An important figure in the lives of Pennsylvania’s two million school-aged children is the school nurse. Most people associate the school nurse with her traditional function of providing medical aid to students and staff. However, the school nurse plays a significant role beyond patching skinned knees.

The health of the students in an entire building or school district can be significantly affected by the actions of the school nurse. The nurse’s role is comprehensive enough such that the children can be screened for a number of conditions, such as asthma and diabetes, and act as a powerful preventative measure. School nurses also deal with issues such as drug and alcohol abuse, school violence and teenage pregnancy. Their services are provided within the framework of professional nursing practice, through which the nurses address the physical, mental, emotional and social health of their students.

The duties and functions of school nurses are determined, in large part, by the health conditions of the populations they serve. As licensed health care providers, the school nurses must respond without direct medical supervision to the unique health related issues present in their schools. Some schools populations, especially in urban settings, may struggle with widespread asthma. Rural districts may face a dearth of nursing services outside of the school setting.

School nurses, in providing these school-based services, fulfill the mandates of both federal and state statutes and regulations. But more precisely, they use the mandates as the baseline of services and often play larger roles than those prescribed by law. Many nurses readily act as counselors and confidants to their students to help them cope with health issues that might not require professional medical care. Their experience in dealing with young people strengthens the education the nurses themselves received in earning their degrees. As certified educational specialists, the school nurses’ role is to support student success in the learning process. Certainly, a child who is not in good health cannot perform well in the classroom.

House Resolution 427 of 2003 directs the Joint State Government Commission to conduct a study on how other states’ laws provide for certified school nursing services within the school environment, including a look at ratios between nurses and students, and the education and certification requirements for school nurses. This report if the culmination of that study.

As background, the report lists health conditions that are reported in Pennsylvania’s schools. The report then lists the health services provided by certified school nurses and describes the school nurses’ functions as health care providers and certified educational specialists.

The report next shows health services provided by school nurses in other states along with the school nurses’ responsibilities in delivering those services. A summary of statutory provisions is provided and a section details selected states’ school nurse responsibilities. Certification, licensure, and continuing education requirements for Pennsylvania and other states’ school nurses are discussed as well. Finally, the report addresses the issue of school nurse-to-student ratios, including the relevant provisions in Pennsylvania and other states, and data on the numerical ratios for schools in the United States.