What it’s Like Working as a School Nurse

It’s currently summer break, and I’ve just wrapped up my first school year working as a school nurse. Before this role, I worked as a Registered Nurse in a primary care clinic in Washington for two years. After moving to Texas, I initially tried to transition back into primary care, but the long commute made it unsustainable, so I decided to pivot.

School nursing had always interested me. I love working with kids, and I expected it to be a lower-stress environment compared to inpatient nursing. Plus, you really can’t beat the schedule! I’m contracted to work 182 days a year and get time off for fall break, winter break, spring break, and summer.

When I was researching school nursing, I couldn’t find many real accounts of what the job was actually like. In this post, I’m sharing my honest experience from year one. I’ll also answer common questions like: What does a school nurse actually do? and Are school nurse jobs hard to get? If you’re considering a career in school nursing, I hope this post gives you a clearer picture of the hiring process, daily responsibilities, and whether school nursing is right for you.

Why I Chose to Become a School Nurse

I decided to go into school nursing for a few different reasons. The main reason, and what I look for with any job, is work-life balance. I knew that I wanted to have kids sooner rather than later after getting married, and I felt that the schedule of school nursing would work really well with having a family.

Another reason school nursing was appealing was the built-in breaks. As someone who loves to travel and has family in a completely different state, the 2 weeks of PTO you would get at a clinic didn’t cut it. One of the best parts of the school nursing schedule is having about four months off throughout the year between summer, winter, spring, and fall breaks. This past year alone, I was able to spend three weeks visiting family in Washington, travel to Denmark for two weeks, and go on several longer camping trips—something I never could’ve done with my old clinic schedule.

What is the Hiring Process Like for Being a School Nurse?

I started looking for school nurse positions toward the end of the school year, which is when contracts often aren’t renewed and openings begin to pop up. In Texas, the school year typically runs from August to May, so I began my search in late March or early April.

I went directly to the websites of local school districts to find open positions. In total, I applied to around 12 school nurse jobs across 4 different districts.

Each school district has its hiring process. For the district I ended up joining, the first step was a screening interview with Health Services. During this interview, I was asked about:

• My understanding of the school nurse role
• How I would respond to various student health scenarios
• My nursing experience
• Why I felt school nursing was a good fit for me

After passing the initial screening, I was sent a list of schools that were hiring within the district. I selected the schools I was interested in, and my resume was forwarded to the principals.

Soon after, I began receiving calls from principals and assistant principals to schedule interviews. I accepted the first offer I received because the school felt like a great fit, and it was only a few minutes from my house. Even though I had other interviews lined up, I didn’t continue the process with the other districts once I accepted.

Overall, I found the hiring process to be straightforward and relatively low-stress. I wouldn’t say it’s “hard” to get a school nursing job, but requirements vary between districts. In my district, you need to have a BSN and at least two years of nursing experience. The other new hires came from a variety of backgrounds, including OR, labor and delivery, med-surg, and outpatient clinics.

What a Typical Day Looks Like

Every day as a school nurse is a bit different. There are always emergencies or surprise curveballs that pop up. Since I have a full post on what a typical day looks like as a school nurse looks like, I am just going to give a quick overview!

Before School Starts

Before school starts, I am typically answering emails, restocking the clinic, reviewing immunizations (especially in the beginning of the year), and making a to-do list for the day. As soon as students are let into the building, they start coming into the clinic even if school has not started. 

Morning

After school starts, students will need a pass to come to the clinic. Generally, the morning is much busier than the afternoon. I work in a school with 1200+ middle schoolers, and before I got my clinic management down, I was seeing upwards of 60 students a day. During the second semester, after setting more first boundaries, I typically saw around 25- 30 students, and most came in during the morning or lunchtime. Typically, students are coming in for stomachaches, headaches, PE injuries, asthma, nosebleeds, or other various concerns. I also have my daily scheduled medications to give that start in the morning. In between students, I try to catch up on documentation.

Lunch

Lunch is the busiest time of the day! Since students do not need a pass, there are often many students trying to come into the clinic. I limit the clinic capacity to 3- 4 students at a time. Usually, there are the most scheduled medications around lunch, so I have students who will come in daily. During lunchtime, I also have diabetic students who need to check their blood sugars and have insulin administered. In middle school, many of the diabetic students are independent, but some do need help with carb counting or administering insulin.

Afternoon

After lunch, things usually start to calm down. This is when I can catch up on charting, screen students for vision/hearing/scoliosis, follow up with parents or teachers about non-urgent concerns, and schedule meetings. There typically aren’t as many scheduled medications in the afternoon, but sometimes there are a few. I will also continue seeing students for any clinic visits until the final bell rings.

