CSNO History

History of CSNO
By Dr. Beverly Bradley, Kathy Ryan, Charlotte Brandt and Dr. Sheri Coburn

In the United States, more than 40% of school-aged children and adolescents have at least one chronic health condition,such as asthma, obesity, other physical conditions, and behavior/learning problems. Coupled with chronic health conditions, adolescent illicit substance use continues to increase.  According to the 2019 National Survey on Drug Use and Health, 17.2 percent of all adolescents aged 12 to 17 used illicit drugs in the past year 2.  An estimated 4.5 percent of adolescents had a past year Substance Use Disorder (SAMHA). As a result, children and adolescents do not leave their health care issues at the school's front door (Coburn). With over 6 million children in California, school nursing services and health services support to promote physical and mental health well-being of students are critical.
1) National Survey of Children’s Health. NSCH 2018 19: Number of Current or Lifelong Health Conditions, Nationwide, Age in 3 Groups website. childhealthdata.org.
2)Substance Abuse and Mental Health Services Administration. (2020a). Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP20-07-01-001, NSDUH Series H-55. Retrieved from https://www.samhsa.gov/data/
3) Coburn, S. (2014). SB 277 Testimony to California Senate Health and Education Committees. California State Capitol, Sacramento, CA.
In 1950, under the leadership of Sally Williams and Susan Lordi, school nurses in Orange County and Los Angeles County joined together to form the California School Nurses Organization (CSNO). The focus of the newly formed organization was to provide a forum to share professional learning opportunities and standardize the practice of this evolving nursing specialty practice. There were two sections in the beginning; one in the North called Northern Section and another in the South called Southern Section. In 1970, Sally Williams became the founder and first elected president of the National Association of School Nurses (NASN). Other CSNO members who have served as NASN Presidents include: Judy Beck, Lillian Cassidy, Susan Lordi and Linda Davis-Alldritt. 
The founding members of CSNO viewed school nurses as the essential link between health and academic success, and wanted to strengthen and standardize the delivery of health services to students in California schools. Initially, there were no credential programs for school nurses, so the nurses had to develop an educational curriculum and then find Colleges and Universities where they could take the courses that they felt were essential to this evolving specialty practice.
Prior to the late 1930’s there was no medical coverage for outpatient medical care, so the majority of students did not receive any preventive medical care. During the 1950's health came to be accepted as a primary objective of education. The health educator role of the school nurse became more important with the primary focus on immunizations, nutrition, and mental health.
School nursing services followed a community health/public health model. School nurses administered polio and measles vaccines in California public schools. During the 1950’s, polio was a major public health threat with over 58,000 Americans affected. Polio vaccines distributed through schools and public health clinics resulted in a 95% decrease in the incidence of polio by 1961. 
With the many modern advances in medicine, the number of students with health concerns, requiring assessment and management by school nurses has increased significantly. These students require daily medical support to be at school. These children do not leave their medical concerns at home when they go to school each day, and they need the knowledge and expertise of a credentialed school nurse to provide a safe, supportive and healthy school experience regardless of what medical concern(s) they are living with. Over seventy years later, California school nurse continue to utilize the public/community health model to optimize the health of our students and enhance learning.

CSNO wishes to thank Dr. Beverly Bradley and Kathy Ryan for sharing this information.....June 2, 2017; Dr. Sheri Coburn for updated references

History of the Sections
Southern and Northern Section
In 1950, Southern Section School Nurse leaders (from Los Angeles County and Orange County) came together to form a statewide Organization to support nurses. The State organization was originally comprised of two sectional areas Southern Section and Northern Section

Central Valley Section-By Charlotte Brandt
In 1965, the Central Section of CSNO (one of four sections) had 204 members and spanned from Central Coast to Nevada Border, north from Kern to the Bay Area. A steering committee to investigate the idea of breaking off from the Bay/Coast area was formed and first met in Fresno on March 5, 1965. Ruth Thomas was named chair. A "Call to Charter" was held on May 17, 1969 to get enough signatures to petition CSNO to start the Central Section.

CSNO State President Margaret Helton noted in her 1969 annual report that the Central Valley Section was chartered as the fifth Section of CSNO. The new section was formerly the eastern half of Central section. Following separation, it was decided by the members to name the Western remaining half as Bay Coast Section.

