Kids get sick and they play rough. They're simple facts of life. Put hundreds of children in the same building, all day long, five days a week, and the odds of your child becoming ill or taking bumps and bruises go up dramatically.

Who does your child go to when she's sick or gets hurt at school? Your knee-jerk answer is probably, "A trained medical professional, like a nurse," right? You may be surprised.

Rare Breed

According to the National Center for Education Statistics and the National Association of School Nurses (NASN), only 45 percent of the public schools in the US have a full-time nurse, 30 percent have a part-time nurse and 25 percent have no nurse at all. Also, the NASN recommends, as a minimum, that there be one registered nurse for every 750 students. Not many states meet this goal.

What happens when there's no nurse at all? The task of caring for the students usually falls on the school principal, a secretary or a teacher.

Types of Nurses

When it comes to school nurses, you'll most likely come across one of two types of nurses: registered nurses (RNs) or licensed practical nurses (LPNs). Each state has its own laws about education and licensing requirements for each type. There are also laws on what medical activities each type can and can't do. In general, though:

  • RNs have a two- or four-year college degree and pass an examination to become licensed or certified in the state where they work. Because of their advanced training and education, RNs can perform a variety of medical activities, such as create health care plans for patients, administer practically any medication and make independent decisions about how and when to treat an injury or illness
  • LPNs must have a high school diploma, complete a one-year nursing program and also pass an examination for a license. The test is much different than the RN test. LPNs have to be supervised by a doctor or an RN, and they usually perform duties like taking temperatures and administering some medications

Both RNs and LPNs have advanced training in emergency first aid and CPR.

School Rules are Different

When it comes to school RNs and LPNs, the states have different laws, too. For example, some states, like Connecticut, require school boards or districts to hire at least one school nurse. Other states, like Texas, have no such requirement.

The rules vary on other matters, too. In Connecticut, for example, the school district nurse must be an RN, have at least one year of experience and a valid state license. In Texas, if a school or district decides to hire a nurse, he must be licensed by the state.

The NASN recommends against having only an LPN in a school setting. That's because they don't have the training RNs have at recognizing the differences between minor and major health problems and determining the proper amount of medication to use, for example. However, many schools follow Connecticut's lead and hire LPNs to help RNs.

An Even More Rare Breed?

The Great Recession had an impact on school nurses. And it may be long lasting. States and cities are dealing with budget cuts and crunches, and school nurses are an easy target to cut costs and save money. Obviously, this means your child may not get quality, immediate medical assistance if something happens at school.

It's even more bleak for parents with children with pre-existing or chronic problems, like diabetes. They typically rely on school nurses to make sure their children get the proper medical attention.

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Tagged as: Education Law, School Law, school nurses, school law lawyer