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Requirements for School Nurses

Alaska

Last Updated: 6/10/2008

Pre-service Requirement: 04 AAC 12.355 (1995) requires the completion of a program in a special services area from an accredited institution, the possession of a bachelor's degree, and the completion of six semester hours of credit in the past five years prior to applying in order to receive a Type C Special Services Temporary Certificate. School nurses are also required to take the Alaska Studies and Alaska Multi-Cultural Studies coursework according to the code. 

Professional Development: None specified. 

Student-to-Nurse Ratio: None specified.


Alabama

Last Updated: 9/6/2010

Pre-service Requirement: Administrative Code 610-X-6-.06 (2004) states that a school nurse is responsible for the nursing care delivered to students. Administrative Code 610-X-4-.01 (2004) requires the completion of an approved registered nursing program or an approved practical nursing program, the possession of a high school diploma, and the passing of the board approved licensing examination to be qualified as a school nurse. Code 16-22-16  (2009) allows school districts to employ licensed practical nurses (LPN) in addition to registered nurses (RN). There may not be more than 5 LPNs for each RN within each school system.

Professional Development: None specified. 

Student-to-Nurse Ratio: The School Nurse Act (no link availabe) (2009) sets the goal of having one state-funded nurse for every 500 pupils as funding becomes available in the State's Education Trust Fund and is appropriated by the Legislature.


Arkansas

Last Updated: 12/28/2013

Pre-service Requirement: Pre-service Requirement: Code 6-18-706 (1993) defines a school nurse as a licensed nurse engaging in school activities. The state qualifies both registered nurses and licensed practical nurses. Code 17-87-301 (1995) requires the completion of both a high school course of study and an approved professional nursing education program, and the passing of a board approved examination for licensure as a registered nurse in the state of Arkansas. For licensure as a practical nurse, Code 17-87-304 (1995) requires the completion of both a high school course of study and a state-approved program for preparation of practical nurses, and the passing of a board approved examination. The School Nurse Roles and Responsibilities Practice Guidelines (2007) provides furtherguidance.

Professional Development
: None specified.

Student-to-Nurse Ratio
: Only upon the availability of funds, all school districts are required to have no fewer than 1 full-time school nurse per 750 students according to Code 6-18-706 (2003).


Arizona

Last Updated: 8/27/2009

Pre-service Requirement: State Board of Education Administrative Code R4-19-309 (2004) requires school nurses to obtain a school nurse certificate issued by the Department of Education. Certification requires a candidate to hold a current license as a professional nurse in Arizona. Licensure as a professional nurse requires the completion of an approved professional nursing program and the possession of a bachelor's degree as outlined in ARS 32-1632 (2002).

Professional Development: None specified.

Student-to-Nurse Ratio: None specified.


California

Last Updated: 2/19/2009

Pre-service Requirement: Education Code 49426 (1994) states, A school nurse is a registered nurse currently licensed under Chapter 6 (commencing with Section 2700) of Division 2 of the Business and Professions Code [the Nursing Practice Act (2001)], and who has completed the additional educational requirements (bachelor's degree) for, and possesses a current credential (minimum of 26 units beyond the bachelor's degree) in school nursing pursuant to 44877 of the Education Code (1994).

Professional Development Requirement:  Registered nurses in California must complete a minimum of 30 contact hours of related professional development to renew the Registered Nurse (RN) license (California Code of Regulations, Title 16, Division 14, Article 5, 1451).

Student-to-Nurse Ratio: None specified.


Colorado

Last Updated: 11/9/2010

Pre-service Requirement: Statute 12-38-111 (2003) requires the completion of an approved nursing education program, a bachelor's degree, and the passing of a board-approved examination for licensure as a professional nurse. For school nurses to obtain a special services license as a school nurse, they must have a valid Colorado RN license and a baccalaureate degree in nursing. If their baccalaureate degree is not in nursing, they must have 3 years school nurse experience and pass the National School Nurse Certification exam.

Professional Development: For an initial license holder, State Board of Education Regulation 2260.5-R-12.01 (2004) requires steps towards completing the requirements for a professional license every 3 years until completed. State Board of Education Regulation 2260.5-R-12.02 (2004) requires six semester hours of 90 clock hours of professional development every five years for professional license renewal.

Student-to-Nurse Ratio: None specified.


Connecticut

Last Updated: 4/3/2012

Pre-service Requirement: Public Health Code 10-212-2 (1982) requires each school nurse to be a registered professional nurse currently licensed in the state of Connecticut with at least one-year work experience as a registered nurse in the past five years and 12 credits of academic preparation or 18 continuing education units or 180 workshop or in-service hours. Public Health Code 10-212-2  (2002) requires the person hold a degree, diploma or certification from an approved nursing program and the passing of a board approved examination for licensure as a registered nurse.

Professional Development: Public Health Code 10-212-2 (1982) requires school nurses to participate in 10 hours of professional development approved by the local or regional board of education every two years.

Student-to-Nurse Ratio: There is no specific state policy concerning ratios. However, Statute 10-212 requires each local or regional board of education to appoint one or more school nurses or nurse practitioners.


