11 things to know about North Carolina's school nurses

1) Although North Carolina has, on average, one school nurse for every 1,086 public school students, the ratios range from as low as 319 students to as high as 2,242 students.

2) The average nurse covers two to three schools, but some cover as many as six. Five school systems in the state have one nurse dedicated to every school.

3) North Carolina public school nurses had 2,220,622 student encounters during the 2015-16 school year.

4) More than 9 percent of the total student population received medication at school, and nurses helped 11,512 students with complex procedures, such as using an insulin pump, feeding tube or catheter.

5) Nurses provided 396,199 counseling sessions to students regarding health, mental health and emotional issues, including screening for suicide risk.

6) Local school districts employ the majority of school nurses in the state – 55 percent. Health departments employ 40 percent of school nurses and hospitals and health alliances employ the remaining 5 percent.

7) Unlike local school systems, charter schools are not required to make the services of a registered nurse available in planning and caring for students with complex health needs. About 16 percent of charter schools in the state report having access to a registered nurse at least part-time.

8) On average, a North Carolina classroom can expect to contain:

9) Each school year, 15 to 20 percent of the North Carolina public school student population lives with an active health condition.

10) In North Carolina, about 90 percent of students with illness or health issues who are assessed by the school nurse, when present, are returned to class.

11) Forty-five of North Carolina's 115 school systems – nearly 40 percent – have no electronic documentation of school health records.

"Either they're not documenting or they're using paper and pencil," Nichols said.

Another 16 school systems – about 14 percent – track students' health records in self-created electronic systems, such as Excel or Google Docs.

Few school systems are able to purchase school health record software, according to Nichols. But documenting students' health records on paper or with Excel or Google Docs creates security concerns, she said, because others might be able to access the information. Searching and retrieving information stored that way can also be difficult.

School nurse records and student health information are considered education records and are protected under the Family Educational Rights and Privacy Act, or FERPA.