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Elementary vs. High School Nurse: What is Right for You?

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School nurses are a critical part of many settings. They work in a wide variety of educational environments, including public and private preschools, K-12 schools, colleges, universities, public health agencies, hospitals, and overseas military bases. These specialists are dynamic and integral members of the student support team.

A Brief History of School Nurses

The roots of school nursing began more than one hundred years ago. In 1902, a New York City school district hired Lena Rogers to reduce absenteeism by working with students and families to reduce communicable diseases. After successfully implementing a healthcare intervention, Rogers expanded the role to schools across the entire city.

Since then, school nursing has evolved and expanded to include many essential roles and responsibilities. In those early days, the focus was on school absenteeism and slowing down infectious diseases. After World War 1 and 2, school nurse roles became more diversified, including administering vaccines, health screenings, developing nutritional programs, and focusing on delivering quality healthcare to high-need schools and districts.

Today, school nurses continue with student health protection but have become much more specialized. They are school leaders who work with students with chronic diseases, provide health education to parents and families, conduct vision and hearing screenings, and much more.

What’s the Difference Between an Elementary and a High School Nurse?

The most common school nursing positions are in elementary and high school settings. While both roles are crucial to the school’s overall success, there are significant differences between them. Both jobs involve working with school-aged children, but as students mature and develop, the nurse’s approach varies, too.

Many elementary school nurses help children develop good hygiene practices and self-awareness of their health. High school nurses deal with another area altogether, including sexual health and other adolescent-specific developments. Both roles are rewarding and essential, but candidates for each level should consider the differences.

Elementary School Nurse

The first requirement to be an elementary school nurse is to love working with children. The reward of protecting the health of young students is the drive for those that pursue this profession, especially in elementary school settings. As an elementary school nurse, you can expect a wide range of responsibilities, including:

  • Providing healthcare to students. They administer first aid, conduct health assessments, and evaluate the severity of injuries. As students inevitably get sick or injure themselves, the school nurse is the first line of defense.
  • Serving the school community. Elementary nurses are more than workers tucked into an office; they are sources of information and advice for the entire school community.
  • Acting as leaders in the school. Nurses take on a leadership role in schools, training staff and students, spearheading school and community health efforts, and standing out as a go-to for school programs.
  • Administering medications. Many elementary school students forget to take their medicines regularly, and school nurses ensure that all of those children stay on track. Nurses are aware of all students’ health needs and have their medications accurately organized and ready to administer.
  • Educating and training staff on specific health conditions. Students come to school with a wide variety of health conditions, including asthma, diabetes, life-threatening allergies, and much more. Nurses inform and train staff on what to be aware of and to identify and prevent these conditions from escalating.

High School Nurses

High school nurses need to have children’s health outcomes in mind, but they also have additional duties. Many high school nurses prefer working with older students and enjoy more freedom in their schedules, as the role offers more flexibility than elementary school positions.

The roles of a high school nurse overlap with an elementary nurse in many areas, including providing healthcare to students, identifying the needs of the school community, and stepping up to leadership roles in the educational setting. Additionally, they are still required to administer medications, monitor students with chronic conditions, and educate and train staff about illnesses such as asthma, diabetes, and allergies.

However, high school nurses’ responsibilities expand as students mature and involve:

  • Character development. As children grow into young adults, they face many obstacles that interfere with optimum mental and physical health. From peer pressure to poor hygiene, students can face challenges in the high school setting. High school nurses are critical figures to educate students and to guide them to develop their character successfully.
  • Specific high-school educational programs. High school nurses are tasked with other related roles, such as sexual health, alcohol and drug education, and other teenager-specific programs. These issues are critical to a successful high school student, and the school nurse can be a difference-maker for many children.

Which School Nurse Role is Right for You?

The elementary and high school nurse roles are unique and offer their own rewards and challenges. Many of the responsibilities are similar in each position, but the differences center on the students themselves.

Elementary school students are dependent on adult guidance, and many elementary school nurses thrive on nurturing and protecting the health of these young students. Additionally, elementary children are becoming aware of character development, including fairness, responsibility, caring, and trustworthiness. School nurses at this level can attend to student health needs while also helping to develop these critical traits.

High school students, meanwhile, are changing: physically, mentally, and emotionally. The school nurse serves an integral role in helping these students cope with these changes and create a path to optimum health. Many students at this age are less dependent on adults but still value a guide and advisor, and the high school nurse can fulfill that need.


School nurses are critical at all levels, but the position looks quite different from one setting to the next. If you love working with younger children and want to see them blossom in health and character, an elementary school nurse position may be right for you. If you prefer interacting with older students and wish to help lead them to positive outcomes in the future, you would likely benefit from becoming a high school nurse. Regardless, as a school nurse, you can help countless children succeed and stay healthy.

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Contributor Tera Rowland

Tera Rowland is the vice president of Soliant and has worked in the healthcare staffing industry for almost 20 years in public relations, social media, marketing and operations. In addition to Soliant, Tera worked at the Mayo Clinic as an internal communication manager and for the Children’s Miracle Network. She is a member of the American Marketing Association and the American Staffing Association. Also, Tera has served on the board of directors for the Jacksonville Women’s Leadership Forum as part of the communication committee. She has a Bachelor of Science degree in Public Relations as well as a Master of Business Administration in Marketing from the University of North Florida and has been published in the Huffington Post, Healthcare Finance News, Healthcare Traveler Magazine, and Scrubs Magazine. Make sure to read the rest of Tera's blogs!