District of Columbia

Last Updated: 4/21/2013

Pre-service Requirement:

Professional Development:

Student-to-Nurse Ratio: Section 602 of the Healthy Students Act of 2010 states that or before January 15 of each year, each public school and public charter school shall submit the following information to the Office of the State Superintendent of Education regarding each of its campuses: whether the school has full-time, part-time, or no nurse coverage; the name and contact information of the school’s nurse. This information shall also be posted online if the school has a website and make the form available to parents in its office. The Office of the State Superintendent of Education shall post the information on its website within 14 days of receipt.


Delaware

Last Updated: 12/20/2008

Pre-service Requirement: Administrative Code 14:1582 (2003) requires a minimum of a bachelor's degree in nursing or school nursing, a current registered nursing license, three years clinical nursing experience, and current certification in CPR for a standard school nurse certificate. A registered nursing license can be acquired by fulfilling the requirements outlined in Code 19:1910 (1953), which includes a minimum of a high school diploma or its equivalent and completion of a Board of Nursing approved nursing education program. During the term of the initial education license, the school nurse must complete a 90-hour Induction Cluster of training consistent of school nursing, health education, testing and screening, counseling and guidance, and introduction to exceptional children. In addition, the nurse must successfully pass the Praxis I.

Professional Development: 90 clock hours of professional development every five years are required for relicensure per the Guidelines for Renewal of a Continuing License. Further, the Board of Nursing requires 30 hours every 2 years of nursing continuing education by approved continuing education providers as outlined in Code 19: 1918 (1953).

Student-to-Nurse Ratio: According to the state and based on district salary formula requirements, Code 14:1310 (1979) directs school districts to employ one nurse for every 40 units. Each school is also required to have at least one full-time school nurse. Administrative Code 14:275 (2004) requires charter schools to submit an acceptable plan to assure the health needs of students in school, which includes the services of a registered nurse.


Florida

Last Updated: 3/30/2013

Pre-service Requirement: Statute 1012.55 (2012) requires each person employed as a school nurse to hold a license to practice nursing in the state. Statute 464.008 (2003) outlines the qualifications for RNs and LPNs, to include a high school diploma or the equivalent and completion of an approved professional nursing program.  The preferred entry level is a Bachelor's Degree in Nursing or higher.

Professional Development: The Florida Board of Nursing requires all registered nurses to attend education courses in HIV/AIDS, domestic violence, medical errors prevention and other practice related courses totaling a minimum of 24 contact hours for registered nursing license renewal biennially.  While it is not required, the Department of Health School Health Program encourages national school nurse certification and when funding is available, provides training to assist nurses in fulfilling this recommendation.

Student-to-Nurse Ratio: No state policy.


Georgia

Last Updated: 6/11/2008

Pre-service Requirement: Georgia Code 20-2-771.2 (no date available) requires each local board of education to establish policies and procedures for a school health nurse program. The state further suggests in the School Health Nurse Resource Manual (2001) for schools to utilize registered nurses, licensed practical nurses, or health assistants. According to the manual, registered nurses must have a valid state license, further details provided in Georgia Code 43-26-7 (1994) which requires the completion of and graduation from a nursing education program and the passing of a board approved examination, licensed practical nurses must have a state LPN license, and health assistants must have a high school diploma certificate preferably in a health related field.

Professional Development: None specified.

Student-to-Nurse Ratio: Chapter 1 of the Georgia School Health Resource Manual (2004) [No link available] recommends school nurses be employed at a ratio of 750:1.


Hawaii

Last Updated: 6/11/2008

Pre-service Requirement: None specified.

Professional Development: None specified.

Student-to-Nurse Ratio: None specified.


Iowa

Last Updated: 10/31/2011

Schools and school districts are required to employ a school nurse  per Code 256.11(9B) (2007). The school registered nurse must have a registered nurse (RN) license from the board of nursing, and may be employed, shared, or contracted. 282 IAC 16.7 Special education nurse SPR  provides services with pupils requiring special education, birth to 21. Requirements include a baccalaureate in nursing or a master's degree in nursing, current licensure by the board of nursing, two years experience in public health nursing including service to schools or as a school nurse. Legalization is through a statement of professional recognition (SPR) and not through teacher licensure. The licensed practical nurse may provide nursing care in a non-acute care setting with the supervision of a registered nurse or physician in the same building or for one individual when delegated and supervised by a registered nurse.

Pre-service Requirement: Code 256.11(9B) requires registered nurse licensure on file to be employed as a school nurse.  281 IAC 12.4(12) (2001) School nurse SPR requires registered nurse licensure and a baccalaureate degree.

Professional Development: No specific requirement.

Student-to-Nurse Ratio: Code 256.11(9B) (2007) does not require a specified ratio, however it states that every school shall "work toward the goal of having one school nurse for every 750 students enrolled in the school district."


Idaho

Last Updated: 2/25/2013

Pre-service Requirement: The Idaho State Board of Education Rule 08, Title 02, Chapter 02 (2009) outlines the requirements for a school nurse endorsement. A candidate must possess a valid RN license, and a bachelor's degree in nursing, education or a health-related program from an accredited institution. A candidate may also qualify for endorsement with a valid RN license and nine semester credit hours from a college in at least three of the following areas: health program management, child and adolescent health issues, counseling, psychology or social work, or methods of education instruction.  Two years relevant experience is also required. Statute 54-1408 (2002) provides the qualifications for licensure as a professional nurse (registered nurse) by requiring the successful completion of a professional nursing education program, the passing of a board approved examination, and being in the state of sound physical and mental health.

