Some Houston ISD campuses have gone without a school nurse.
The question of where school nurses are assigned is one many parents have quietly wondered about.
For families of students with medical needs, a campus without a nurse can be more than a statistic. The prospect of a school operating without a full-time nurse on site can raise concerns.
A District-Wide Nursing Shortage Years in the Making
The current gap did not appear overnight. HISD started the 2023-24 school year with 248 school nurses and ended it with 226, according to the Houston Chronicle. That year alone saw 55 nurses leave the district against only 36 hires, a pattern the Chronicle's reporting described as requiring constant hiring just to keep pace.
The numbers got worse from there. By last spring, Houston ISD had just 140 school nurses left, down from nearly 270 the year before — a decline of almost 130 positions and nearly half the district's nursing workforce in a single year, Houston Public Media reported.
What School Nurses Actually Do
School nurses are not just there for scraped knees. They conduct health screenings, track vaccination records and often serve as the primary public-health contact for hundreds, sometimes thousands, of students at once, per Houston Public Media's reporting. District policy also requires every HISD campus to have at least two staff members trained in emergency response, including CPR and AED use, and nurses typically play a central role in administering medications, maintaining defibrillators and responding to emergencies, the Chronicle noted.
Karen Schwind, president of the Texas School Nurses Organization, put it plainly to KXAN: school nurses are taking care of students with diabetes, with seizures, with life-threatening anaphylactic circumstances.
School Nurse Staffing Across Texas
School nurse staffing levels remain a concern as districts face shortages.
Statewide, Texas school districts average one nurse per 839 students, above the ceiling of one nurse per 750 students recommended by the National Association of School Nurses, according to Actionaly. Texas does not require a full-time nurse at every public school, and the Texas Department of State Health Services found that 27 of the state's 254 counties had no school nurse in a public or charter school as of the 2019-20 school year, per KXAN.
The staffing gaps extend to other area districts as well. In 2022, Austin ISD contracted with Ascension Seton to staff its school nurses, but most of its elementary schools lacked a full-time registered nurse. In 2021, ABC13 reported that Waller ISD shared two licensed vocational nurses across four of its eight campuses that lacked full-time coverage, while Alief ISD relied on eight itinerant nurses and 10 floating licensed vocational nurses to help fill the gaps, according to ABC13. That outlet's 2021 survey found 46 Houston-area campuses without a nurse serving nearly 38,000 students combined, and it separately reported 20 HISD campuses without one.
The Stakes of Going Without
The consequences of an unstaffed health office aren't hypothetical. A study published in the Journal of School Nursing found that students evaluated by an unlicensed school employee were sent home 18% of the time, compared with just 5% of students seen by an actual school nurse, according to the same Houston Public Media report.
For families with children who manage diabetes, seizures or other conditions requiring daily medical attention, knowing whether their campus has a nurse can be an urgent concern.
