“School nursing isn’t just about ice packs and band-aids. It’s a complex nursing specialty in community health. In most cases, the school nurse is the only medical professional on site.”
Keisha Simons Major, MSN, Regional Health School Specialist, Prince George’s County Public Schools
In 1902, Lina Rogers became the first school nurse in the United States. She was hired as part of an experiment in New York City to see if providing medical care directly to students could help reduce absenteeism. Previously, students who had contagious conditions were excluded from school rather than being helped to continue attending. During this month-long experiment, Rogers provided care for students in four schools during school hours, and after classes were released, she visited parents and educated them on proper care.
The results were remarkable. Lice all but disappeared, and students with contagious diseases could attend school more than before. Because of her resounding success, Rogers was eventually appointed to New York City’s Board of Health as their first municipally sponsored school nurse. Over the last century, school nursing has grown immensely, and now there are over 95,000 nurses in public and private schools across the country.
School nurses provide critical services to students in educational settings. While most students may interact with their school nurse when they get hurt or unwell, school nurses perform many other critical tasks, including school-wide health surveillance, monitoring student vaccine status, and health education. They can also help students access healthcare or mental health care services outside of school and may work one-on-one with families, educating them on how to best care for their kids, just like Rogers did over 100 years ago.
Jobs for school nurses are in high demand as the Centers for Disease Control and Prevention recommends that schools maintain a ratio of one nurse for every 750 students. However, most districts are falling short. A paper published in 2023 found that in Washington, the ratio across the state was one nurse for every 848 students. This lack of nurses in schools is due to both staffing shortages and district budget shortfalls.
Becoming a school nurse starts with completing a general nursing degree program. Next, aspiring school nurses can complete on-the-job training or pursue additional education through a bachelor’s, master’s, or certificate program. Licensure by the state where they practice is mandatory, but certification is optional.
If providing nursing care to students sounds like a rewarding career, keep reading to learn about top programs, admission requirements, typical job duties, and salary ranges.
Meet the Expert: Keisha Simons Major, MSN-Ed RN, NCSN
Keisha Major is a regional health school specialist with Prince George’s County Public Schools. She is a registered nurse with a master of science in nursing and holds National School Nurse Certification, bringing professional expertise in student health and wellness to her role.
In her work, Major supports the physical and emotional well-being of students, applying clinical knowledge and community care to promote safe, healthy learning environments.
HealthcareDegree.com: What do you wish the people understood about school nurses?
Major: School nursing isn’t just about ice packs and band-aids. It’s a complex nursing specialty in community health. In most cases, the school nurse is the only medical professional on site.
We are making independent nursing assessments on everything from diabetic hypoglycemia to severe allergic reactions to head injuries to everything else in between and rare. Unfortunately, non-medical colleagues see the numerous first-aid needs, such as a scraped knee or nosebleed; yet they don’t see us managing insulin pumps for kindergarteners, the tube feedings or catheterizations of students with various complex medical diagnoses, attending to students suffering with concussions, or the safety plan for students with severe anxiety.
We are the bridge that allows for medically fragile and chronically ill children to be safe, healthy, and ready to learn like their peers to have a normal educational experience. And depending upon where in the nation or world, the school nurse is the only healthcare provider they will see. We are often the first to identify vision deficits, hearing loss, neglect, or undiagnosed chronic conditions. The school nurse is an unsung hero to every student attending school.
HealthcareDegree.com: What advice would you give to aspiring school nurses?
Major: Be prepared to use everything you have learned during and post-nursing school. Most importantly, making that mindset shift from “acute” to “holistic” is key. We aren’t just treating a symptom; we are teaching a child and often the family as well how to navigate the healthcare system, understanding disease processes, and the importance of children “knowing” their own bodies. Every visit and conversation is a teaching moment.
