Pros and Cons of School Nursing
Wondering if a school nursing career is right for you? Being a school nurse is much different from working in a hospital or clinic. Instead of running from room to room on a 12-hour shift and working as part of a team, you’re usually solo and helping kids right where they spend most of their day. Every day is different, but typically you’re managing minor injuries, chronic conditions, and illness. It’s a rewarding role, but one that might not be right for everyone.
In this post, I am sharing the pros and cons of being a school nurse after completing my first year in the role. If you’re wondering whether a school nursing career is right for you, or how school nursing compares to bedside nursing, I hope this post will help you decide.
Pros of Being a School Nurse
Work-Life Balance as a School Nurse
Maybe the biggest of pros to school nursing compared to other nursing roles is the work-life balance! Honestly, I don’t think it can be beat. I am contracted to work 182 days each year. I have 2.5 months off for summer break, 1 week off for fall break, 2 weeks for winter break, and 1 week for spring break. In addition to all the breaks, I also get off all major holidays, and never have to work nights or weekends.
While it’s Monday through Friday most of the year, which can be a con for some, I like that I have a predictable schedule with built-in breaks. It gives me the flexibility to plan trips and visit family so much more easily. When I worked at a clinic, I only had 10 days of PTO a year. It didn’t feel like enough for me, since I love to travel. For anyone wanting a better balance between work and home life, this schedule is hard to beat.
Predictable Routine
Even though no two days look exactly the same, there’s a predictable rhythm to school nursing. I know when my diabetic students will come in for lunch checks and when to expect kids for daily medications. Certain times of day are always busier, like lunch, while mornings and late afternoons tend to be slower, giving me time to catch up on charting. Best of all, there are no unexpected shift extensions, no overnight call-ins, and no scrambling to cover weekend hours. The pace stays steady, and while true emergencies do happen, they’re usually fewer and farther between than in bedside nursing. For me, this means less stress during my day-to-day.
Building Relationships as a School Nurse
One of the best parts of school nursing is the opportunity to build meaningful connections with students, staff, and families. You get to know students over time, often watching them grow from shy sixth graders into confident eighth graders, especially the students you see daily for chronic conditions or medication. These relationships make it easier to provide individualized care because students feel comfortable coming to you when something’s wrong. I personally like the relationship-building aspect of school nursing, and while I miss working as a part of a healthcare team, I like that I get to see the same “patients” over the course of the year. I truly feel like I am making a difference in students’ daily lives, and it is a fulfilling role in this aspect.
Holistic and Preventive Care
While school nursing sometimes means caring for sick or injured children, it’s just as much about education and prevention. Because I work with middle schoolers, I’m often screening for vision, hearing, diabetes, and scoliosis, as well as teaching students about home care, healthy habits, and ways to prevent illness. One of the biggest pros of school nursing is how rewarding it is to help students stay well or catch a potential issue before it turns into a bigger health concern, rather than focusing solely on acute treatment. It’s also about advocating for student health and safety, and making sure kids can stay in school comfortably even after an injury, surgery, or with a chronic condition.
Autonomy in a School Nursing Career
Autonomy in school nursing can be both a pro and a con. As the only healthcare professional on campus, you have full control over your clinic. You can control how it’s organized, how you manage your day, and how you care for students. I love having the freedom to work independently and shape my clinic to fit the needs of my school. On the flip side, you don’t have a built-in medical team to bounce ideas off of, and figuring out the best systems when you’re just starting can take some trial and error. With autonomy, you need to be able to advocate for yourself, know the resources available to you, and seek assistance when you have questions or need help.
Cons of Being a School Nurse
Lower Pay
The lower pay is the biggest con for many when it comes to school nursing. Compared to hospital nursing, the pay for a school nurse can be noticeably lower. This is especially true if you have years of nursing experience or advanced certifications. There is also no overtime, on-call, or shifts that you can pick up. When considering a school nursing position, I recommend taking into account the schedule and time off. However, if you’re planning on working through the summer or picking up a second job just to make ends meet, the schedule alone may not be worth it.