Student-to-Nurse Ratio: None specified.


Illinois

Last Updated: 12/26/2012

Pre-service Requirement: State Board of Education 23 Administrative Code Ch 1-a, Section 1.760 (1987) requires school nurses to hold a School Service Personnel Certificate with the appropriate endorsement. The school nurse endorsement requires school nurses to possess a baccalaureate degree from an accredited institution, be licensed as a registered professional school nurse in Illinois pursuant to the Nursing and Advanced Practice Nursing Act, 225 ILCS 65 (1998), complete an Illinois approved program for the preparation of school nurses, and successfully complete the required certification examinations.

Professional Development: Required to renew certification and to renew RN license. 

Student-to-Nurse Ratio: None specified.


Indiana

Last Updated: 11/29/2010

Pre-service Requirement: State Board of Education 511 IAC 4-1.5-1(i)(3) (2000) stipulates that Student services personnel" who provide heath services must hold credentials as a registered nurse. For licensure as a registered nurse, a candidate must have completed an accredited program of registered nursing and passed the NCLEX-RN to meet the licensure requirements outlined in the Indiana Nurse Practice Act, Code 25-23-1.1 (1999). State Board of Education 511 IAC 4-1.5-6 (2000) requires a school corporation to employ at least 1 registered nurse who possesses a bachelor of science in nursing to coordinate health services.

Professional Development: No state policy.

Student-to-Nurse Ratio: State Board of Education 511 IAC 4-1.5-2 (2000) recommends that there be one registered school nurse per 750 students in the corporation.


Kansas

Last Updated: 11/17/2011

Pre-service Requirement: Licensure as a nurse is required for service as a public school nurse. Statute 65-1115 (2001) requires applicants to have graduated from an accredited high school and an approved school of professional nursing for licensure as a registered professional nurse.

Statute 60-15-101 (2009) outlines the definitions and functions of a registered nurse in a school setting.

Professional Development: As applicable to all nurses.

Student-to-Nurse Ratio: No state policy.


Kentucky

Last Updated: 5/19/2013

Pre-service Requirement: 201 KAR 20:070 (2003) prescribes the process to obtain licensure, by examination, as a registered nurse.  Pursuant toKRS 314.041 (2000), an applicant for a license to practice as a registered nurse must complete and graduate from an approved school of nursing and satisfyKRS 214.615 (2002), which requires all applicants to complete an educational course on the transmission, control, treatment, and prevention of HIV and AIDS.

16 KAR 2:060 (2002)requiresthe completion of 15 semester hours of coursework to obtain a provisional certificate for school nurse and to be working toward completion of a bachelor's degree.

Professional Development: 201 KAR 20:215 (2005) requires 14 approved contact hours of continuing education to validate continuing competency for annual renewal of licensure for nurses.

Student-to-Nurse Ratio: None specified.

Louisiana

Last Updated: 11/21/2011

Pre-service Requirement: Certification requirements for school nurses may be found in the State Certification of School Personnel Bulletin 746 (2011). Requirements include 2 years experience as a registered nurse and a current Louisiana license.

Professional Development: Information relative to continuing education may be found in Bulletin 746.

Student-to-Nurse Ratio: RS 17:28 (1995) requires each school system to employ at least one school nurse for each 1500 students.


Massachusetts

Last Updated: 6/11/2008

Pre-service Requirement:  For licensure as a school nurse, 603 CMR 7.11 (2004) requires a valid registered nursing license in the state of Massachusetts, a bachelor's degree in nursing, a minimum of two full years of employment as a registered nurse in a clinical nursing setting, completion of an orientation program, and a passing score on the Communication and Literacy Skills test. For licensure as a registered nurse, a candidate must have completed a state accredited program of registered nursing, possess a bachelor's degree, and pass a board approved examination according to General Law 112.74 (no date available).

Professional Development: None specified.

Student-to-Nurse Ratio: General Law 71.53 (no date available) requires there to be one or more nurses at each school.


Maryland

Last Updated: 6/8/2011

Pre-service Requirement: Code 8-302 (1995) requires the completion of an approved registered nursing program or an approved practical nursing program and the passing of the board approved licensing examination to be qualified as a registered nurse. In Maryland, the registered nurse (RN) is always the leader of the school health nursing team. The registered nurse (RN) makes the decisions about how care is provided and who provides the care to the child in the school system. As such, only the school registered nurse has the authority to use the title school nurse. All other health staff must be referred to by their title of licensed practical nurse (LPN), certified nursing assistant (CNA), or Health Assistant (health technician, etc.). 

Additional information on the definition of the role of the school nurse is available in the Maryland State School Health Guidelines Role of the Health Services Staff in Schools (2006).

The Maryland Board of Nursing requires School Health Nurses (public and nonpublic) to complete a Case Manager/Delegating Nurse training program. 