It’s also important to possess and trust strong assessment skills because there won’t always be a beeping monitor to tell you that something needs to be done, or worse yet, someone is in critical condition and needs care ASAP. As a school nurse, you will rely on your eyes, ears, and nursing equipment. School nurse success depends on relationships with the principal, teachers, and other building staff (members of the interdisciplinary team). Understanding the big picture that school nurses are supporting educational goals, by making sure that their medical needs are met, so they can be successful in attaining their education.
HealthcareDegree.com: What is your favorite thing about being a school nurse?
Major: My favorite thing is that the only thing you can depend on is that there is always change. Like in an emergency room or urgent care, you “treat ’em and street ’em.”
In school nursing, you get to see, bond with, and educate the terrified kindergartner with asthma, helping them grow into a confident middle schooler who knows exactly when their inhaler is needed. You get to witness the long-term impact of the care provided.
There is incredible value in being the one adult in the building who doesn’t care about their grades or their homework, but just cares about “them.” Being the person a student trusts enough to disclose that they are hungry, scared, or hurting is a privilege that never gets old. Let’s be real: having weekends, holidays, severe inclement weather days, and summers off to recharge allows each school nurse to be better when school is in session. Having a true work-life balance is something that is hard to find in nursing—and unfortunately, [this] has led to significant burnout being rampant in bedside nursing.
School Nurse Specializations & Degree Types
School nursing is a specialization within the field of nursing. To work as a school nurse, one must first complete a nursing education program. Typically, nursing programs take two years to complete as either an associate’s or four years as a bachelor’s. However, this timeline can vary based on previous education completed and sometimes takes as little as a year.
While it can be possible to work as a school nurse by completing a general nursing program and gaining on-the-job experience, most school nurses complete additional education. The most common programs are a bachelor’s of science in nursing (BSN), a master’s of science in nursing (MSN), or a certificate.
Admissions Requirements for School Nurse Programs
Nursing program admissions can be quite competitive, so it is imperative that candidates submit the best possible application. While the specific requirements can vary from program to program, the two most common ones are prerequisite coursework in biology, math, anatomy, and science, and a minimum 3.0 GPA. Other factors to consider include prior healthcare experience, other completed education, and veteran status.
Advanced programs, such as a master’s or certificate, may have additional requirements for admission, such as already having completed a bachelor’s degree, letters of recommendation, a statement of purpose, and work experience in the field.
School Nurse Program Accreditation
Before enrolling in a nursing program, prospective students should ensure that the school is accredited. Accreditation is a voluntary process that programs undergo to evaluate the quality of the faculty, facilities, curriculum, and more. Accreditation also looks at students’ outcomes to ensure the program adequately prepares graduates for future work.
Most states require that registered nurse license applicants have completed an accredited program, as do most certificate programs. Nursing programs are accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN).
On-Campus School Nurse Degree Programs
Duke University – School of Nursing
At Duke University School of Nursing, students can earn their bachelor’s of science in nursing in just two years of study. This accelerated program is patient-centric and prepares nurses for the challenging work in this field. While this is not a school nurse-specific program, completing a nursing degree program is required to start this career. This is a full-time, on-campus program, so students should plan accordingly. Working is not recommended for students pursuing this degree.
Admission requirements for this program include having already completed a bachelor’s degree in any field as well as having completed prerequisite coursework in microbiology, statistics, anatomy and physiology, and human growth and development. While not required, coursework in nutrition is highly recommended. Clinical coursework is at the heart of this degree, and students can choose to complete it in their local community or to participate in a global exchange program that can provide a diverse and international experience.
- Location: Durham, NC
- Duration: 16 months
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
William Paterson University – School of Nursing
The masters of science in nursing in school nursing at William Paterson University is a 33-credit graduate degree designed for registered nurses who want to deepen their expertise in school health and nursing practice. This concentration combines 24 credits of school nurse instructional coursework with 9 credits of graduate-level core nursing studies, preparing students to expand their clinical, leadership, and educational skills in the school environment. As part of the program, students complete a school nurse student teaching practicum, and upon finishing the instructional component, they become eligible for the Educational Services Endorsement needed for certified school nursing practice in New Jersey. The curriculum includes courses such as school health services, legal issues in school nursing, counseling skills, and special education foundations.
