Parents may be surprised to hear that finding a nurse in every local school may not be that easy; in fact, school nurses aren’t even required in some states.

The National Association of School Nurses recently surveyed each state when it comes to the number of nurses in schools.

While West Virginia ranked 28, Ohio ranked as one of the worst at 45.

Union Local’s nurse, Tracey Childress, sees about 100 sick students every day with illnesses like allergies, diabetes and asthma.

Over the years, Childress’ job has continued to change. It involves more than handing out medication. Now, she handles real health issues.

“You never know when a child is going to have an asthma attack, when their blood sugar is going to drop, in addition to dealing with the common colds and the flus,” said Childress.

Some parents do not know if a nurse is always in their child’s school.

“I have no clue. I never even thought about it,” said local father Brian Ferguson.

Childress said, “A lot of schools get a nurse one day a week or half a day. If the nurse isn’t around the day their child gets sick, then (parents) realize what's going on."

Many school nurses cover multiple buildings across multiple miles, and many students.

About 12 states have mandates of school nurse to student ratio. West Virginia requires at least one nurse to every 1,500 students. Ohio has no such mandate and, according to the Ohio Association of School Nurses, it’s an issue.

OASN reports the average nurse- to-student ratio in Ohio is 1 to 2,300. While that statistic worries some parents, others tell NEWS9 they’re not concerned.

“I know that we have a school nurse. I work for Steubenville City Schools and there's always been a nurse around. So, I was never really worried about it,” said Kristy Jackson, a local mom.

For the most part, the school board or the local health department hires school nurses. However, in Ohio, school districts are not required to have school nurses. They must provide the health care to students, but it doesn't have to be by a certified professional.

Nurse Childress says a secretary or teacher normally cares for students if a nurse is not available.

“Anyone can hand out a pill or give an inhaler, but they don't know what to do if that medication doesn't work. They don’t know how to administer emergency medicine. They don't have the assessment skills; it requires a professional nurse,” said Childress.

Childress said the number of needed nurses can be different in every district and it depends on the students.

“If a district has a nurse they need to talk to them and find out how many diabetics, how many asthmatic students they have,” said Childress. “Then they should staff their nurses according to the needs in the district."

Some parents say the findings are shocking and a real wake-up call.

“I would definitely push to make sure there are people trained in the schools. I honestly never thought about it,” said Ferguson. “I thought it was a norm in every school."

The OASN is pushing for legislation to mandate nurses, and the organization encourages parents to contact local lawmakers.