Professional Development: Maryland has no specific state policy for the professional development of school nurses. However, Code 7-504 (1996) establishes standards and policies for the training of school personnel, and others responsible for counseling or supervising student activities, in suicide prevention to meet the requirement that all schools have Youth Suicide Prevention Programs. Beginning in 2005, the Maryland Board of Nursing requires RNs in Assisted Living, Developmental Disabilities Administration, Juvenile services, and School Health (public and non-public) settings to complete a Case Manager/Delegating Nurse training program. The curriculum covers topics including, but not limited to: delegation requirements, principles of adult education, communication, and how to teach the updated medication technician training program. RNs who want to teach the medication technician training program must complete this curriculum. The Maryland Board of Nursing approved the 14 hour RN Case Manager/Delegating Nurse Training Program for School Health.

Student-to-Nurse Ratio: None specified.


Maine

Last Updated: 12/14/2012

Pre-service Requirement: For certification as a school nurse, Education Rule Chapter 115, Part 2, Section 1.16 (2005) requires a candidate to hold a current registered nursing license in the state of Maine and possess a baccalaureate degree from an accredited institution. The candidate must have a minimum of three years experience as a nurse, with 1 of those years within the previous 5 years prior to initial application. For licensure as a registered nurse, a candidate must have completed a state accredited program of registered nursing of not less than 2 years.

Professional Development: All certified school nurses are required to complete continuing education to maintain licensure.

Student-to-Nurse Ratio: Statute Title 20-A 6403-A (1985) requires each school board to appoint a registered professional nurse to supervise and coordinate health services and health-related activities. Maine's Essential Programs & Services (1997) established 800 students: 1 school nurse, as part of the school funding formula.


Michigan

Last Updated: 6/12/2008

Pre-service Requirement: MCL 340.1166 (1976) specifies the criteria for school nurse certification as holding a valid registered nursing license issued by the state board of nursing and the acquiring of additional credits beyond those required for a registered nurse from an approved teacher education or nursing education institution. MCL 338.10301 (1989) requires the completion of an approved registered nurse education program, the possession of a bachelor's degree or an associate degree with a major in nursing, and the passing of the state approved NCLEX-RN examination.

Professional Development: MCL 340.1165 (1976) requires a school nurse to submit evidence of continuing attainment of theoretical and practical knowledge.

Student-to-Nurse Ratio: No state policy.


Minnesota

Last Updated: 9/4/2009

Pre-service Requirement: State Board of Education Rule 8710.6100 (2002) requires a candidate for licensure as a school nurse to hold a bachelor's degree in nursing from an accredited college or university, be currently certified as a public health nurse, and be licensed as a registered nurse. For licensure as a registered nurse, Statute 148.211 (2004) requires the completion of a course of study in a board approved nursing program and passing the board approved examination for professional nursing.

Professional Development: State Board of Education Rule 8710.7100 (2003) requires all teachers to obtain 125 hours of continuing education in their field every five years for re-licensure. Furthermore, nurses must meet the continuing education requirements of the Board of Nursing every two years.

Student-to-Nurse Ratio: Statute 121A.21 (2003) requires districts with 1000 pupils or more to employ at least one full-time licensed school nurse, contract with a public or private health organization or another public agency, or enter into another commission-approved agreement.


Missouri

Last Updated: 6/12/2008

Pre-service Requirement: No state policy.

Professional Development: The Missouri State Board of Nursing states that nurses have a responsibility to engage in on-going education and training. 

Student-to-Nurse Ratio: The Department of School Health Services funded programs are required to work toward or maintain a 750:1 ratio.


Mississippi

Last Updated: 5/27/2010

Pre-service Requirement: State Board of Education Policy 4009  (2007) requires school nurses to  possess a valid license as a practical nurse or a registered nurse issued by the Mississippi Board of Nursing. For licensure as a practical nurse, Code 73-15-21 (2000) requires an applicant to possess a diploma from an approved high school, complete of a State Department of Education approved practical nursing program, and pass a board selected examination. For licensure as a registered nurse, Code 73-15-19 (2000) requires an applicant to complete an approved nursing program, provide evidence of competence in English, and pass a board selected written examination.

Professional Development: Code 49-71-31 (2010) requires require school nurses to attend certified asthma educators training.

Student-to-Nurse Ratio: None specified.


Montana

Last Updated: 12/19/2012

Pre-service Requirement: No state policy. State Board of Public Education Administrative Rule 10.57.501 (2002) does require a teaching license for the appropriate level of education if nurses are teaching in a classroom setting.

Professional Development: No state policy. State Board of Public Education Administrative Rule 10.57.501 does require nurses who are teaching in a classroom setting to undergo the same professional development as a regular teacher.

Student-to-Nurse Ratio: None specified.


North Carolina

Last Updated: 5/21/2009

Pre-service Requirement: The Student Services Job Description requires school nurses to have completed training necessary for licensure as a registered nurse. For licensure as a registered nurse, Section 90-171.29 of the Nursing Practice Act (2001) requires the completion of an approved registered nurse education program and the passing of a board approved examination for licensure as a registered nurse. Statute 115C-315 (2002) does not require school nurses to be nationally certified to continue employment in the public schools.