- Location: Wayne, NJ
- Duration: Two years
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
The University of Texas at Arlington College of Nursing and Health Innovation
At The University of Texas at Arlington College of Nursing and Health Innovation, students can earn a bachelor’s of science in nursing. This program aims to develop competent, self-directed practitioners who are ready to enter the workforce or pursue further education, depending on their goals and interests. Students in this program gain their hands-on experience in a variety of clinical settings, including acute care, hospitals, public health agencies, and schools.
To be considered for admission, applicants must have completed extensive prerequisite coursework in biology, anatomy, microbiology, chemistry, psychology, composition, and math. The nursing component of this degree program spans the student’s junior and senior years, so they must complete all general education requirements first. Other admission requirements include passing both a background and drug test.
- Location: Arlington, TX
- Duration: Two years
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
There are two educational options for aspiring school nurses offered at Lewis University. The first is a one-year non-degree school nurse program that prepares students to sit for the Illinois state school nurse exam. The second is a comprehensive master’s of science in nursing with a concentration in school nursing. Both programs require similar classes such as learning theories and schooling, exceptional learners in inclusive communities, and literacy for other school personnel. Likewise, both programs require an internship to put the new education into practice.
The master’s program is overall more comprehensive, and students are required to complete a capstone project where they design and implement a school nursing project into an actual educational setting. It should be noted that students are required to sit for and pass the Illinois State Board of Education content area test in school nursing before starting the internship component.
- Location: Romeoville, IL
- Duration: As little as one year
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
Registered nurses who have already earned a bachelor’s degree can complete a graduate certificate in school nursing at New Jersey City University. The goal of this program is to prepare registered nurses for the unique rigors and challenges of working as school nurses. Training includes working with diverse populations, addressing school-wide health, and bridging the gap between healthcare and education.
The two options for this certificate include a Non-Instructional School Nurse Certificate and a Standard (Instructional) School Nurse Certificate. The first certificate is only 15 credit hours, while the second is 21 hours. The primary difference between the two programs is the addition of an extra school nurse practicum. Designed for the adult learner, either certificate program can help advance already established careers.
- Location: Jersey City, NJ
- Duration: Varies
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
Online or Hybrid School Nurse Degree Programs
National Association of School Nurses
Since school nurses are not required to have a formal education program aside from their nursing school, it can be advantageous to complete independent additional coursework specific to school nursing, such as those offered through the National Association of School Nurses. In addition, all registered nurses must complete continuing education credits, and the NASN is accredited by the American Nurses Credentialing Center’s Commission on Accreditation, making these courses an excellent choice for both current and aspiring school nurses.
The NASN offers many online courses and webinars that can teach even the most veteran school nurse new tricks. All coursework is available to all nurses, but members receive waived or reduced tuition. Current offerings include assessing substance abuse risk in students, Covid-19 prevention in schools, improving health through school-located vaccinations, and decreasing absenteeism in students with migraines.
- Location: Silver Spring, MD
- Duration: Varies by course
- Accreditation: American Nurses Credentialing Center’s Commission on Accreditation
Elms College School of Nursing
The online master’s of science in nursing at Elms College School of Nursing offers an emphasis on school nursing for nurses who want to work in an educational setting. This distance learning program offers a high degree of flexibility for nurses already working in the profession who want to complete additional education. Graduates will have the skills to track the potentially complex health needs of individual students and a school population as a whole. This program places a specialized emphasis on school nurses as public health educators to help improve the overall health of an educational setting.
Admissions to this program are offered on a rolling basis, allowing students to start at a time that suits their needs. Required coursework includes nursing and healthcare informatics, leadership and management in healthcare, pharmacology, principles of population health, students with disabilities, and school nurses as public health educators.
