Children who aren’t healthy can’t learn. That’s the premise behind a campaign to require every public school in Virginia to have at least one full-time registered nurse. The campaign is led by Dana Holladay-Hollifield, BSN, RN, NCSN, a school nurse.

Holladay-Hollifield started a Change.org petition calling for legislation requiring a nurse in all Virginia public schools, with priority for schools with larger numbers of students who suffer chronic illnesses or are without access to primary health care. Holladay-Hollifield’s petition says this “out of the box” vision could have huge impact: “School nurses could help the state of Virginia in reaching its goals for wellness, health equity, and reduction in health care cost.”

Schools are the primary places many students get health care services, and often the school nurse is the only health care provider a student sees on a regular basis. In Virginia, school nurses are required to report a child they suspect is abused or neglected, and child protective services cannot act without a report. This places nurses in a critical role.

According to a report by the National Education Association, the average student-to-nurse ratio in Virginia is 873:1—far behind the nation’s leaders in child health care: the average ratio in Vermont is 275:1 and in Massachusetts, 419:1.

The school nurse campaign’s goal is to have a bill the Virginia state legislature can vote on when it convenes next January. The petition already has more than 1,360 signatures, toward its goal of 1,500.