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By 2020, achieve the Center for Disease Control’s recommended school nurse-to-student ratio of 1:750.

North Carolina hasn’t come close to meeting the national standard nurse-to-student ratio of 1:750 at any point in the last 10 years. While the state started making significant progress before the last recession, that progress has stalled and funding was cut for the School Nurse Funding Initiative at the NC Department of Health and Human Services.

NC Average School Nurse-to-Student Ratio

Modern school nurses do much more than dispense aspirin and band-aids. School nurses are increasingly important as students with complex health conditions are integrated into mainstream education settings. Students with disabilities or chronic diseases like asthma and heart disease require a highly trained health professional at school, so that they can attend class and focus on learning. Some examples of duties described by the National Association of School Nurses include: providing direct primary care such as flu shots; screening for abuse, neglect, or depression; providing health care training for other school personnel; and assessing the health and safety of the school environment.1 Research shows that school nurses provide a positive return on investment by providing more cost-effective care, and increasing the productivity of teachers, administrators, and parents.2

Far too many North Carolina schools have no nurse on campus. The current nurse-to-student ratio is 1:1,177.3 Many schools stock emergency health supplies, such as epinephrine, but they do not have nurses to give the injection. And in high-poverty districts, a school nurse may be the only health professional that children have access to.

North Carolina should require that schools be staffed with enough health professionals to meet the recommended ratio of one nurse for every 750 students.


1 For more on school nursing responsibilities: The National Association of School Nurses. “The Role of the School Nurse.” 

2 Wang LY et al. (July 2014). "Cost-benefit study of school nursing services." JAMA Pediatrics.

[3] North Carolina Department of Health and Human Services. “School Nurses.” 

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