Professional Development: No state policy.

Student-to-Nurse Ratio: Part III of the North Carolina's Basic Education Plan for Public Schools (1994) requires there to be one nurse for every 3,000 students in a school district.


North Dakota

Last Updated: 6/15/2008

Pre-service Requirement: No state policy.

Professional Development: None specified.

Student-to-Nurse Ratio: None specified.


Nebraska

Last Updated: 11/30/2011

Pre-service Requirement: The minimum requirement for a school nurse endorsement is a current Nebraska license as a registered professional nurse according to 92 NAC 24-007.02 (no date available). 

Professional Development: Statute 79-830, the Professional Growth Requirement, requires all certificated employees to provide evidence of 6 semester hours of professional growth or an alternative activity approved by the school board every 6 years.

Student-to-Nurse Ratio: The HHS School & Child Health Nursing Coordinator promotes the ratio of 750:1 based on the National Association of School Nurses.


New Hampshire

Last Updated: 6/15/2008

Pre-service Requirement: RSA 200:29 (1971) requires a school nurse be a registered nurse licensed in New Hampshire.  For licensure, RSA 326-B:20 (2001) requires applicants to complete an approved nursing program, possess a bachelor's degree, and pass a board approved examination.

Professional Development: None specified.

Student-to-Nurse Ratio: No specific policy; however RSA 200:29 allows each school board to appoint a registered professional nurse currently registered in the state to function in the school health program.


New Jersey

Last Updated: 12/26/2011

Pre-service Requirement : N.J.S.A. 18A:40-3.3 (1999) states that a school district shall only employ persons holding an educational services certificate with an endorsement as a school nurse issued by the State Board of Examiners to provide nursing services in the public schools. It also states that such endorsements may only be issued to persons licensed as registered nurses. Additionally, State Board of Education Administrative Code N.J.A.C. 6A:9-13.3 (2004) requires a candidate to hold a New Jersey registered professional nurse license, a bachelor's degree, current CPR and AED certificates, and complete a department-approved college curriculum or a program of studies outlined in the code for a school nurse endorsement that authorizes the holder to perform nursing services and to teach health-related areas in grades K-12. State Board of Education Administrative Code N.J.A.C. 6A:9-13.4 (2004) possess the same requirements as stated in State Board of Education Administrative Code N.J.A.C. 6A:9-13.3 except the requirement of an alternate program of studies for a school nurse/non-instructional endorsement. For licensure as a professional nurse, N.J.S.A. 45:11-26 (1966) requires the completion of a professional nursing course of study at an accredited school of professional nursing, the possession of a high school diploma, and the passing of a board approved examination.

School nurses may be employed as a substance awareness coordinator per State Board of Education Administrative Code N.J.A.C. 6A:9-13.2 (2004).
 
Professional Development: Certified school nurses are considered teaching staff members and are thus required to fulfill 100 hours of professional development per State Board of Education Administrative Code N.J.A.C. 6A:9 (2008).
 
Student-to-Nurse Ratio: There is no specific student-to-nurse ratio stipulated, but State Board of Education Administrative Code N.J.A.C. 6A:16-2.3 requires there be at least one certified school nurse per district.

New Mexico

Last Updated: 3/18/2011

Pre-service Requirement:There are three (3) levels of licensure for Health Services school employees: (1) 6.63.2 NMAC, School Nurse PreK-12 – Associate, Professional, Supervisory. The Associate is required to have completed an Associate’s degree in Nursing and possess an RN license issued by the NM Board of Nursing. The Professional is required to have completed a Bachelor’s degree in Nursing and possess an RN license issued by the NM Board of Nursing. The Supervisory is required to have completed a Master’s degree in Nursing and possess an RN license issued by the NM Board of Nursing.

(2) 6.63.16 NMAC, Licensed Practical Nurse PreK-12 – The LPN is required to be 18 years old and have completed a state approved program of study of practical nursing and possess certification as an LPN issued by the NM Board of Nursing; and possess certification in CPR, have 1 year of supervised experiences outside the school setting, and be oriented to school duties by a licensed RN.
(3) 6.63.15 NMAC, Health Assistant PreK-12 – The Health Assistant is required to have a high school diploma, complete a NM Department of Health training for school health assistants, possess certification in CRP and First Aid, and have verification from an employing school authority that a local orientation related to assigned duties and facilitated by a licensed RN was completed.
 
Detailed information for this area can be found on the Public Education Department web page under Professional Licensure Bureau under Licensure Pathways/Requirements.

Professional Development16.12.2.10.S (3) NMAC, requires 30 hours of approved CE to be accrued by RNs and LPNs within the 24 months immediately preceding expiration of licensure.

Student-to-Nurse Ratio: There is no mandated ratio in New Mexico. Health services are required to be provided; however, the number of school nurses in a district is determined at the local level and is based on the size of the school/district and the assessed needs of the students.

Nevada

Last Updated: 6/16/2008

Pre-service Requirement: An endorsement as a school nurse requires the possession of a baccalaureate degree from a nursing program and holds a valid registered nursing license issued by the state board of nursing. For licensure as a professional nurse, NRS 632.140 (1973) requires the completion of and a diploma from an accredited school of professional nursing and the passage of a board approved examination. 

