School Nursing

The Relentless School Nurse: A Question from the Field – Are School Nurses Being Outsourced in Your State?

Staffing for school nursing is a major issue across the country. In my own state of NJ, while we have mandates for certified school nurses in every “complex,” that is being challenged as well. Ann Garton reached out to me to discuss her concerns about the outsourcing of school nurses in her district. She wants to support the school nurses through a letter writing campaign and/or petition and was curious about how other districts/states have handled similiar challenges. 

I invited Ann to write a guest blog post so that we can poll the readers of The Relentless School Nurse and help crowd source or “nurse source” feedback to help this important cause. If it has not happened in your district or state yet, but prepared, it may be coming. Budgets are tight everywhere and eliminating school nursing positions or outsourcing them to agencies is happening across the country.

Ann Garton, MSN, RN-BC

Today’s blog has a little different flare. We are looking to you the experts for valuable information. Let me introduce myself. My name is Ann. Although I have been a nurse for 25 years, and substituted a little in the school systems, I am far from being an expert school nurse. Hence why I need you!

We have a son who is a sophomore in high school this year and the district is discussing budget needs. Yep, you guessed it – outsourcing school nurses has become a hot topic.

A little about our district – we are in the middle of the country. Our schools are 55% white, 19% Black, and 14% Hispanic. It is the most diverse district in our area and our inner city high school is the eighth most diverse in the state.  We have a substantial population affected by social determinants of health. Sixty-five percent of our students across the district are eligible in free or reduced lunch programs with many of our schools supporting 90% of their students in this program. As we all know, these ultimately affect our children’s health and education.

I am hoping that those of you who have experienced these discussions in your school systems can share the data! Qualitative or quantitatively – I love both. What resources did you use to support your cause? I have pulled some statements from NASN and contacted our state school nurse organization but want to hear your successes and opportunities. The more information shared, the better our leaders can make an informed decision.

Please do not let this become a bashing against our peers who work as outsourced school nurses. My Mother was one in a private boarding school for 20 years and they had fantastic outcomes because of the way they developed that partnership. So for some – it can and does work. Yet, I also know that it is not best practice for those of us in the majority with similar demographics as ours.

Thanks in advance for sharing and especially for all that you do to keep our students healthy and learning!

Bio: Ann Garton, MSN, RN-BC 
Ann serves as the Director for the Institute for Person-Centered Care and Clinical Associate Nursing faculty at St Ambrose University. She has practiced as an acute care bedside nurse and educator and has also experienced teaching in both private and public secondary education. In both health care and education, she has worked towards creating environments supporting person-centered practices. She enjoys engaging the person in their educational or health care needs to assist in meeting their goals. She believes in the power of walking in solidarity with others, and practices this through her volunteer work as a Safe Family, volunteering in the refugee camps abroad, and as a Board member for Tapestry Farms, a local non-profit supporting the local refugee population.  

Please share your responses by emailing and I will be sure that Ann gets your messages. You can also post on my Twitter, @RobinCogan, or The Relentless School Nurse Facebook Page.


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