The History of School Nurses


Posted to Nursing, Nursing Jobs, Nursing Specialties, School Nurses

An interesting article on Philadelphia’s answers a question I hadn’t really thought about: Why we have school nurses in the first place.

Up until the very beginning of the 20th century if students were sick, they were sent home with a note. Caring for the sick child and getting medical attention if necessary was the responsibility of the child’s family.

The nurse and social reformer Lillian Wald had a better idea — why not treat the children in school?
In 1902, she started to provide four New York City public schools (serving about 10,000 students) with nurses from her Henry Street Settlement. Her experiment was so successful that New York officials expanded it citywide.

By hiring 25 nurses, the public schools reduced the number of students sent home from roughly 10,000 in 1902 to a little more than 1,000 in 1903 – an astounding decrease of 90 percent. School nurses also made home visits to children who were removed from school, treating their illnesses and instructing their families in hygiene and prevention.

Other cities quickly followed New York’s example. Los Angeles put nurses in its schools in 1904, Boston did so the following year, and Philadelphia hired its first school nurses three years after that, in 1908.

Over the ensuing century, school nurses provided a variety of crucial health services. As public vaccination expanded, nurses helped ensure that children were protected against polio, diphtheria, and other diseases. And when the federal government required schools to accommodate handicapped children, including those who needed catheterizations and feeding tubes, their care often fell to – you guessed it – school nurses.

Today we’re told that nurses are too expensive for cash-strapped school districts. But the same objection was raised back in Wald’s time, at the dawn of school nursing. “There are still many people, even kindly souls, who cry out about this ‘fad’ because of the cost,” wrote Lina Rogers, New York’s first full-time school nurse. “What willful, heartless blindness.”

She was right. A hundred years later, let’s hope kindly Americans will open their hearts – and their wallets – to school nursing. The alternative is to close our eyes, like little children, and pretend nobody can see.

This recent post examines the issue of school nurses, budgets and the many services school nurses now provide in more detail.