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School nursing associations are the professional organizations that help members collaborate with each other, keep up-to-date with trends and advances within the profession, advocate the positions of the profession, and provide a place of connection with stakeholders and government entities. Participation by members in professional associations is waning across the country affecting the work they can do. The Illinois Association of School Nurses took a proactive approach to reorganize and revitalize their organization and membership.

The purpose of this descriptive study was to explore utilization of nurse substitutes in the school setting in Illinois. The literature described personnel who staff the school health office in the absence of the school nurse and the barriers to obtaining nurse substitutes. There were no empirical studies conducted on school nurse substitutes in the literature. Thus, a sample of 148 Illinois school nurses was recruited to complete a 20-item online survey. In the absence of a school nurse, 10.1% of health offices were not staffed, 37.8% were covered by a nurse who was simultaneously responsible for their usual assignment, and 25.7% were staffed by non-licensed personnel. Therefore, 73.6% of the respondents' assignments had no registered nurse immediately available the most recent day the nurse was absent.