Professional Development: None specified.

Student-to-Nurse Ratio: None specified.


New York

Last Updated: 9/16/2009

Pre-service Requirement: Per Education Law 902 (no date available), a school nurse must be a registered professional nurse, which requires the completion of a professional nursing program, a bachelor's degree in professional nursing, and passing the board approved NCLEX-RN examination per Education Law 6905 (no date available). 

For certification as a school nurse-teacher, a candidate must possess a bachelor's degree, have completed six semester hours of professional education courses, hold a registered nursing license in the state of New York, have participated in the child abuse identification and school violence prevention workshops, and have fingerprint clearance. 

Professional Development: No state policy. 

Student-to-Nurse Ratio: No state policy.


Ohio

Last Updated: 6/16/2008

Pre-service Requirement: OAC 3301-24-05 (2003) requires school nurses to hold a professional pupil services license which allows them to work with children of any grade level. The code also requires school nurses to hold a professional pupil services license, possess a bachelor's degree, and a current license as a registered nurse. ORC 4723.09 (2002) requires the completion of an approved registered nurse education program and the passing of a board approved examination for licensure as a registered nurse. 

Professional Development: ORC 3319.221 (2001) requires a school nurse to be a registered nurse in the state and fulfill all the renewal requirements for educators holding a pupil services license to maintain licensure. ORC 3319.073 (1995) requires the board of education to develop a 4-hour in-service training program in child abuse prevention for all elementary school district employees and service center work. 

Student-to-Nurse Ratio: None specified.


Oklahoma

Last Updated: 9/2/2008

Pre-Service Requirement: Statute 70-1-116 (1994) requires school nurses to be a registered nurse licensed by the Oklahoma State Board of Nurse Registration and Nursing Education, and must also be certified according to the rules and regulation of the State Board of Education. Statute 59-567.5 (2003) requires the completion of an approved nursing program, the possession of a bachelor's degree, and the passing of the NCLEX-RN examination for licensure as a registered nurse.

Professional Development: The state provides funds for staff development in the area of HIV and offers other professional development opportunities for school nurses.

Student-to-Nurse Ratio: None specified.


Oregon

Last Updated: 11/8/2010

Pre-service Requirement: OAR 584-021-0110 (1992) requires the completion of an approved program of preparation consisting of health services coursework and a practicum in a school setting, the possession of a baccalaureate degree, the successful completion of a state board of education examination, and a current registered nursing license in the state, which can be obtained after completing an approved professional nursing education program outlined in OAR 584-021-0120 (1993), for certification as a provisional school nurse.

Professional Development: OAR 584-048-0065 (1992) requires a recommendation from an approved program that is contingent upon the satisfactory completion of 9 quarter hours leading up to a Standard Personnel Service License.

Student-to-Nurse Ratio: HB2693 (2010) requires each school district ensure that the district has a sufficient number of licensed nurses  and school nurses to provide one licensed nurse or school nurse for every 225 "medically complex" students, one for every 125 "medically fragile" students, and one for every nursing-dependent student (as defined in the statute). In addition, each school district is encouraged to have one nurse for every 750 students in the district.


Pennsylvania

Last Updated: 1/2/2012

Pre-service Requirement:  A school nurse requires an Educational Specialist's Certificate. 022 PA Code 49.102 (1999) states that an Educational Specialist I Certificate will be issued to those applicants who have successfully completed a Department of Education approved educational specialist preparation program, have satisfactorily achieved in the prescribed assessments and has the college or university preparing program's recommendation 

To be considered for the educational specialist certificate program for school nursing, the individual must be licensed as professional nurses (RNs) and possess a bachelor's degree in nursing. For licensure as a registered nurse the Professional Nursing Law, Section 5 (2003) requires the completion of a state-approved associates degree, diploma or baccalaureate degree nursing program and the passing of a board-approved examination.

Professional Development: Act 48 (1999) requires professional educators and educational specialists and administrators to complete 6 credits of collegiate study, 6 credits of continuing education courses, and 180 hours of continuing professional education programs, activities, or learning experiences every 5 years for maintenance of licensure.

Student-to-Nurse Ratio: 24 P.S. 14-1402 (1966) and 14-1410 (1957) requires schools to provide one certified school nurse per 1500 students. 028 PA Code 23.51-.53B (1962) requires private, parochial, and public school children to receive nursing services through the public school system. The number of students to be served by a school nurse shall be determined by the school administrator by the number of school, the distance and travel time between schools, and special health needs of the areas.


Rhode Island

Last Updated: 1/30/2013

Pre-Service Requirement: Statute 16-21-8 (1976) requires each school district to employee a certified nurse-teacher personnel. Section 7.2.1 of the Rules and Regulations for School Health  (2009) requires a candidate for certification as a nurse-teacher personnel to be licensed as a registered nurse and certified by the Department of Elementary and Secondary Education. For licensure as a registered nurse, the Rules and Regulations for the Licensing of Nurses (2004) requires the possession of a high school diploma, successful completion in an approved professional nursing education program, and the passing of the NCLEX-RN examination.