What Surprised Me Most

The Volume of Visits

When I first started, I was shocked by how many students came into the clinic each day. I honestly don’t even remember seeing the school nurse when I was in middle school! While not every visit is a medical emergency, the constant flow of minor concerns adds up quickly. Some students just need a band-aid, others want to chat or decompress, and many come in during finals season with stress or anxiety-related symptoms.

At the beginning of the year, I struggled with managing the volume. I didn’t have time to chart during the day and would often stay late just to catch up. It was stressful and unsustainable! Eventually, I implemented a few changes that made a huge difference:

• I sent out clinic expectations to staff (like requiring passes for all visits).
• I created a small self-care station for minor needs.
• I stopped taking students during passing periods.
• I reduced “frequent flier” visits by encouraging teachers to address non-urgent issues in class.

Once those were in place, I had a much more manageable flow and could better prioritize higher-acuity needs.

Emotional Support Role

What surprised me was how often the nurse’s office becomes a safe space. Students come in because they’re overwhelmed, anxious, or just need a quiet moment to reset. I didn’t expect to play such a consistent emotional support role, but it’s become one of the most meaningful parts of my job.

The Non-Clinical Workload

I was also surprised by how much non-clinical work school nursing involves. There’s a lot to juggle behind the scenes:

• Managing immunization records
• Writing individualized care plans
• Coordinating with parents and providers
• Attending 504 and IEP meetings
• Completing mandatory health screenings

School nursing requires strong time management and organization. There are deadlines to meet, meetings to fit in, and chronic conditions to monitor. And since I’m the only medical professional in the building, there’s no one to divide the workload with. It’s a big shift from working in a clinic, where I had a whole team of nurses to lean on.

Is School Nursing Right for You?

School nursing might be a good fit for you if you enjoy working with pediatrics, working independently, and want to work on a school schedule. If you prefer the clinical setting, working in a fast-paced environment, or team support, school nursing may not be the right fit for you. I could go on about the pros and cons of school nursing (and I do in another post!), but here I want to highlight a few important questions to ask yourself if you’re considering making the switch.

Are you willing to sacrifice higher pay for more time off and lower stress?

One of the biggest trade-offs in school nursing is salary. It typically pays less than hospital or clinic jobs, but in return, you gain built-in breaks, holidays off, and a much better work-life balance. If you’re someone who values your time outside of work, school nursing might be worth the financial adjustment.

Do you prefer a consistent schedule?

School nursing offers a highly predictable routine. You’re generally working weekdays only, with no nights, weekends, holidays, or on-call shifts. If having a structured, stable schedule is important to you, especially if you’re raising a family or want to travel during school breaks, this role is a great fit.

How would you feel about being the only nurse on campus?

Unlike a hospital, you won’t be surrounded by a team of nurses or doctors. You’re often the only medical professional in the building, and that can feel isolating at times. You need to feel confident in your judgment, be comfortable working independently, and know when to escalate situations.

Are you comfortable managing chronic conditions solo?

You’ll be responsible for students with asthma, diabetes, seizure disorders, and more. You’ll administer emergency medications, respond to symptoms, and collaborate with parents and staff. There’s a learning curve, but it’s manageable with strong organization and preparation.

Can you balance compassion with boundaries?

You’ll see students for both physical and emotional needs, and it’s easy to feel like a safe haven for kids who need extra support. That said, it’s important to set boundaries so you don’t burn out. You’ll need to communicate clearly with staff and students about when visits are appropriate and when to redirect.

Are you able to stay organized and manage your time effectively?

There is a lot to juggle as a school nurse, and if you’re not able to manage your time well, it can quickly become overwhelming. You’ll be balancing daily student visits, medication administration, documentation, screenings, meetings, parent communication, and care plan updates—often all in the same day. Since you’re likely the only nurse on campus, it’s up to you to keep everything running smoothly. Strong organizational skills and time management are essential for staying on top of tasks without letting things slip through the cracks.

Do you have experience working as a nurse already?

While some nurses do go into school nursing straight out of school, it’s helpful to have some clinical experience under your belt. Working independently in a school setting means you’ll need to feel confident in your assessments, communication skills, and ability to respond to emergencies without a medical team nearby. If you’re a new grad, you may still be able to find a position, but be prepared to learn quickly and ask lots of questions.

Conclusion

One year in, I’m still adjusting, but I’ve grown a lot. School nursing is front-loaded with responsibilities, but once the year gets going, things settle into a manageable rhythm. I’ve renewed my contract and feel excited to return next year.

If you’re considering school nursing, I hope this post gave you a real look into what to expect. It’s not for everyone, but if you love working with kids, enjoy autonomy, and crave a consistent schedule, this role could be a great fit.

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! 🙂