The Nationwide School Nurse Shortage and How It Impacts Students


A new bill in New Mexico, House Bill 476, would require a full-time nurse to be present at all public schools, including charter schools, with 250 or more students. Currently, many schools in the state are forced to share nurses, which can limit students’ access to care. But the bill does not include funding for these additional nurses, so districts will need to come up with the money themselves. As many praise the intentions of the bill, some remain skeptical of the cost. Learn more about the school nursing shortage and how this bill aims to change it. 

What Does a School Nurse Do?

According to the American Academy of Pediatrics, school nurses are responsible for:

  • The assessment of health complaints, medication administration, and care for students with special healthcare needs.
  • A system for managing emergencies and urgent situations.
  • Mandated health screening programs, verification of immunizations, and infectious disease reporting.
  • Identification and management of students’ chronic healthcare needs that affect educational achievement.

In many cases, the school nurse may be a student’s only access to healthcare. Students living in poverty or rural areas often lack access to primary care providers and other specialists, which puts more pressure on schools to provide these services.

Why Lawmakers Want a Full-Time Nurse at Public Every School

With school nurses caring for students at multiple schools at the same time, many lawmakers and educators in New Mexico are doing their best to make school nurses more of a priority in the state.

If a student is involved in an accident or suffers some other kind of health incident, such as an asthma attack, diabetes attack, or those related to more serious conditions such as cancer and congenial heart disease, not having a nurse onsite could spell disaster and may lead to costly hospital and ambulance fees. Many students living with a serious illness or chronic condition depend on schools to meet their healthcare needs. Some students may require a lifetime of specialized nursing care, which must be made available at their learning institution or they risk falling behind on their studies.

House Bill 476 would ensure students, including those with special healthcare needs, will have access to the care they need throughout the school day.

Funding Issues Associated with the Bill

Despite the intentions of the bill, it does not provide additional funding for these new nurses, which means school districts will need to come up with the money themselves. According to the bill’s fiscal review of the proposal, a full-time registered nurse earns over $46,000 a year on average, not including benefits. The state currently has a shortage of 305 school nurses, and the fiscal review estimates the total cost to fill these positions would be just over $14 million per year. If the bill is passed, it remains unclear how school districts would come up with the additional funds.

Tracking the Nation’s School Nursing Shortage

New Mexico currently has 780 students per school nurse. That’s a lot of students for one nurse to handle, especially when they’re floating between several different schools at once. But New Mexico is far from the worst state in terms of the school nurse shortage. Utah and Michigan both have over 4,000 students per school nurse, drastically limiting students’ access to care.

Many schools across the country simply don’t have room in their budgets to hire a full-time nurse. Schools generally make the cost of education their first priority when allocating funds, which means students’ healthcare needs often go overlooked. According to the American Federation of Teachers, just 50% of schools employ a registered nurse for at least 30 hours per week, and 18% have no nurse at all.

Where the Bill Goes from Here

House Bill 476 narrowly passed the house with a 6-4 vote. It now moves onto the House Health and Human Services Committee for review. Even if the bill is passed, districts will need to find ways to comply with the law despite financial limitations.

Possible Solutions to the Nursing Shortage

To address these funding issues, states could raise additional funds for school nurses by raising taxes, implementing electronic health records in schools to reduce the cost of care, hiring community healthcare workers to fill vacant nursing positions, or implementing a vehicle registration fee for the state’s residents.

States could also reroute some of their Medicaid funds to school nurses. They could try creating community healthcare facilities as a way of relieving the pressure put on individual schools. Schools could also partner with local healthcare providers, including hospitals and physicians, to increase students’ access to care.

The school nursing shortage continues to be a concern for schools, parents, teachers and students across the country. While New Mexico is making bold moves to counteract the shortage, public schools in the state still lack funds to hire these additional nurses. Schools, states and the healthcare community will need to work together to curb the school nursing shortage.









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