AFT - American Federation of Teachers

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Every Child Needs a School Nurse

Over 75 percent of schools have a full- or part-time school nurse, as well as other healthcare professionals such as speech therapists, social workers and psychologists. The American Federation of Teachers represents over 14,000 school nurses and works with the School Health Leadership Subcommittee, a group of school nurses and school health personnel designated by the leadership of AFT Healthcare to identify and address the range of health-related issues that need action.

The breadth of the health issues and needs of children in our schools can be mind-boggling. While everyone recognizes schools as education centers and sites for extracurricular activities, there is far less awareness that the vast majority of schools are also healthcare settings. Whether in a free-standing school-based health clinic or in the school itself, school nurses work with students, paraprofessionals, teachers, other healthcare providers and parents to ensure that children are healthy so they can make the most of their opportunity to learn.

Every school day, children present myriad health needs that school nurses and other school personnel must meet. Among those needs are acute emergencies like seizures, low blood sugar and asthma attacks; emotional and psychological turmoil; required Early and Periodic Screening Diagnosis and Treatment for Medicaid-eligible students; as well the administration and monitoring of medication and procedures such as tube feeding. School nurses also provide students and faculty with strategies to promote good health and up-to-date information on infectious and contagious diseases. Ultimately, the school nurse manages the assessment, planning, intervention and evaluation of health services for students.

The Definition of School Nursing:

"School nursing is a specialized practice of professional nursing that advances the well-being, academic success, and life-long achievement of students. To that end, school nurses facilitate positive student responses to normal development; promote health and safety; intervene with actual and potential health problems; provide case management services; and actively collaborate with others to build student and family capacity for adaptation, self-management, self-advocacy, and learning." NASN/1999

Possibly the entire school team’s most overwhelming responsibility is meeting the health and safety requirements children with severe illnesses. Youngsters with a range of conditions once might have been institutionalized, but now they are living in our communities and attending our schools. These medically fragile children with very special healthcare needs present many challenges for school personnel.

While not all children have such severe needs, there are other conditions that require expert assessment and care. Diabetes, childhood obesity and asthma are common conditions that create challenges and expand the responsibilities of school nurses. These days, a struggling economy that undermines the financial security and living status of children can also pose health problems.

The Solutions:

Over the past 20 years, AFT Healthcare and the School Health Leadership Subcommittee have worked to create resources, policies and expert support to make certain that children with special health needs receive safe and appropriate care. Chief among the resources is the third edition of The Medically Fragile Child: Caring for Children with Special Healthcare Needs in the School Setting ( This manual spells out roles and responsibilities for the entire school team, as well as standards of care and legal considerations.

The School Health Leadership Subcommittee has identified childhood obesity and juvenile diabetes as priorities that must be addressed through both education and prevention strategies, as well as through ongoing care management and staff education. The subcommittee has developed a brochure, called The Diabetes Dilemma (, outlining policy considerations and guidance for school personnel to safely address the specific needs of over 150,000 diabetic children.

The National Association of School Nurses Web site contains a wide range of material for school nurses, including current trends in child health and links to free online resources:

The Action for Healthy Kids organization provides free resources and guidance on child nutrition, as well as activities designed to address and prevent childhood obesity: