In the old days, school nurses applied bandages to students' cuts and abrasions or administered Tylenol to a kid with a headache.

And though school nurses still play an important role in students' health and medical issues, long gone are the times when they were staffed at each school to attend to pupils' daily playground bumps, bruises or abrasions.

In the Alpine School District, school nurses provide first aid and CPR training to school employees acting as first responders, assist with student immunizations and preventative health measures, and develop care plans for students with chronic medical disabilities, recovering from injuries, or other health issues.

"They're dealing with children with health problems that were never in the schools" previously, said Margie Golden, the Utah County Health Department's director of school nursing. Students with diabetes, epilepsy, asthma, allergies and other non-contagious diseases require special care to protect their health and provide them with the care they need, even at school. They also help teach maturation classes in the fifth and sixth grade to help students learn about hygiene and how to take care of their bodies.

"It's not sex education," said Mimi Webb, a registered nurse for the health department assigned as a school nurse at six Orem area schools. "It's just to tell them how to take care of themselves. A lot of parents do get concerned about that."

Webb splits her time between Orem Junior High, Geneva Elementary, Suncrest Elementary, Vineyard Elementary, Pleasant Grove Junior High and Cedar Hills Elementary.

District efforts to mainstream children with long-term diseases and physical impairments in schools is important to those students and their families, she said.

"They still want to come to school," said Webb, who was recognized as the employee of the month by the Utah County Health Department in August. "If they're not healthy, they won't do well in school."

Though there's no question that school nurses are spread thin (during the school year they visit each school typically only once a week), she said in some families of students she sees, the school nurse is the only medical professional the child ever sees when ill. Either because of poverty, lack of education or health insurance, or other factors, some children simply don't have access to health care like they should.

Eight out of 100 children in Utah have no health insurance, Webb said.

"Some schools call me that the have a student who was hurt over the weekend. ... A lot of them never get a vision screening if we don't give them one," she said, adding that she'll even be asked to make a house call. "A lot of them don't have any health care or primary care."

Webb has an open-door policy with the students she aids, and makes them feel comfortable so that they'll come back to her if they ever have a medical concern or question. She tells them there's "no need to worry. I'm not giving shots in the office."

School nurses including Webb helped calm district educators and parents and provide them with information during the recent H1N1 flu outbreak this spring. They gave instructions on detecting symptoms, proper hand-washing techniques for prevention, and when to get tested by a physician.

Golden said the school nurses' association with the health department and the schools was an asset for quick communication and preventing any further spread of the disease.

Lance Madigan, spokesman for the Utah County Health Department, said the county got lucky with the H1N1 outbreak in that the school nurses were able to detect trends in general school children's health status, whether it be the flu, head lice or some other communicable disease.

"School nurses often form the first line of defense," Madigan said. "We are one of the few counties left that still have school nurses as health department employees."

Though technically employees of the health department, 32 school nurses are assigned to cover about six schools each in the Alpine, Nebo and Provo school districts, Golden said. Half of their salaries are paid by the county while the other 50 percent comes from the school district the nurses are assigned to, she said.

Dan W. Peterson School in American Fork enrolls 135 children with severe disorders, who are cared for by a team of nurse specialists, Golden said. The county health department also has school nurses specifically trained to work with special needs and other medical-needs students in the three school districts.