Increasing numbers of students enter schools with chronic health conditions that require management during the school day. The AAP supports the goal of professional preparation for all school nurses and recommends the use of appropriately educated and selected school nurses to provide school health services. School nurses, working with pediatric patient-centered medical homes, school physicians, and families, are in a critical position to identify unmet health needs of large populations of children and adolescents in the school setting. The impact of social determinants of health are felt in the school setting and well known to school nurses.2,3 School nursing is a specialized practice of professional nursing that advances the well-being, academic success, and lifelong achievement and health of students. Responsibilities include development of plans for responding to emergencies and disasters and confidential communication and documentation of student health information. School nurses are well positioned to take the lead for the school system in partnering with school physicians, community physicians, and community organizations. One in five young people between the ages of 4 and 17 years experiences symptoms of minor to severe mental/behavioral health problems. Any conflicts have been resolved through a process approved by the Board of Directors. Position Statement: Education, Licensure, and Certification of School Nurses, Healthy People 2010: Understanding and Improving Health, Pediatrician Guidance in Supporting Families of Children Who Are Adopted, Fostered, or in Kinship Care, Evaluation and Management of the Infant Exposed to HIV in the United States, Routine Neuroimaging of the Preterm Brain, Follow American Academy of Pediatrics on Instagram, Visit American Academy of Pediatrics on Facebook, Follow American Academy of Pediatrics on Twitter, Follow American Academy of Pediatrics on Youtube,,, PROFESSIONAL PREPARATION FOR SCHOOL NURSES, Copyright © 2008 by the American Academy of Pediatrics. There should be a process by which additional certification or licensure for the school nurse is established by the appropriate state board. Association for Supervision and Curriculum Development. The school nurse has a unique role in provision of school health services for children with special health needs, including children with chronic illnesses and disabilities of various degrees of severity. In 2010, 215 000 people younger than 20 years in the United States had a diagnosis of either type 1 or type 2 diabetes.20 The prevalence of food allergies among children younger than 18 years increased from 3.4% in 1997–1999 to 5.1% in 2009–2011.21 An average of 1 in 10 school-aged children has asthma,22 contributing to more than 13 million missed school days per year.23 As the number of students with chronic conditions grows, the need for health care at school has increased.24 The rise in enrollment of students with special health care needs increases the need for school nurses and school health services.25, Caring for children with chronic conditions in schools requires registered professional school nurses. Their daily presence in the school setting further augments and potentiates the pediatrician’s professional interventions with individual children and adolescents.14, Collaboration among pediatricians, families, school staff, school physicians, and school nurses is increasingly critical to optimal health care in both office and community settings. The American Academy of Pediatrics recognizes the important role school nurses play in promoting the optimal biopsychosocial health and well-being of school-aged children in the school setting. The school nurse serves in a leadership role for health policies and programs. Without a school nurse, unlicensed personnel who are uncertain what to do medically are at risk of sending children home from school or to the emergency department needlessly.37, The presence of a coordinated school health program, often led by school nurses, contributes to both educational achievement and the educational system.38 School nurses can provide key leadership in all the components of the Whole School, Whole Community, Whole Child model.39 Direct health services provided by a school nurse are linked to positive academic achievement. Pediatricians can offer direct support of school nurses by serving on school wellness policy committees, school health advisory committees, emergency preparedness committees, or other school-related decision-making bodies. Barbara L. Frankowski, MD, MPH, Immediate Past Chairperson, Centers for Disease Control and Prevention. As a leader of the school health team, the school nurse must assess the student's health status, identify health problems that may create a barrier to educational progress, and develop a health care plan for management of the problems in the school setting. School health services staff also are responsible for coordinating care by communicating with the student’s family and health care providers so that they can stay healthy and ready to learn. School nurses play an important role in interpreting medical recommendations within the educational environment and, for example, may participate in the development of action plans for epilepsy management and safe transportation of a child with special health care needs.11,12 School nurses may also provide insight to a student’s pediatrician when attendance concerns, parental noncompliance with medical home goals, or even neglect or abuse is suspected. The school health service promotes healthy development and wellbeing, helping students reach their full potential. Policy statement: community pediatrics: navigating the intersection of medicine, public health and social determinants. 2003. This policy statement describes for pediatricians the role of the school nurse in serving as a team member in providing preventive services, early identification of problems, interventions, and referrals to foster health and educational success. Breena Welch Holmes, MD, FAAP, Chairperson, Nina Fekaris, MS, BSN, RN, NCSN – National Association of School Nurses, Veda Johnson, MD, FAAP – School-Based Health Alliance, Sheryl Kataoka, MD, MSHS – American Academy of Child and Adolescent Psychiatry, Sandra Leonard, DNP, RN, FNP – Centers for Disease Control and Prevention, Cynthia DiLaura Devore, MD, FAAP, Past Chairperson, Jeffrey Okamoto, MD, FAAP, Immediate Past Chairperson, Carolyn Duff, RN, MS, NCSN – National Association of School of Nurses, Linda Grant, MD, MPH, FAAP – American School Health Association, Elizabeth Mattey, MSN, RN, NCSN – National Association of School Nurses, Mary Vernon-Smiley, MD, MPH, MDiv – Centers for Disease Control and Prevention. The school nurse provides direct care to students.13 The school nurse provides care for injuries and acute illness for all students and long-term management of students with special health care needs. Schools and school nurses can partner with medical homes and public health agencies to increase access to or to deliver vaccines. Dynamics of obesity and chronic health conditions among children and youth. Pediatricians should play an active role in supporting the availability and continuing education of the school nurse. Physical and emotional health problems rank high among the factors contributing to chronic absenteeism (missing 10% or more of school days for any reason), a key risk factor for failing to complete school.35 Health-related problems contributing to academic underachievement are a primary responsibility of the medical home, the family, and the school health services team led by the school nurse in the health office on a daily basis. Although the concept of a school nurse has existed for more than a century, uniformity among states and school districts regarding the role of a registered professional nurse in schools and the laws governing it are lacking. Her early success in reducing absenteeism led to the hiring of 12 more nurses. The percentage of children 6 to 11 years of age with obesity increased from 7% in 1980 to nearly 18% in 2012, with more than one-third of children now overweight or obese.31. Provide consultation on school health issues, both clinical and management, to parents, students, school administrators, school nurses, school physicians, local boards of health, health educators, teachers, counselors, municipal agents, health care providers, etc.