- Location: Chicopee, MA
- Duration: Two years
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
At Western Governors University, aspiring school nurses in Florida, Indiana, Missouri, Nevada, New Mexico, Texas, and Utah can complete their nursing education primarily through distance learning. This innovative program has navigated complex licensure laws to prepare students residing in these states for professional careers as registered nurses and, eventually, school nurses. While the length of this program varies, ambitious students can complete it in as little as 18 months, but the most common timeline is two-and-a-half years.
In total, students must complete competencies, not credits, in order to earn this degree. Those with field experience can complete the program faster than those who have never studied nursing. Tuition is charged per six-month term rather than per credit, so there is no price increase regardless of how many classes are completed in that time frame. About 60 percent of this course is online, while the remaining 40 percent is in a clinical intensive completed near the student’s home.
- Location: Millcreek, UT
- Duration: 18 months
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
Ashland University offers an online certificate option for aspiring school nurses who want to complete advanced education without committing to a master’s program. Students only need to complete 13 to 16 credits to earn this certificate, which is significantly fewer than most master’s degrees. However, there is an internship requirement that ensures students gain hands-on experience in this field.
Required classes include health care of the school community, health determinants and academic indicators, educational strategies for healthcare providers, and interprofessional collaboration. The internship is guided by an Ashland University faculty member and can be completed in the student’s home community. Graduates of this program are well prepared for entry-level work as school nurses.
- Location: Ashland, OH
- Duration: Varies
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
At Azusa Pacific University, students can earn an online master’s of science in nursing as a School Nurse Services Credential (SNSC) and Family Nurse Practitioner (FNP). This intensive degree offers a range of designations that, with the proper licensure and examinations, enable graduates to independently provide primary care as school nurses.
The clinical component of this program focuses on educational settings and prepares students for future careers. Since this program is primarily online, students will need to coordinate with the school to find suitable locations near them.
To be eligible for this program, applicants must already be licensed registered nurses and have completed a bachelor’s degree or higher. Other admission requirements include a written statement of purpose, a current resume, and at least two professional or academic recommendations.
- Location: Azusa, CA
- Duration: Two to three years
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
How Long Does it Take to Become a School Nurse?
It takes approximately two years to complete the general nursing education requirements in order to start a career as a nurse. However, most two-year programs have prerequisite coursework requirements that can take a year or more to complete.
Once general nursing education has been completed, nurses can apply for entry-level work as school nurses or they can complete additional education and training as they see fit. These advanced programs can take one to three years to complete.
How To Become a School Nurse – Step-by-Step Guide
Step 1: Graduate from High School or Complete a GED (Four Years)
Graduating from high school or earning a GED is the first step toward becoming a school nurse. Students should focus on science and math classes to help prepare them for college-level coursework. Aspiring school nurses can also volunteer in their own school’s health center to gain early hands-on experience in this field.
Step 2: Complete a Nursing Program (One to Four Years)
All nurses must complete a nursing program in order to enter this field. Nursing programs typically take two years to complete, although some accelerated programs can be completed in as little as one. Students can earn either an associate’s of science in nursing or a bachelor’s of science in nursing. Please note that to qualify for the Nationally Certified School Nurse (NCSN) credential, a candidate must have at least a bachelor’s degree.
Step 3: Pass NCLEX-RN (Timelines Vary)
Upon completing a nursing program, graduates must sit for the National Council Licensure Examination- Registered Nurse exam. All states require this as proof of competency in this field and to earn licensure. More details can be found in the certifications and licensure section below.
Step 4: Apply for State Licensure (Timelines Varies)
After passing the NCLEX-RN, nurses can apply for a license in their state. All school nurses are registered nurses with licensure to practice. More details can be found in the certifications and licensure section below.
Step 5: Complete Additional Education or Exams (Timelines Vary)
Some states or school districts may require additional education or exams in order to work as a school nurse. Certificates and master’s degrees are often listed as requirements on job applications. Requirements vary by employer and by state, so professionals in this field should ensure they have the most competitive education and training possible.
What Do School Nurses Do?
