School Health Studies No. 11 July, 1925

DEPARTMENT OF THE INTERIOR
BUREAU OF EDUCATION '

WASHINGTON. D. 0.

SCHOOL NURSE ADMINISTRATION

Prepared in the Division of Physical Education and School Hygiene,
James F. Rogers, Chief '

At the present time the most important special agent in school
health work is the school nurse. The employment of a competent
person in this post has practically always meant her retention, raise
of salary, and often reduction in the number of pupils assigned to her
by the employment of other nurses. Her work has changed con-
siderably; she is no longer chiefly a searcher for and eradicator of
vermin; and with the invitation of parents to attend the physical
examination of their children, her labor in “following up” physi-
cally defective pupils and getting something done for them is being
lightened. The better training of teachers in observing the physical
traits of pupils will also relieve her of work; but there is still very
much to occupy her time, and she continues an indispensable agent
in every well-ordered school system. In fact in cities of smaller size,
and in the rural districts, her worth is just being discovered. The
number of cities employing nurses has more than doubled in the past
10 years, while the proportionate increase for rural schools is very
much greater.

The work of the nurse has always added point to the health teach-
ing in the schools, and in some instances from special study or apti-
tude she has been put in charge of this work. More and more her
duties were away from those of the traditional nurse, and the name
so long connected with sickness seems far from appropriate, though
doubtless the old title will cling to her until by training she is further
specialized.

Hitherto school nurses have been recruited chiefly from nurses
with only sick—room training, but many now enter upon their duties
with an additional'schooling in public health work and a very few
with special training in the service they are to assume. For those
who undertake, among other duties, the supervision of or assistance
in health-habit teaching, something more than the ordinary training
of a nurse is essential.

54541—25°

2 SCHOOL NURSE ADMINISTRATION

Where the medical work of the school is under the administration
of the department of health the school nurses are usually under the
direction of that department, but the tendency has been for all school
health activities, save the management of cases of communicable
disease, to be taken under the management of the department of
education. ' _

.The results of a brief study of present practice in school nurse
administration in cities of more than 30,000 population should be of
interest to all school authorities.

Of 179 cities in the United States having a population of 30,000
or more which furnished information in regard to school nurses, 136,
cities'reported that the school nurses are employed by the board of
education; 34 cities reported that the school nurses are employed by
the health department; 5 cities reported a joint control by the board
of education and the board of health; 3 cities reported employment of
the nurses by the local welfare organization; 1 city reported the school
nUrse as employed by the Red Cross.

In 116 of these cities the nurse is employed for the school year, and
in 58 for the calendar year. Five cities did not answer this question.

The average number of children per nurse as given by these cities
is about 3,000, the lowest 800, while the highest is 7,000.

The minimum salary reported for a staff nurse is $637 (8% months)
and the maximum $2,700. Average salaries paid in certain cities
will be found in the accompanying table.

In 66 cities nurses are appointed through examination; 88 cities
reported no examination necessary for appointment; 12 cities specify
that it is necessary for a nurse to hold a certificate as R. N., and 13
cities did not furnish information on this subject.

In 41 cities the school nurse receives the benefit of a retirement
fund; 122 cities reported that the school nurse does not receive the
benefit of a retirement fund, and 16 cities did not answer this question.
- In most cities the school nurse works from 9 a. m. till 4 p. m.

In 110 of the cities sick leave with pay is granted, the number of
days with full pay varying from 5 to 30. In 102 cities vacation with
pay is given. '

To the question, would you suggest a more appropriate name for the
school nurse? the majority answered in the negative; several suggested
the name of “Health teacher.”

Many interesting remarks accompanied the ansWers, as follows:

“No deduction is made in salary for illness not exceeding a month.”

“Nurses are on same salary schedule as the grade teachers.”

“Visiting nurses organization pays the school nurse’s salary through the sum-
mer months, out of a community chest.”

“A $50 bonus is paid all teachers and nurses attending summer school.”
“We have two assistant nurses, ,not graduates.”

SCHOOL NURSE ADMINISTRATION 3

One city allows “$200 per year traveling expenses to each nurse, in addition to
her regular salary. Leave is granted to attend conventions with pay and ex-
penses.” ,

“Nurses are employed in summer camp for undernourished children during
summer months.” -

“We call our nurses ‘instructive nurses of hygiene.”’

“In this State (New York) we have summer schools for nurses in one or two of
our universities.” , , A

“School nurses receive same holidays and sick leave as teachers and are on
same Schedule.” ‘

“School nurses here do not receive benefit of retirement fund, but they should.”

“If school nurse takes preliminary summer course, she receives $110 per month
when she begins her work; otherwise she receives $100. The second year $135;
if no summer course is taken, she onlyrecei‘ves $125.” A

“N urses’ contract same as teachers; salary apportioned on 12 months’ basis.”

“Name of school nurse now under discussion.” ‘

“Nursing service not authorized by laws of our State. We have some trouble
with organizations opposed to health programs.”

The National Education Association recently made a study of
public—school salaries. Their report gives the median salaries paid to
school nurses in the past two years in cities of different sizes, as follows:

Median salaries of school nurses in cities of difierent sizes

 

 

 

 

 

 

 

 

 

Population In11922—23 In 1924—25
2,500 to 5,000- $1, 388 $1, 503
5,000 to 10,000- -- 1, 425 1, 515
10,000 to 30,000- 1, 510 1, 545
30,000 to 100,000- ‘ 1, 389 1, 504
100,000 or more 1, 423 . 1, 507

 

The following table shows the trendin median salaries paid in city
schools for the period 1913—14 to 1924—25:

Trend of nurses’ salaries '

 

Per cent Per cent

of in- of in-

. . _ _ crease crease
Populatlon of city 1913—14 1919—20 1922 23 1924 25 192%2’5 192¥23
over over

1913—14 1922—23

 

More than 100,000 $792 $1, 246 $1, 423 $1, 507 90. 28 5. 90
30,000 to 100,000- --- 800 1, 164 1, 395 1, 504 88. 00 7. 81
10,000 to 30,000- 758 1, 100 1, 510 1, 545 103. 83 2. 32

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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