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Delaware School Nursing History

By Megan Fioravanti, BSN, RN, NCSN posted 06-08-2019 07:24

The first mention of school nurses in Delaware was in 1919 when there was a notation in public records of two school nurses, Elizabeth MacLaughlin, RN and Elizabeth Rogers, RN who served in Wilmington Public Schools. Both were public health nurses who were assigned to the schools. In 1930 another nurse, Mary Miller, RN, was added to cover the northern Claymont area, with Ruth Webb, RN to follow in 1931. By early 1940 several other nurses were added to the schools throughout Delaware.
In 1946, Title 14 of the Delaware Legislative Code passed requiring every school district in Delaware to have a full-time school nurse and in the 1949-50 school year regulations were expanded requiring that school nurses be certified in order to practice. Also in that year, school nursing became a separate division in the Delaware Nurses Association. Sadly, school nurses felt left out and in late 1950 joined the Delaware State Education Association (DSEA) and formed a separate school nurse section.
In 1959 there was a certification overhaul and it was recommended that all school nurses in Delaware have their BSN. In 1960 it passed, but by 1964, school districts were saying that they were having difficulty finding a nurse to employ who had earned a BSN. The regulation was softened and a Licensed RN was the standard for employment. In 1974, the regulation for a BSN was re-introduced and passed and has been in the regulations ever since.
Pearl Ake, who is currently 86, recalled that she became a school nurse in 1945. She described how they would hold up a watch for hearing screenings and would use a Snellen chart of vision screenings. School nurses supplied clothing through the Needlework Guild and fed children at school. She explained, “They were hungry, so we fed them”. She also said that school nurses regularly took children home when they were sick because “nobody had cars or phones in those days.”
In 1956 the Delaware School Health Advisory Committee was organized. The committee included the State Board of Health, State Department of Public Instruction (now the Department of Education), Administrators, the State PTA, Delaware Dental Association, University of Delaware, AI DuPont Hospital and school nurse representatives. This group looked at school health issues and worked together to dictate priorities and policies. School Nurse Ake was on the founding committee.
In 1962, the Delaware School Health Advisory Committee recommended hiring a school nurse supervisor, but the State Board of Education did not fund the position. By the 1963-64 school year, 126 school nurses were working in Delaware Schools. Two years later, The School Nurse: A Guide to Responsibilities and Duties was released. It was the first formal manual that delineated school nurse practice in Delaware.
Finally, in 1968 Edith Vincent, RN, M.A., B.S. was hired as the State Supervisor of Health Education and School Nurses. Edith practiced school nursing in Delaware from 1947 until her retirement in 2005. Her energy and commitment to school health was a driving force for school nursing in Delaware. The School Nurse Advisory Committee (SNAC) was formed in 1968 to focus on issues such as school nurse image and the acceptance of school nurses as professional team members. SNAC did a formal job analysis of the school nurse’s role which led to the development of screening protocols, school nurse certification, and unit count in funding for school nursing positions.
Twenty years later, Jean Allen, Vice President of the State Board of Education drafted and Senator Dave Sokola introduced legislation requiring one school nurse in every school. It passed and was entered into the Delaware Legislative Code.
Delaware School Nurse Association (DSNA) minutes and newsletters dating back to January 1975, shows that the organization (then called Delaware School Nurses- DSN) was a part of Delaware State Education Association. The dues to join the organization were $5. DSN paid $15 a year to be an organizational member of the National Education Association and paid $2 to Delaware Nurses Association as a donation. The treasurer’s report showed that the organization had $758 in assets and had 34 active members.
Throughout the 70s and 80s, Delaware school nurses were very active legislatively. The Legislative Committee of the Delaware Association of Superintendents and Administrators introduced a bill to change the language in the regulations from “school nurse” to “school health personnel” in an effort to hire non-nurses to cover the health offices. Delaware School Nurses lobbied and testified and the change did not take place. DSN also weighed in on nurse-student ratios, K-12 Family Life Curriculum- which included reproductive and teen pregnancy regulations, and national certification pay equity.
In the years that followed, school nurses used their voices legislatively and as recent as 2017, school nurse Sue Smith, MEd., RN testified before the senate subcommittee on professional regulations. As a result, school nurses now have the option of using the NCLEX as the test to measure competency in lieu of the Praxis exam required for other educators. Mrs. Smith also is currently a board member on the Professional Standards Board at the Department of Education.
Many of the health topics that we see today are the same issues reflected throughout the archived minutes including: stress management, school funding, changes in nursing, epilepsy, membership concerns, chronic illnesses, dental health, substance abuse, AIDS, Medicaid reimbursement and health promotion….and some things not quite so much anymore: Reyes Syndrome, the “new role” of nurse practitioners, and “no-nits” policies.
Delaware school nurses were and continue to be involved in community partnerships and are active members of many organizations. They have held positions on the Governor’s Task Force on Health & Adolescent Pregnancy, School-based Clinics Task Force, DE School Psychologists Coalition, Delaware Health Care Alliance, Nemours Advisory Committee, League of Woman Voters Healthy Children DE, ADHD DE Committee, DPH Community Liaison, Asthma Consortium, Safe Kids Coalition, DE Tobacco Prevention Coalition, and the American Lung Association. Many Delaware school nurses sit on community boards and are active volunteers in many health promotion agencies and organizations throughout the state.
The Delaware School Nurse Association was officially established in 1983 and the yearly dues were $7.50. Four percent of DE school nurses were members of the National Association of School Nurses (NASN), paying a membership cost of $35. The following year, DSNA formed a Family Health Committee and had the foresight to set the goal of having school nurse representation in community organizations throughout Delaware. In 2004, after several years of debate and discussion, DSNA became a unified affiliate of the National Association of School Nurses.
Delaware is proud of the great school nurse leaders who have made such superior contributions to school nursing and NASN. Two of our school nurses have risen to the position of President of NASN.
Dr. Linda Wolfe served from 2001-2003 and most recently, Beth Mattey, MSN, RN who served from 2015-2017. In addition, five Delaware school nurses have been inducted as NASN Fellows including: Madalyn Schultz Petit (2005), Linda Wolfe (2007), Elizabeth “Libby” Thomas (2007), Janice Selekman (2012), and Beth Mattey (2018).
The Delaware School Nurse Association eagerly looks to the future and aspires to continue with our mission of empowering school nurses through advocacy, community, and leadership. It is our vision to have exceptional school nurses, supportive communities, and students who are healthy and ready to learn.



Thank you for posting the history of school nursing in Delaware. I worked as a school nurse in Delaware for 6 years. Delaware is a small state but its impact on school nursing is great. The number of school nurse educators and school nurse leaders from the state demonstrates the commitment of Delaware nurses to the specialty.
Delaware is a leader in school nursing.   Thank you Megan for sharing our rich history.  Early on Delaware established the link between health and education and pursued opportunities to ensure that school nurses were supported as a critical member of the educational team.   Advocacy and strengthening partnerships were fundamental in our early leaders efforts to establish school nurses as a necessity in all Delaware schools. Today, school nurses in Delaware continue this legacy as we work to keep Delaware students healthy, safe and ready to learn.