School Nursing

The Relentless School Nurse: Tonja Frank is on a Mission to Change the Perception of School Nursing

Tonja Frank BSN RN – A Relentless School Nurse
2016 Nebraska School Nurse of the Year

Twitter is a powerful tool to connect school nurses from all across the country.  One of the school nurses that has a robust Twitter presence is Tonja Frank, @SchoolNurseT. She is passionate about safe staffing ratios in our schools and to do that she is on a mission to change the perception of school nursing.  Tonja may be relatively new to school nursing, yet within a few years, she was named the 2016 Nebraska School Nurse of the Year. She has served as President of the Nebraska School Nurses Association and is currently Central Nebraska School Nurses Association and the annual School Health Conference Treasurer.  All of this and Tonja jumped into school nursing after only a 2-hour orientation!

Tonja is on a mission to make sure that there is a school nurse in every school in Nebraska and beyond. She is a woman in action. Tonja is as skilled lobbying her state legislators as she is caring for students in her health office. She is clearly a #RelentlessSchoolNurse!

Meet Tonja Frank, A Relentless School Nurse on a Mission!

“My husband and I have a running joke, that on my days off I just lie around eating Bonbons as he slaves away at work. We both know this is not true, but if I don’t accomplish as much as I want to that day, this is what I tell him, so his perception is I am being lazy. Some people say that perception is reality and I somewhat agree with that. What people perceive as true becomes true in their minds. This often makes me wonder about what people really think school nurses do in a day.  How does the public really view a school nurse?  I was curious to find out, so I asked around to find my answer. 

Senior nursing student: I really didn’t know what you did. I just thought school nurses gave out medication, ice packs and Band-Aids. 

Middle School Teacher: Our school nurse gives out medicine for a wide range of reasons, checks blood sugar levels, changes catheters, takes temperatures, tube feeds kids, takes care of bloody noses, and the list goes on and on.

 A former parent: My daughter went to the nurse’s office multiple times a day for a bottled water, to talk and to get a boost in positivity A school nurse is just not someone who puts a Band-Aid on something, they provide support for the school and for the students in it. A nurse can become an added support for a student.  They can build a different relationship and the student can feel comfortable about who they are and receive guidance.  No, I did not pay you extra but I feel like I owe you so much for being there to take care of my daughter when I was not able to. For that, I will always be thankful

Hospital Chaplain: We have one registered nurse that covers multiple schools. (Not sure how many.) We also have a health tech Para at each school. Mostly, it’s Band-Aids and ice packs. They do distribute meds. I don’t think there any special requirements to be a health tech.

While these are all valid answers, they do not represent the role of a school nurse. Nurses roles have changed substantially over the years.  In 1887 nurses were more housekeepers than caretakers (“A List of Rules”, 2018) and school nurses’ have come a long way from just handing out band-aids and ice packs. 
In 1897, health authorities in New York City hired doctors to examine public school students for infectious diseases—not to treat them, but to identify children who would be sent home as not to infect their classmates. Five years later, in the wake of an outbreak of infectious eye diseases that prompted officials to send home thousandsmore children, local nurses volunteered to provide actual treatment to these students. The effort was an eye-opener, in more than one sense. Permitted into the schools on a trial basis, nurses began solving a public health problem with long-term implications for children’s health and education.

“Many of the children needed only disinfecting treatment of the eyes, collodion applied to ringworm, or instruction as to cleanliness,” reported one of the nurses, Lina Rogers Struthers (“School Nurses”, 2010). Struthers went down in history as the nation’s first school nurse, and in the 118 years since, the profession she pioneered has become an increasingly critical, if often overlooked, component in the nation’s health care system. 

The reality is, school nurses do so much more than hand out ice packs.  As a school nurse this is just a glimpse into what I am charged to do daily:  

·     Give 20-30 medications
·     Inhalers, tube feedings, epi pens
·     Individualized Education Plans
·     Student Action Team
·     Attendance Team
·     Concussion Management Team
·     Lead the Emergency Response Team
·     Seizure plans, Asthma Action Plans, Anaphylaxis Action plans, Diabetic Action plans, Individualized Health Care Plans,                Student transportation emergency plans
·     Suicide screening, Substance impairment screening
·     Assist students who are hungry, scared, tired, sick, infectious, bored, happy and sad.
·     Clarify doctors’ orders, be the liaison between what teachers see in classroom behaviors and what the doctor is told.
·     Maintain both online and paper charts.
·     Document Every. Single. Thing. I Do.
·     Maintain immunization records (In Nebraska it is a Class 5 misdemeanor if a student is in school without proper                          documentation of immunizations with a $100/day fine for each day they attend without the documentation).
·     Make sure that for every medication or inhaler I have that it is not outdated, I have the parents release to give it
and a current doctors order.
·     Make sure all 250 of my 7th graders received physicals after March 1st of the current year.
·     Teach a 4-hour human growth and development class to potentially 250 6th graders whose parents gave written approval.
·     Answer health questions from staff and take vitals as needed.
·     Monitor for disease outbreaks and attendance issues-are they sick, in poverty, chronically ill or just truant.
·     Contact multiple parents a day reminding them of medication needs or updating them about their child’s health at school.

That is what I do in and for my school.  I am confident that if you ask any school nurse to describe what they do it would be very similar.  The students who I work with are fortunate to have a school nurse that is there every day to assist them.  But what about the students that only have a nurse at their school part-time or no nurse at all?  Every student deserves a full-time school nurse because for many students the nurse is the person they need the most to keep them on track to be successful in class.  However, the only way to get full-time school nurses in all schools is to educate the public about what school nurses REALLY do.  We have a public perception problem about school nursing and it is our job to actively change it. Are you ready to help me change the public’s perception?”-Tonja Frank, BSN RN

Bio: I am in my 9th year of school nursing. I started with a 2-hour orientation from a previous school nurse and was then let run. This was at North Bend Central, a rural school district with 600 students. I soon became a passionate advocate for school nursing. I was honored with the Nebraska Excellence in School Nursing Award in 2015-2016. I have been with Omaha Public Schools, a school district with 53,000 students and 73 school nurses for 3 years. I am a past president of Nebraska School Nurses Association. The current president of the Central Nebraska School Nurses Association and the annual School Health Conference Treasurer. I have been married to my husband Tom for over 30 years and have 6 kids, mostly grown, and a grandchild on the way.

School Nurses: Keeping Children Healthy and Ready to Learn. (2010, August 18). Retrieved February 25, 2018, from


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