The kiddos are back to school, and so are the school nurses. You may recall the school nurse as the person you went to when you got sick during the school day and who called your parents to pick you up, but their role goes far beyond that! School nursing began in the United States in 1902 to address contagious diseases and promote hygiene in New York City. When there was a drop in absences from 10,000 to just over 1,000 in ONE year, school nursing expanded across the country. School nursing has continued to transform.
I wanted to highlight the role of today’s school nurse and give a shout out to our local Hamilton City School District (HCSD) Nurses for the important work they do every day!
Role of the School Nurse
The National Association of School Nurses (NASN) defines the role of school nursing as a specialized practice of nursing that “protects and promotes student health, facilitates optimal development, and advances academic success. School nurses provide care coordination, advocate for quality student-centered care, and collaborate to design systems that allow individuals and communities to develop their full potential.”
School nurses help support the health and well-being of our students and community. This role has become more challenging with the increase in children with complex health care needs and chronic illnesses, in the provision of health education and emergency preparedness, and with the increasing demand for identification and support of mental health needs. The school nurse may be the student’s first access to a healthcare provider.
School nurses play a vital role in identifying potential health issues and connecting students and their parents to needed resources. School nurses help prevent and control the spread of infectious diseases and collect local health data. They distribute medications that a student may need and provide required medical care and treatment. School nurses are on the front line in evaluating any illness or injury that occurs at school and provide important routine assessments such as vision and hearing. School nurses also provide initial care in life-threatening emergencies such as allergies and seizures.
School Nurse Training Requirements
School nursing is a specialized nursing practice. School nurses in the HCSD:
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must be a Registered Nurse (RN) with a minimum education requirement of a bachelor’s degree in nursing (BSN) and have an active Ohio RN license.
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must complete a School Nurse Certificate program and obtain a School Nurse Professional Pupil Services License from the Ohio Department of Education.
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must successfully complete background checks by the Ohio Bureau of Criminal Investigation (BCI)/FBI.
Research Supporting School Nurses
In schools where nurses are present, students are healthier; and healthier students are better learners! Research has proven that schools with nurses present:
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see improved attendance, fewer illness-related early dismissals, and higher graduation rates.
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reflect cost savings relative to medical costs and lost productivity for parents and teachers.
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save time for teachers – up to 2 hours daily.
Recognizing the critical importance of school nurses, the Academy of Pediatrics (AAP) issued a policy statement in 2016 strongly recommending a minimum of one full-time RN in every school.
Our Hamilton City School District Nurses
Our HCSD has a full-time school nurse at each of our 8 elementary schools, our 2 middle schools, the freshman school, and the high school.
Our HCSD Nurses have a website at https://sites.google.com/hcsdoh.org/hcsdnursessite/home. Here you will find the resources and forms to help you prepare for the school year.
Our HCSD Nurses have partnered with Primary Health Solutions to provide healthcare services at the Primary Health Solutions Clinic located at Garfield Middle School. Transportation is provided to and from the student’s school. Appointments can be made by contacting your school nurse.
Q&A with Tracy Heinecke
I recently had the opportunity to speak with Tracy Heinecke, the Lead Nurse with the HCSD, and ask her some questions.
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What do you see as the rewards and challenges of being a school nurse?
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School nursing is rewarding; nurses can have a huge impact on students’ lives. Often, they are the link between the student with the healthcare system, enabling them to get the care they need. They have been able to demonstrate decreased student absences and help students remain in school.
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Challenges include high caseloads and the increasingly wide range of health needs of students. For example, in the 2024-2025 school year, there were over 43,000 clinic visits, over 38,000 medications provided, over 14,000 diabetic treatments, over 5,000 each for vision and hearing screens, over 3,000 ‘other’ treatments, e.g., tube feedings, and over 800 staff visits! The school nurse is the only medical person in a building of hundreds of students and educators. Language and cultural barriers can also be challenging to navigate.
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Please share information about the collaboration between school nurses and local physicians.
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HCSD is fortunate to have healthcare partners to help provide needed services. There is the partnership with Primary Health Solutions, as well as Cincinnati Children’s Hospital Medical Center (CCHMC), Dayton Children’s Hospital, Miami University, University of Cincinnati (UC) and the City of Hamilton Health Department. CCHMC diabetes services are ranked #2 in the nation and have been a great resource for our diabetic students. Nurses in the school nursing programs at Miami University and UC assist with vision and hearing screens.
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Please share more about the services provided by the school-based health center at Garfield Middle School.
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The Primary Health Solutions Clinic provides medical, dental, behavioral health, and vision care. They provide well-child checks, sports physicals, sick visits, vaccinations, medication management, and mental/behavioral health services.
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Would you share some recent wins within your school nursing program?
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There has been a focus on health literacy to ensure that all forms are easy for parents to understand. They also received a grant from the Community Health Foundation and 17Strong that enables feminine hygiene products to be provided free of charge.
In closing, I’d like to share a statement from a January 2025 JAMA Health Forum article: “Investing in school nursing is not only about fostering a healthier future for children, but also strengthening communities for generations to come.” Thank you to all school nurses!