WCH: School Nurses


The Division of Public Health, School Health Consultant Team, part of the School Health Unit within the Children and Youth Branch, is committed to promoting the health and learning of the state's children and youth.

"School nursing is a specialized practice of professional nursing that advances the well-being, academic success, and life-long achievement and health of students. To that end, school nurses facilitate normal development and positive response to interventions; promote health and safety including a healthy environment; intervene with actual and potential health problems; provide case management services; and actively collaborate with others to build student and family capacity for adaptation, self- management, self-advocacy, and learning." (National Association of School Nurses, 2010)

"Having a full-time school nurse in every school is the best means of ensuring a strong connection with each student’s medical home." (American Academy of Pediatrics, June 2016)

At minimum, one school nurse should serve no more than 750 students, depending on community and student population. (CDC, Healthy People 2020 goal, Objective 5.1)


In North Carolina more than 1,200 registered nurses are employed to provide school nursing services. Each school nurse serves and average of 1,112 students, 48 percent more students than the federally recommended ratio of 1 nurse per 750 students. School nurses in North Carolina are employed by a variety of agencies, including local school districts, local health departments, hospitals, or a combination of agencies. In most schools, the school nurse is the only licensed health care provider in the school, and in most school districts, a school nurse manages all school health services and coordinates all school health programs. She or he also serves as consultant and resource for school health education. Additionally, school nurses are employed by private or religious schools in the state, and some state-supported charter schools also employ school nurses.

Given the breadth and variety of practice settings of school nurses, the School Health Unit makes available the services of one state school health nurse consultant, six regional school health nurse consultants, and one charter school health program to provide leadership, training and consultation services to school nurses and school staff. Additionally, the school health consultants support parents, teachers, administrators, and community collaborators who also promote the health and learning of children and youth. Through their influence, the school health consultants collaborate with multidisciplinary representative specialists across the Division of Public Health and with local communities to promote maximum physical, social, emotional, and educational growth of children and adolescents in the school setting. Among the goals of the School Health Consultant Team are to improve the quality of school health programs and school nursing practice, including raising the number of school nurses in the state achieving national school nurse certification and the number of school districts in the state improving their school nurse to student ratio. Currently, 51 percent of the state’s school nurses have reached school nurse certification. The goal of improving the school nurse to student ratio is heavily influenced by actions of the NC General Assembly, which has, beginning with the 2004-05 school year, provided state funding for some school nurse positions. The School Health Unit administers the General Assembly’s School Nurse Funding Initiative through contracts and agreements with health departments serving nearly all of the 115 school systems. 


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Last Modified: June 19, 2019