Keeping Our Country's Schools Healthy and Happy

Did you know school nursing began in the early 1900s as an experiment in New York City? Children were missing school on a regular basis because of treatable diseases, so a nurse, Lina Rogers, RN, was brought into the school system to see if she could make a difference. The rate of absences decreased drastically, and school nursing grew to be a critical nursing specialty. Today, school nurses are responsible for caring for students who get sick or injured during school hours, as well as educating students about healthcare and growth development.We recently spoke with Nina Fekaris, MS, BSN, RN, NCSN, president of the National Association of School Nurses (NASN), to learn more about the role of the school nurse in modern society.

Nursing Notes (NN): Can you share a little bit about your nursing career and what led you to become a school nurse?

Nina: I first started working in a hospital after nursing school, but after the birth of my first daughter I stayed home for several years. When I decided to go back to work, I noticed a job opening as a nurse for a school district, and I thought it would be a great fit because I would be on the same vacation schedule as my daughter. Although I began my career because it worked with my family's schedule, I have stayed 30 years because I became passionate about my role in my schools. I was the only healthcare provider in my schools, and I needed to be the advocate for my students with chronic and acute health conditions. It was very empowering to me to know that with my interventions, students could fully maximize their school experiences.

NN: What is the role of a school nurse in today’s education system and how has it changed over the years?

Nina: Today, still make sure students are healthy and able to attend school, and we do a lot more. One of the things that has changed is the dramatic increase in the number of students with chronic diseases, like asthma, anaphylaxis, and diabetes, which can potentially impact their school day. School nurses also work in the areas of public and community health, health promotion, care coordination, leadership, and data collection for quality improvement. 

NN: What are your day-to-day responsibilities in your current role as a school nurse?

Nina: I'm responsible for approximately 3,000 students (one elementary and one high school). I write individual health plans for students with medical conditions that could impact them at school, and I train teachers and school staff using that plan so they are aware of symptoms they might see and actions they should take certain situations. 

NN: What are some of the most common medical issues you see among the students at the schools you work in?

Nina: Mental health issues like anxiety, depression, and panic attacks, as well as gastrointestinal symptoms, are most common. Other issues include asthma, anaphylaxis, diabetes, and concussions.

NN: In your opinion, what is the most rewarding aspect of being a school nurse?

Nina: I love being there for the kids. This year, a senior in the health career program asked to interview me. She has epilepsy, and I have written her health plan since she was diagnosed in 2nd grade. She told me, “I had no idea you were behind me all those years.” We often work behind the scenes, but it’s about the kids and doing what I need to do to help them succeed.

NN: As back-to-school season nears, what is one thing school nurses can do to prepare for the new school year?

Nina: I would like all school nurses to write a letter to the families at their schools, introducing themselves as the healthcare provider and sharing what the school nurse does for their child. 

NN: What advice would you give to a nursing student who is interested in becoming a school nurse?

Nina: School nurses must be able to work independently with confidence. We deal with many "gray areas," so we must be able to use judgement and have confidence in our decisions. I would also suggest they take communication classes. Much of what we do is sharing information, so the more skilled you are at communicating, the better. 

NN: What would you say is your greatest achievement in your nursing career?

Nina: Being elected as president of NASN is my greatest achievement to date. It is an honor to be able to provide leadership and direction for the 17,000 members of our organization and to work on policies that hopefully will impact all school nurses.

NN: Is there anything else you would like to add?

Nina: My focus during my NASN presidency will be about trying to empower school nurses to use their voices to tell the stories of their students and about the lives they have touched, so that the public can better understand the role of the school nurse and our positive impact on the future of children in our country.

Visit for more information about NASN. To learn more about pursuing a career as a school nurse, visit And to get a glimpse into the daily responsibilities of a school nurse, check out the Campaign’s “A Day in the Life” video featuring Sheila.

Article courtesty of Johnson & Johnson

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