After years as a nurse, whether in an intensive care unit or an elementary school, Mary Ellen Heer agrees laughter is the best medicine.

"You have to keep a sense of humor," said Heer, president of the Smithtown Professional Nurses. Although there's often more work to do than there are hours in the day, "We do the best we can to support the kids, the faculty, the staff, visitors, everyone in the school."

Key to that success is that the Smithtown school district on Long Island provides a school nurse in every building, and additional help for the three buildings with the largest populations.

"Every day is different; you never know what you're going to get," said Diane Cucciniello.

She travels between the district's two high schools to help assure that each will have a full-time nurse at all times. The schedules tries to provide two nurses during peak periods.

"After the increase of the medically fragile children and the growing population of special-needs students coming to school, the big change is the increase in mandated reportings," Heer said.

"Of course emergencies trump everything, but more time is on mandated reporting," said Jane Canfora.

In September, the Smithtown nurses will have to start reporting student Body Mass Index as part of a new Health Provider Network the state is phasing in to track student data.

All three nurses have been with the Smithtown schools at least two decades. They said the students and their colleagues are favored aspects of the job.

"And you also get much more stable hours as a school nurse compared to being in a hospital or with an agency," Cucciniello said. "You can plan weekends and holidays off."

All of the registered nurses and SPN members are concerned about a shortage of people entering the nursing profession as well as the growing salary disparity within nursing.