Role Confusion
Teachers, parents, and administrators do not always understand the role of a school nurse or what we actually do. You may be asked to perform tasks that are outside of your scope, or be questioned if you set an appropriate boundary. You need to know what’s within your scope of practice and license, and be able to advocate for yourself if put into a position that would compromise this.
Medical Limitations and Limited Resources
Because school nurses typically work under standing orders and not alongside physicians, there are limits on what you can do. You can assess and triage, but you can’t diagnose or treat beyond your protocols. Sometimes this can feel frustrating, especially when you know what a student needs but must refer them elsewhere to get it. Additionally, some concerns may require calling 911 rather than providing hands-on treatment.
Limited resources can provide another medical limitation or barrier to providing care. Working in a school, you may have a small budget, outdated equipment, and be working independently. This can make it challenging to provide the level of care that you would like.
Lack of Clinical Skill Use as a School Nurse
If you’ve spent years in acute care or a specialty unit, you might notice your hands-on clinical skills aren’t being used as much. You won’t be starting IVs, administering complex medications, or responding to major traumas regularly. As far as clinical skills, you will be administering medication most often. You may come across a student who needs to use a catheter, G-tube feedings, and maybe trach care. Often, students with more complex conditions will have a private duty nurse who is always with them. Over time, it can feel like your skills are getting rusty, and potentially it can limit you if you try to go back to bedside.
Level of Care Provided
School nursing is most often focused on low-acuity issues like headaches, stomachaches, and minor injuries. While this is rewarding in its own way, you won’t be managing patients who need higher-level care or learning new interventions as frequently as you would if you were working bedside. If you are a nurse who enjoys working in a fast-paced environment with complex patients, school nursing may not be for you.
FAQs for School Nursing
Is being a school nurse stressful?
School nursing, in my opinion, tends to be less stressful than hospital or bedside nursing. Usually, you are working with lower-acuity issues and are working predictable hours. It’s also considered a “soft nursing” job to most. That being said, the stress of being a school nurse can come from other avenues, such as being the only medical professional on campus, not having a system in place, or being overwhelmed by clinic visits as a new school nurse.
Do school nurses get summers off?
Yes! Most school nurses work on a teacher contract schedule, which is around 180- 190 days each school year. In my district, I have the opportunity to pick up additional paid time during summer school, camps, or outside school events such as field trips or sporting events. However, those are all optional! If you’re looking into school nursing, be sure to confirm in your contract, since this can vary by district.
What skills do you need to be a school nurse?
Strong assessment and triage skills, great communication, the ability to advocate for yourself and students, and organization are some of the most important skills that you will need working as a school nurse. I think that it helps to be able to work independently, as well as being resourceful, because if you don’t know the answer to something, you have to figure it out!
Is it hard to go back to bedside nursing after school nursing?
From my perspective, it may be harder to go from school nursing to bedside nursing than from unit to unit in a hospital. I do not have any bedside nursing experience. However, I feel like I utilize more of my skills now than I did while working as a clinic nurse. I know many nurses who have gone from clinic nursing directly out of nursing school to bedside nursing, so I think, depending on the unit, hospital, and job market, it isn’t impossible. One way that you can stay current on your hands-on clinical skills that you won’t utilize working in school nursing is by taking continuing education classes or picking up PRN hospital shifts if you’re unsure if you want to stay in school nursing long-term.
Pros and Cons of Being a School Nurse
While a school nursing career isn’t for everyone and can come with its own challenges, like lower pay, limited resources, and fewer opportunities to provide high-level clinical skills, it also has its rewards! It can be a very fulfilling role where you build lasting relationships with students, promote wellness and illness prevention, and have the autonomy to shape your clinic and nursing practice. If you’re looking for a nursing role with a predictable schedule, lower stress, and the chance to help kids thrive inside and outside the classroom, school nursing might be for you!
I hope these pros and cons of school nursing have helped you decide whether being a school nurse is right for you. If you want to know more about my background as a school nurse and what it’s like working as a school nurse, you can read my previous post here.
As always, you can find me on Instagram @maddie_deer here. You can also follow me on my Facebook page to be alerted of any new posts here. Have questions about school nursing or want to share your own experience? Feel free to leave a comment below or DM me. I’d love to hear from you! 🙂
