Considerations in School Safety and Threat Assessment Teams and the Integral Role of the School Nurse

By Renee Woodworth, R.N., BSN NCSN posted 11-25-2019 09:20


Over the past 18 months, I have taken a deep dive in school safety and emergency preparedness. As a nationally credentialed school nurse, emergency nurse and disaster response nurse, my findings have been alarming. When developing school safety teams and school threat assessment teams, many school districts do not include the school nurse as part of that team.

Of the over 1,000 attendees at the National School Threat Assessment Conference two weeks ago, three were school nurses.

School safety studies list mental health factors in their findings but never identify school health needs as they relate to safety.  Imagine students with limited mobility, vision and hearing limitations, severe autism and diabetes not being considered in the school safety plans.  How do we manage our diabetics during a lockdown?  The input of the school nurse is integral to the school safety conversation.

In the 2018 Virginia School and Division Safety Study, school nurses are NOT listed as a member of the threat assessment team, nor are they mentioned anywhere in the study results.   The assumption is that school nurses fall under the mental health umbrella. However, school nurses know many students present to their health office with complaints of headache, stomachache, and chronic fatigue; school nurses recognize that these complaints are often symptoms of mental health distress or illness. Their role in recognizing these complaints as symptoms is crucial to initiating important referrals to school counselors and mental health providers.

A few things for schools to consider:

  1. Is there a school nurse on your School Safety/Emergency Preparedness/Threat Assessment Team?

School nurses provide valuable information about student health which is essential in emergency planning especially when considering students' specialized healthcare needs.  How will student healthcare needs be managed during lockdown?  How will students with physical limitations be supported during an emergency evacuation? 

Additionally, prior to purchasing emergency preparedness resources for the schools, consultation with the school nurse is essential to ensure the appropriate medical kits (go bags, bleeding control kits, classroom backpacks and lockdown buckets) are acquired and placed in appropriate locations on campus for easy access and use.


  1. Does your school have wellness team?

Create a regular meeting with the school nurse, counselor, social worker, SRO and school administrator to discuss students with specific needs (family, health, housing, safety, education, etc.) so you can start to understand student needs early on and implement strategies for management of their health and safety requirements.

  1. Consider developing a school nurse/SRO (school resource officer) partnership. This allows both school nurses and SROs to provide care in the safest possible environment. I often hear from SROs that when the school nurse is at another school, the School Resource Officer becomes the first responder administering First Aid. Working together and understanding the SROs concerns about student safety and wellness helps ensure our students needs are met even when school nurses are not available or vice versa. Perhaps schedule a weekly school nurse/SRO "walk-about".
  2. Require a health office assessment after a student’s extended absence. Research has shown that incidents of targeted violence show many early warning signs and often occur after a student has returned from a period of extended absence (inpatient hospital stay, suspension, etc.). Perhaps it would be good practice to have students "check-in" either with the school nurse or the counselor prior to returning to their regular schedule to perform a student needs/wellness assessment?

Here is the link to the Secret Service's National Threat Assessment Center (NTAC) School Safety Resources which you might find helpful in your planning and practice.