School nurses work in all kinds of educational settings and with students of all ages. Places of employment can range from daycares to high schools and colleges. In general, the duties of school nurses include:
- Establishing and monitoring health initiatives within a given school
- Coordinating testing for health conditions such as scoliosis, dental issues, vision problems, and lice
- Educating students on proper hygiene techniques
- Administering immunizations
- Auditing immunization records to ensure all students are up to date
- Implementing drug prevention programs
- Helping students who feel ill during the course of the school day
- Providing first aid to students who are injured on campus
- Referring students to additional services such as mental health therapy, occupational therapy, or specialists
School Nurse Certifications & Licensure
School nurses straddle the line between education and healthcare. At a minimum, all school nurses must be licensed as registered nurses in the state where they practice. The requirements to obtain an RN license are set by each state nursing board and typically include completing an accredited education program, passing the NCLEX-RN exam, a background check, and a drug screening.
In addition to a registered nursing license, many states require school nurses to obtain additional certification. These requirements can vary significantly, so it is imperative to contact the state school and nursing board to know the qualifications. In California, for example, the requirements to be a school nurse are:
- Have a bachelor’s degree or higher
- Hold a valid registered nurse license in California
- Have two years of work experience as a school nurse with a preliminary credential
- Complete a Commission-approved school nurse program and obtain the formal recommendation of the college or university where the program was completed
In addition to required state licenses, there are voluntary certifications that school nurses can earn. These certifications demonstrate a high level of competency in this field and assure employers and students alike that the certificate holder has the skills and education to excel as a school nurse.
The primary certification school nurses earn is the Nationally Certified School Nurse (NCSN) from the National Board for Certification of School Nurses (NBCSN). To be eligible to sit for the exam for this certification, candidates must have earned at least a bachelor’s degree and have 1,000 hours of practice as a school nurse.
How Much Do School Nurses Make?
The Bureau of Labor Statistics (May 2024) offers salaries for nurses on the whole, without distinction for specialization. Currently, there are 3,282,010 nurses in the United States, and they earn $98,430 per year on average. As of January 2026, the latest available percentiles for wages were:
- 10th percentile: $66,030
- 25th percentile: $78,610
- 50th percentile (median): $93,600
- 75th percentile: $107,960
- 90th percentile: $135,320
School Nurse Career Alternatives
Here are some alternatives to a career as a school nurse:
Become a Health Educator
Health educators promote the wellness of individuals and communities through targeted education programs. They do this by first conducting surveys to determine a community’s needs. They develop a curriculum, implement it, and monitor results. Typically, they work for hospitals, clinics, government agencies, nonprofits, and public health centers.
- Typical Education: Bachelor’s
- Licensing or Certifying Organization: National Commission for Health Education Credentialing (NCHEC)
Become a Public Health Nurse
Public health nurses are concerned not only with the health of a single patient but rather with the health of a specific population or community. They work to create programs to help at-risk groups to improve the overall health of a community. Often, they participate in education programs or campaigns, wide-scale vaccine clinics, and strategic interventions.
- Typical Education: Bachelor’s of science in nursing
- Licensing or Certifying Organization: National Board of Public Health Examiners.
Become a Social Worker
Social workers provide practical support to clients who have trouble accessing services or need mental health support. Typically, social workers are employed by nonprofits and government agencies. However, they can work anywhere clients need help, including hospitals and clinics.
- Typical Education: Master’s degree
- Licensing or Certifying Organization: Association of Social Work Boards (ASWB)
Kimmy Gustafson
WriterAt HealthcareDegree.com, Kimmy Gustafson has delivered in-depth and insightful articles since 2019, aiding prospective students to navigate the complexities of choosing the right healthcare degree. Her recent work includes topics such as the ethics of gene editing and physician assistant’s fight for autonomy.
Kimmy has been a freelance writer for more than a decade, writing hundreds of articles on a wide variety of topics such as startups, nonprofits, healthcare, kiteboarding, the outdoors, and higher education. She is passionate about seeing the world and has traveled to over 27 countries. She holds a bachelor’s degree in journalism from the University of Oregon. When not working, she can be found outdoors, parenting, kiteboarding, or cooking.