Establishing a Standard

Recognizing the breadth of their work as school nurses and having a desire to establish a professional standard, the National Association of School Nurses (NASN) formed a future projects committee to explore the feasibility of a certification exam. In 1985, NASN partnered with a testing firm to develop and administer that exam, and NBCSN was formed, issuing the NCSN credential.

“The NCSN is the gold standard of school nursing practice and was created exactly because there was no national standard,” said Cogan. “This is a way to say this group of school nurses has met this rigorous standard.”

To earn the NCSN credential, school nurses must demonstrate that they hold foundational healthcare expertise for the wide range of ages they treat. “They need to be an expert in a lot, and the NCSN credential provides validation that they do because we test on the full spectrum of care that they have to provide,” said Theresa Field-Bobroski, NBCSN Executive Director.

Social Change Highlights School Nursing

If school nursing was a hidden healthcare system, the COVID-19 pandemic brought the role of the school nurse to the forefront of community healthcare. “There’s a lot of work that’s been added to a school nurse’s job to ensure that children are coming to a place that they’re safe and will hopefully remain healthy,” said Field-Bobroski. For example, contract tracing—the task of finding out and then contacting anyone who has been in contact with a person who tested positive for COVID-19—has become a vital part of school nurses’ jobs, though that often takes place after hours and without additional compensation for the additional hours.

“Unfortunately some of us have gotten into difficult conversations with parents right now because we’re giving them information that is hard to hear,” said Cogan. “Has their child been exposed and has to quarantine? Is their child positive? It’s been a rocky road through COVID because of the public health mitigation strategies that we have to implement for safety.”

Despite the challenges and additional work, school nurses have worked through the long days and difficult conversations in an effort to support the health and wellbeing of their students, schools, and communities.

Beyond the School

While much of school nurses’ work takes place within the school, the positive effects of their work expand into the communities. “It’s important for people to understand not just the tasks we complete but the impact we have on our students,” said Cogan.

Field-Bobroski shares the story of an NCSN who recognized that access to dental care was a challenge in her community, so she worked with a local dentist to came to the school to provide basic dentistry services to the students.

Cogan, a preschool NCSN, shared a personal experience with a new student who had arrived to the school after a year-long journey from Guatemala. Lunchroom staff noticed that instead of eating the breakfast and lunch she was served, the preschooler would instead fill her pockets with the food. Concerned about her refusal to eat, school staff turned to Cogan for guidance. Cogan ultimately discovered that the preschooler, age 4, felt responsible to help feed her family, who had dealt with food scarcity on their journey, and was bringing the food home for them instead of eating it herself. The school held a food drive for the family to help them until they were established in their new home and community. The little girl blossomed in her class and went on to become preschool valedictorian—a true testament to the school community and the role NCSNs play in supporting students and their families through every situation.

“When students are healthy, when their bellies are full, they’re going to be better students, they’re going to be better able to pay attention in class,” said Field-Bobroski. “When school nurses meet that NCSN requirement to do their job, and the better job the school nurses do, the better and healthier their students will be.”

“School nursing has been a hidden healthcare system in our country for way too long,” said Robin Cogan, Med, RN, NCSN, Outreach Co-Chair for the National Board for Certification of School Nurses (NBCSN). Indeed, school nurses not only care for patients from age 5 through 21, they also serve as a conduit to other healthcare and welfare systems, ensuring the health and wellbeing not only of the entire school community—including students, teachers, and administrators—but also of the families and the communities in which the schools are based.