TheRegulations Governing the Certification of Educators in Rhode Island (effective January 1, 2012) details a comprehensive redesign of the certification system that updates the requirements and procedures that govern educator certification in Rhode Island.  Specific details of Rhode Island School Nurse Teacher Certificate are outlined in All Grades School Nurse Teacher, Grades PK-12. The All Grades School Nurse Teacher Certificate is valid for assignment as an All Grades School Nurse Teacher and as an

All Grades Health teacher in grades PK 12 in Rhode Island public schools.

Applicants must achieve a passing score of 160 on the Praxis II Principles of Learning and Teaching - Grades K-6 (0622/5622) OR a passing score of 157 on the Praxis II Principles of Learning and Teaching - Grades 7-12 (0624/5624). Applicants prepared in a program where the language of instruction was not English must achieve a passing score of 64 on the Versant Pro Speaking and Writing assessments.        See Certification Tests - Effective September 1, 2013.

Professional Development: See Section 8.0 Continuing Education Requirements of the Rules and Regulations Pertaining to the Licensing of Professional (Registered), Certified Registered Nurse Practitioners, Certified Registered Nurse Anesthetists, and Practical Nurses and Standards for the Approval of Basic Nursing Education Programs[R5-34-NUR/ED]

As per the Regulations Governing the Certification of Educators in Rhode Island,professional development is embedded in the state approved local evaluation system requirement that all educators receive annual evaluation ratings and professional growth plans.

Student-to-Nurse Ratio: No state policy.


South Carolina

Last Updated: 4/8/2012
Pre-service Requirement: South Carolina does not have a policy requiring schools to employ school nurses. However, if a nurse were to be employed by a district, State Board of Education Regulation R 43-50 (2000) defers the licensing of nurses to the Professional and Occupational Licensing Board of Nursing. For licensure as a registered nurse, The Nursing Practice Act Code 40-33-22 (2002) requires the completion of all requirements from an approved school of nursing and the passing of a board approved examination.
 
Professional Development Requirement: The School Health Program Manual (1997) [no link available] states that a school nurse is responsible for participating in programs for continued education and professional development.
 
Student-to-Nurse Ratio: No state policy.

South Dakota

Last Updated: 1/8/2013

Pre-service Requirement: Statute 13-33A-1 (1993) requires school health services to be coordinated by a registered nurse. For licensure as a registered nurse, a candidate must have completed a state accredited program of registered nursing, possess a high school diploma, and pass a board approved examination as outlined in Board of Nursing Administrative Rule 20:48:03:01 (1994) and the Nurse Practice Act 36-9-30 (1981). 

Professional Development: None specified.

Student-to-Nurse Ratio: None specified.


Tennessee

Last Updated: 9/26/2011

Pre-service Requirement: The Guidelines for Use of Health Care Professionals and Health Care Procedures in a School Setting (2007) define a school nurse as someone who is professionally educated as a registered nurse and whose role is to strengthen and facilitate the educational process by improving and protecting the health status of students. For licensure as a registered nurse, Rules of the Tennessee Board of Nursing (2007) requires the completion of an approved school of professional nursing and the passing of a board-approved examination.

Professional Development: Continuing education for re-licensure is not mandatory in Tennessee.  However, mandatory continuing competency is required in Tennessee.  In order to maintain continued competence, the board requires the nurse to have practiced in nursing in the last five (5) years and additionally, the Board sets out standards of competence and requirements to maintain competence.  See Rules of the Tennessee Board of Nursing 1000-1-.14 and 1000-2-.14 (2007).

Student-to-Nurse Ratio: Code § 49-3-359 (2004) provides funding to public school systems for school nurses at the ratio of one per 3,000 students or one per school system, whichever is greater, and allows school systems to employ school nurses or contract them through the Public School Nurse program established in Tenn. Code Ann. § 68-1-1201 (1988).


Texas

Last Updated: 10/1/2010

Pre-service Requirement: Education Code 21.003 (1995) requires a school nurse to be certified by the proper state agency. 

Professional Development: None specified. 

Student-to-Nurse Ratio: None specified.


Utah

Last Updated: 2/8/2012

Pre-service Requirement: The state does not have a policy requiring districts to employ nurses in the schools. Code 53A-11-204 (2002), however, states that public schools would be better protected against health and safety risks if a registered nurse were readily available. For licensure as a registered nurse, Code 58-31b-302(3) (2005) requires the completion of an approved practical nursing education program or an equivalent as determined by the licensing board, the possession of a high school diploma or its equivalent, and the passing of the board approved examinations.

Professional Development: No state policy.

Student-to-Nurse Ratio: Code 53A-11-204 encourages school districts to provide one registered nurse for every 5,000 students.


Virginia

Last Updated: 11/16/2010

Pre-Service Requirement: Code 22.1-274 (1999) allows school boards to provide pupil personnel and support services. School boards may employ nurses if they meet standards as may be determined by the Board of Education. Subject to the approval of the appropriate local governing body, a local health department may also provide personnel for health services for the school division.

12VAC30-50-229.1 (2002) allows school divisions participating as a Medicaid provider to provide skilled nursing services to a child who has a prescribed educational program under Part B of IDEA. These services must be performed by a Virginia licensed registered nurse (RN) or licensed practical nurse (LPN) under the supervision of a licensed RN.

