAP) and has continued working with COSH most recently as editor of the upcoming 8th edition of the School Health Manual. As a native Spanish-speaker and a Colombian, she knows that different heritages, cultures and experiences bring important perspective to medicine.
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