Central Coast-by Dr. Sheri Coburn
In 2019, at the 69th Annual CSNO State Conference Business Meeting, which was held in Monterey, CA, eleven school nurses stood in unity requesting the formulation of a new CSNO Section in and around the central coast of California. Citing geographical isolation and lack of professional learning opportunities, these school nurses believe they would be better served as an independent section within CSNO.The CSNO State Bylaws state: "Sections 5.22 (a) CSNO shall have at least two sections. The sections of CSNO are Bay Coast, Central Valley, Northern, San Diego/Imperial and the Southern section. The sections are developed to meet the regional professional learning needs of school nurses within their areas. (b) The CSNO State Board will have ultimate authority and discretion in creating sections.(c) Sections may be created in geographic locations as the need arises. A motion, second and vote was made for the CSNO State Board to explore the possibility of a new section. A motion, second and vote was made to provide $1,500 of seed money if a new section is formed. Over the next several months, the CSNO State Board took measures to assess the interest of a new section. On June 21, a survey disseminated to CSNO members in Monterey, Kern, Kings, San Luis Obispo, Santa Barbara, and Ventura Counties. Survey results returned with overwhelmingly supporting the formation of a new section, the counties to be included in the section, the name of the section and officers to represent the section. Officers for the section, were installed at CSNO Leadership in August of 2019.

CSNO Acknowledgement of Leadership Excellence

CSNO State Presidents from 1950 to Current

CSNO School Nurse Administrator of the Year/Excellence in School Nurse Administration

CSNO NASN Directors (Term years served with CSNO)

President's Above and Beyond Award

This award is given to an outstanding school nurse that has dedicated an inordinate amount of time, energy and commitment to improve the organization. The President's Above and Beyond Award is selected by the CSNO State President.  Sections also award their respective President's Above and Beyond award.

CSNO President Above and Beyond Award

Lydia Smiley Award

Lyda Smiley Award CSNO LYDA SMILEY Award
This award is given to an outstanding person, other than a school nurse, who has made significant contributions to school nursing. Presented during the annual CSNO conference. CSNO ceased awarding the Lyda Smiley award in 2015.

NASN Academy of Fellows CSNO-NASN Fellows 1998 to current  An Honor of the highest recognition that members can receive from NASN bestowed on the Association's professional members who have made significant, unique, and extraordinary achievements that have had broad influence in contributing to the advancement of the specialty practice of school nursing and NASN.

Locations of CSNO Conferences

2025-San Diego-Loew's Coronado Bay Front Resort-75th CSNO Conference
2024-Rancho Mirage/Palm Desert-Omni Rancho Las Palmas-74th CSNO Conference
2023-Riverside-Riverside Mission Inn Hotel and Spa and the Riverside Convention Center-73rd CSNO Conference
2022-Monterey-Monterey Hyatt Regency Hotel and Spa on the Del Monte Golf Course-72th CSNO Conference
2021-Was to be held in Rancho Mirage/Palm Desert-Omni Rancho Las Palmas however the COVID-19 pandemic paralyzed the global health systems and economy and -71st CSNO Annual Conference was moved to electronic venue.
2020-Garden Grove-Hyatt Regency Orange County-70th CSNO Conference
2019-Monterey-Monterey Hyatt Regency Hotel and Spa on the Del Monte Golf Course-69th CSNO Conference
2018-Riverside-Riverside Mission Inn Hotel and Spa and the Riverside Convention Center-68th CSNO Conference
2017-Monterey-Monterey Hyatt Regency Hotel and Spa on the Del Monte Golf Course-67th CSNO Conference
2016-Fresno-Double Tree Hilton-66th CSNO Conference
2015-Anaheim-Anaheim Hilton Hotel-66th CSNO conference
2014-Sacramento-Hyatt Regency and Grand Sheraton-64th CSNO Conference
2013-San Diego-Town and County Resort Hotel-63rd CSNO Conference
2012-San Francisco-Marriott Marquis-62nd CSNO Conference (In conjunction with NASN)
2011-Fresno-Double Tree Hilton-61st CSNO Conference
2010-Hollywood-Westin Hollywood Hotel-60th CSNO Conference
2009-Sacramento-Hyatt Regency Hotel-59th CSNO Conference
2008-San Diego--Town and County Resort Hotel-58th CSNO Conference
2007-Santa Clara-57th CSNO Conference
2006-Fresno-56th CSNO Conference
2005-Los Angeles-55th CSNO Conference
2004-Sacramento- Hyatt Regency Hotel-54th CSNO Conference
2003-San Diego-53rd CSNO Conference
2002-Santa Clara-52nd CSNO Conference
2001-Fresno-51st CSNO Conference
2000-Los Angeles-50th CSNO Conference
1999-Sacramento-49th CSNO Conference
1998-San Diego-48th CSNO Conference

History of School Nursing

School Nursing Celebrates 120th Anniversary

by Mataeo Smith

More than 100 years ago, nursing pioneer and activist Lillian Wald, with her nurse colleagues, philanthropic partners, and others, set out to transform health care and create a network of social services for residents of New York City's Lower East Side and, ultimately, the entire city. Today, one of Wald’s key innovations—school-based health services for children—are taken for granted as a prominent part of the health care ecosystem for school-age children. Wald spearheaded this effort to reduce student absenteeism, starting with an experiment that led to widespread reform of care for sick children across the nation.

