Release Date: 3/28/2025
Originally presented: 2025 MASN Spring Conference
Project Sponsor: Missouri Association of School Nurses, Missouri Department of Health and Senior Services, and the Missouri Healthy Schools Grant
Project Leaders:
Christian Bertel, BSN, RN, NCSN
Marjorie Cole, MSN, RN, FASHA
Project Team Members:
Angie Anderson, BSN, RN, NCSN
Renee Falkner, BSN, RN
Lauren Grimes, BSN, RN
Angie Midnight-Oest, MSN, RN, NCSN
Kelly Vaugh, RN, BS
Stacey Whitney, MSN, RN, NCSN
Project Descriptor:
Whether you are a new school district lead nurse or a seasoned veteran, you are tasked with ensuring that those providing hands-on care to your students and staff consistently follow procedures and understand the expectations for delivering this care. As a specialty practice within the nursing profession, we are guided by the School Nursing: Scope and Standards of Practice, school policies and procedures, the Missouri Nurse Practice Act, and other state statutes and rules. School nurses utilize these resources, along with evidence-based practices, to establish the foundation of their practice. As the leader, it is essential to provide tools that can be easily accessed and referenced during day-to-day operations and emergencies required by your school district’s health staff.
Many factors can influence what you include in your manual, as each school system is as unique as the community it serves. However, beginning with the common elements at the heart of school nursing is a strong starting point. You can expand your content from that foundation as specific areas are identified.
As the lead school district nurse, this guide aims to assist you in creating your school health manual. You can modify this format and the suggested content to better suit your school district and community needs. It’s crucial to stress that our goal is not to produce your manual. However, we genuinely hope to offer you a professional and practical resource that will encourage consistency across school health clinics within your district, utilizing evidence-based practices as your foundation.
The guide's structure will be streamlined into a Table of Contents with written context for your consideration as you review each section. This model is designed to be a live document that the lead nurse can modify in real time, ensuring the document is central to finding practices, district policies, and the appropriate forms and communications for our staff and families. Instead of chapters filled with information to digest, it offers a structured template to retain what you need while removing what isn’t necessary. It allows you to add content that specifically pertains to your school community and maintain those core identified areas relevant to school nursing at every level.
We strongly encourage you to watch a few instructional videos from the beginning. Linda Wolfe’s Developing School Health Manual, Parts 1 and 2, provides a solid blueprint for building your school health manual that meets the needs of your school community. The third video comes from the Show Me School Health, Policy, Procedure, and Protocol SMSH Learning Module. If you haven't done so, you must enroll to receive the password. This module will help you understand the differences between, and the importance of, policies, procedures, and protocols in school nursing practice, as well as which sections of your manual should intentionally include these supports.
School nursing can seem overwhelming to a new nurse entering this specialty. Sometimes, the mission of leading school clinics can feel just as daunting. However, you aren’t expected to have all the answers to every possible scenario on day one or ever. As school nursing evolves, so will your practice, and to do this successfully, we should be committed to continuous improvement and evaluation of our guidance and our expectations for those we lead. Your manual should reflect those transitions and grow with your practice. Remember, this is a continuous journey, not a quick trip. However, your destinations are worth it.