For licensure as a registered nurse, Code 54.1-3017 (1988) requires the completion of an approved four-year high school, the possession of a diploma or degree from an approved professional nursing education program, and the passing of a board of nursing approved examination. For licensure as practical nurse, Code 54.1-3020 (1998) requires the completion of two years of high school or its equivalent, the possession of a diploma from an approved nursing education program, the passing of a written examination required by the Board, and has not committed any acts requiring disciplinary action.

Professional Development
: None specified.

Student-to-Nurse Ratio
: Code 22.1-274 recommends there be one nurse per 1,000 students.

Vermont

Last Updated: 10/4/2010

Pre-service Requirement: Board Rules 5441 and 5445, 5440-65 (2005) require school nurses to have a minimum of a bachelor's degree from a nursing program accredited by the National League for Nursing or the Commission on Collegiate Nursing Education, a valid Vermont license as a Registered Nurse, current certification in CPR and first aid, four years of clinical nursing experience beyond nursing education, and have completed the Department of Education's educational orientation program. An applicant must also demonstrate knowledge in specified general and school nursing concepts and skills and meet three specified performance standards.

Professional Development: None specified.

Student-to-Nurse Ratio: None specified.


Washington

Last Updated: 6/16/2008

Pre-service Requirement: For certification as a school nurse, a candidate must be 18 years of age, present good moral character and personal fitness, have completed a two semester hour course approved by the State Board of Education, possess a valid registered nursing license in the state of Washington, and possess a baccalaureate degree in nursing. For licensure as a registered nurse, a candidate must have completed a state accredited program of registered nursing according to RCW 18.79.160 (2004). 

Professional Development: WAC 392-192-030  (1990) requires all local school districts to adopt a professional growth program for certified classroom teachers and support personnel unless a collective bargaining agreement provides otherwise. 

Student-to-Nurse Ratio: None specified.


Wisconsin

Last Updated: 12/13/2012

Pre-service Requirement

Statute 115.001 requires a school nurse to be a registered nurse licensed under section 441.06 ch. 441 or in a party state, as defined in s. 441.50(2)(j) who submits evidence satisfactory to the department that he or she has successfully completed a course, determined to be satisfactory to the department in public health or community health (2011).”  

Code PI 34.31 (2004) requires an applicant for school nurse licensure to have completed a baccalaureate degree program in nursing from an approved program which includes a practicum in school nursing and be a registered nurse in the state. For licensure as a registered nurse, Statute 441.04 (1987) requires the completion of an accredited school of nursing program, the possession of a high school diploma, and the passing of the NCLEX-RN examination. Code PI 34.31(2), states that a school nurse license is not required. However, they may be issued to a school nurse who completes a school nurse practicum and receives an institutional endorsement.

Professional Development: Code PI 34.18 (2004) requires the completion of a professional development plan that demonstrates increased proficiency every five years for license renewal. The plan's completion is verified by a professional development team. 

Student-to-Nurse Ratio: None specified.


West Virginia

Last Updated: 12/20/2010

Pre-service Requirement: State Board of Education Policy 5202 (2006) requires a school nurse to hold a bachelor's degree in nursing (BSN), state certification in school nursing (CSN) and valid RN license issued by the West Virginia Board of Examiners to be fully certified.   School nurses with masters of science of nursing (MSN) and national school nurse certification from NBCSN may receive WV department of education certification. A full-time permit may be issued to associate degree in nursing or Diploma nurse for an emergency situation within an area of shortage, as long as proof in the form of an educational agreement, with current enrollment in a BSN program between the RN candidate for employment and higher education.  The RN on a Permit must complete a BSN with CSN within 5 years to continue employment within school nursing while renewing with at least 6 hours of college credit every year, as defined in educational agreement.

Professional Development: Board Policy 5500 (1997) establishes the general implementation of staff development activities for the 18 hours of job-related training required for all school personnel each school year.

Student-to-Nurse Ratio: Code 18-5-22 (2006) requires counties to employ one School Nurse per 1,500 students for grades K-7 and and provides additional funding to support school health service needs that exceed the capacity of staff as mandated in this section. The additional funding is set for students with high acuity  and direct nursing service needs in with diagnoses of asthma, seizures, insulin-dependent diabetes and airway management. State Board of Education Policy 2422.5 (2010) provides guidance for the utilization of licensed practical nurses within the delegation structure. LPNs however do not count toward the school nurse ratio.


Wyoming

Last Updated: 3/25/2012

Pre-service Requirement: Rule 4898, Chapter 14, Section 2 (1994) requires school nurses to be licensed as a registered professional nurse in order to obtain a School Nurse Permit. Upon receiving a permit, applicants are authorized to provide health service to students and provide instruction under the supervision of a certified teacher. For licensure as a registered professional nurse, a candidate must have completed a state accredited program of registered nursing, possess a bachelor's of science in nursing, and pass a board approved examination according to Rule 4301, Chapter II (2001) and the Nursing Practice Act Statute 33-21-127 (2005). 

Professional Development: None specified. 

Student-to-Nurse Ratio: None specified.


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