Prior to Wald’s intervention, children of low-income families in New York City were susceptible to diseases that consistently kept them home from school. Of equal concern: the children of hardworking families often attended school with contagious conditions. Many of these children lived in the tenement district, which was home to some of the poorest immigrant families in the city, with little access to medical services. Unsanitary conditions in school classrooms only exacerbated the issue. An investigation by the New York City Department of Health discovered that children with contagious diseases like measles, diphtheria, and scarlet fever were crammed into sweltering and overcrowded classrooms (Houlahan, 2018). Subsequently, the city put forth a new system that made compulsory the medical inspection of all school children by a physician. The measure was made in vain, however, as sick children received no treatment and were simply excluded from school; some never returned (Houlahan, 2018).

Wald’s (1915, p. 46) impetus to reform school health services stemmed from a personal encounter with an illiterate 12-year-old boy named Louis whose absence from school was attributed to not being able to “cure his head.” As she described in her memoir, Wald (2015, p 47) determined that he had a treatable case of eczema. Louis’s mother had been worried about her son’s future, because his despite treatment from several local free clinics, schools had denied Louis admittance. The exchange with Louis greatly affected Wald; she and her colleague Mary Brewster created a list of children who had been excluded from school for treatable medical reasons (Wald 1915, p.48). Similar to Louis’s, most of their conditions were amenable to nursing interventions. Wald couldn’t fathom the thought of a treatable disease impeding a child’s education. At her suggestion, a one-month school nurse experiment began in October 1902.

Photo of Lina Rogers - used with permission from Henry Street Settlement

Wald—aware that nurses were placed in British schools—offered the services of one of the Settlement nurses, Lina Rogers, for the experiment because of her expertise in pediatrics (Houlahan, 2018). Roger’s main objective was to keep the children in school. For two months, Rogers, on her own, cared for students across four New York City schools, whose combined enrollment was 10,000. Space was minimal: In one school, she treated students in an unused stair closet (Houlahan, 2018). In just the first month, Rogers treated 829 students and made 137 home visits (Houlahan, 2018). Rogers not only treated the children but taught families about health promotion and disease prevention. During home visits, she provided families with a means for ongoing health care and advised them on ways to keep their children and homes clean. Rogers officially became the first municipal school nurse on November 4, 1902, launching a permanent position within New York City schools (Houlahan, 2018).

This October 2022, The National Association of School Nurses (NASN) and Henry Street Settlement celebrate the 120th anniversary of school nursing in the United States. The NASN began in 1968 as the Department of  School Nurses (DSN) in the National Education Association. By 1979, the DSN became their own incorporated entity as NASN. Its goal is to boost the ability of every child to succeed in the classroom and advance the quality of school health services. NASN continues to champion school health, develop educational programs through partnerships with national health organizations, and advocate for school nursing services among stakeholders. To advance 21st century school nursing practice, NASN provides school nurses with clinical practice guidelines, toolkits, education programs and modules, manuals on care coordination and addressing chronic absenteeism. School nurses continue to work with students and families to promote health, prevent disease, advance health equity, and develop partnerships  so that students can learn safely and in good health.

Henry Street Settlement today continues to provide social services in New York City public schools. The organization operates 11 school-based mental health clinics on the Lower East Side, provides afterschool care in five schools and two local community centers, and runs both a preschool and college preparation program. In keeping with the Settlement house model of meeting the needs of individuals, families, and communities, the teams working in each of these settings seek to meet all aspects of their student families’ needs, referring them to assistance both inside and outside of the organization for health, educational, financial, nutritional, and other social support.


Houlahan B. (2018). Origins of School Nursing. The Journal of School Nursing. 2018;34(3):203-210. https://doi:10.1177/1059840517735874

Wald, L. (1915). The House on Henry Street. Accessed at https://www.google.com/books/edition/The_House_on_Henry_Street/An_aAAAAMAAJ?hl=en&gbpv=1&printsec=frontcover

Page last updated 7/11/2023