Trusted but Underutilized: What National Polling Reveals About the Role of School Nurses in Population Health -

Lynn Nelson, MSN, RN, NCSN

School nurses are often the first place a student goes. Not just for a bandage, but when something doesn’t feel right.
That daily access gives us a unique view into the health of children and communities. But national polling suggests something important: while the public trusts school nurses, it doesn’t fully understand how we contribute to population health.

High Trust, Incomplete Understanding

A 2024 national survey conducted by the Morning Consult on behalf of the National Association of School Nurses indicated that:

87% of adults have a favorable view of school nurses, the highest of any school-based professional group
After learning more about their responsibilities, favorability increases to 91%
80% of adults believe it is essential to have a registered nurse in schools

On the surface, this looks like strong alignment between public perception and the importance of school nursing. But the details tell a different story.

While 78% of adults report awareness of school nurses’ responsibilities, understanding remains heavily skewed toward visible, episodic care such as first aid and illness assessment. Less visible, but arguably more impactful, functions such as care coordination of chronic conditions, mental health support, and population-level data collection, are far less recognized.

Approximately 22% of adults are unaware of the full scope of school nursing practice.

This disconnect of high trust paired with partial understanding is not simply a communications issue. It is a structural one.

A Workforce Positioned for Population Health

In practice, school nurses are not just responding to individual student needs we are tracking patterns.

School nurses operate at a unique intersection of healthcare, education, and community systems. We provide care to millions of children daily, many of whom face barriers to accessing traditional healthcare services.

The scope of practice extends well beyond episodic care. As outlined in national standards and reinforced by survey findings, school nurses:

Manage chronic conditions such as asthma, diabetes, and seizure disorders
Provide mental and behavioral health support
Prevent and control communicable diseases
Connect students and families to community health resources
Collect and report health data to inform local and state decision-making

These functions align directly with population health activities: surveillance, prevention, care coordination, and health promotion.

Yet they are not consistently recognized or resourced that way.

From Perception Gap to Systems Gap

When the role is reduced to “first aid,” what gets missed is everything that happens behind the scenes:

Their role in chronic disease management is underleveraged
Their contribution to mental health systems is undervalued
Their ability to serve as early warning systems for emerging health trends is underutilized
Their data are not systematically integrated into broader public health surveillance efforts

In effect, the system is not designed to fully use a workforce that the public already trusts.

This is particularly consequential in the context of rising complexity in student health needs, including increasing rates of chronic conditions, mental health concerns, and health-related drivers of absenteeism.

Public Support Signals Readiness for System Change

For those of us working in school health, this level of agreement is striking and important.

90% of adults support placing a registered nurse in every school
85% support increased funding to ensure school nurse availability
Support is consistent across political affiliation and geography
More than two-thirds of voters report they are more likely to support candidates who prioritize school nurse funding

This level of bipartisan consensus is rare in health policy.

This suggests that the barrier to advancing school nursing is not lack of public support but rather a lack of alignment between public support and how systems are designed.

Equity Implications: Uneven Access to a Trusted Resource

We see this difference every day. Students in under-resourced communities often rely on the school nurse as their most consistent point of care.

The survey also highlights disparities in access to school nursing services.

Students in rural communities and lower-income areas are less likely to have access to a school nurse, reflecting broader inequities in school funding and healthcare access.

These disparities are particularly concerning given that school nurses often serve as:

The first point of care for vulnerable populations
A critical connector to community-based services
A stabilizing presence for students managing complex health needs

From a population health perspective, unequal access to school nursing services represents a missed opportunity to address health inequities at scale.

Implications for Public Health Nursing and Systems Leaders

For public health nurses and system leaders, the takeaway is not simply that school nurses are valued.

It is that we are not consistently built into systems where we could have the greatest impact.

Advancing population health will require moving beyond recognition toward intentional inclusion of school nurses in:

Surveillance systems: Incorporating school health data into local and state monitoring frameworks
Community health planning: Engaging school nurses as partners in identifying and addressing community health needs
Workforce strategies: Expanding and supporting school nursing capacity as part of the broader public health workforce
Cross-sector collaboration: Strengthening alignment between education, healthcare, and public health systems

Conclusion

The public has already made its position clear: school nurses are trusted, valued, and essential.
The question is not whether school nurses are trusted. The question is whether we are being used in ways that match that trust. As healthcare continues to shift toward prevention, early intervention, and data-driven decision-making, school nurses represent a critical, yet underutilized, bridge between individual care and population health impact. Closing the gap between perception and integration is not simply an opportunity. It is a necessity for building a more responsive, equitable, and effective public health system.

As we recognize National Nurses Week and School Nurse Day this May, the question is not whether school nurses should be celebrated. It is whether our public health systems are designed to fully use a workforce that is already trusted, present, and positioned to impact population health every day.

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