Washington State

House of Representatives

Office of Program Research

BILL

ANALYSIS

Education Committee

HB 1346

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Brief Description: Clarifying the authority of a nurse working in a school setting.

Sponsors: Representatives Springer, Muri, Dolan, Harris, Appleton, Tarleton, Cody, Santos and Ortiz-Self.

Brief Summary of Bill

  • Provides that only a registered nurse (RN) or an advanced registered nurse practitioner (ARNP) may supervise, direct, or evaluate a licensed nurse working in a school setting with respect to the practice of nursing.

  • Prohibits school administrators from interfering with nursing care provided by a RN or an ARNP working in a school setting, but allows administrators to supervise a RN or an ARNP in all other aspects of employment.

Hearing Date: 2/2/17

Staff: Megan Wargacki (786-7194).

Background:

Students attend school with a broad range of health conditions. These range from potentially life-threatening acute and chronic conditions to correctable vision problems. Before a child is allowed to attend public school, the school must receive a medication or treatment order addressing any life threatening health condition the child has that may require medical services, including nursing services, to be performed at the school.

The scope of practice and training for nursing is regulated through a tiered licensure system, with licensed practical nurses having the least amount of training and advanced registered nurse practitioners (ARNP) having the most training. The National Association of School Nurses (NASN) recommends that, at a minimum, a school nurse should be licensed as a registered nurse (RN).

In addition, NASN recommends that a school nurse be clinically supervised and evaluated by an RN knowledgeable about the scope and standards of practice for school nursing. Many of the duties of a school nurse must be carried out by an RN or an ARNP, such as:

In a first class school district (2,000 or more enrolled students), a school nurse must hold an education staff associate certificate. The knowledge and skills acquired through the certification process are over and above the knowledge and skills required for licensure as an RN.

Summary of Bill:

School administrators may not interfere with nursing care provided by a RN or an ARNP working in a school setting, but may supervise a RN or an ARNP in all other aspects of employment. Only a RN or an ARNP may supervise, direct, or evaluate a licensed nurse working in a school setting with respect to the practice of nursing as defined below.

This does not:

The Superintendent of Public Instruction must notify each school district of these requirements, within existing funds.

The "practice of nursing" means registered nursing practice, advanced registered nursing practice, and licensed practical nursing practice as defined in nursing care statute. Such practice includes the administration of medication pursuant to a medication or treatment order and the decision to summon emergency medical assistance. It also requires compliance with any state or federal statute or administrative rule specifically regulating licensed nurses, including any statute or rule defining or establishing standards of patient care or professional conduct or practice.

Appropriation: None.

Fiscal Note: Not requested.

Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.