Bill to undo requirements for school nurses introduced in House

Monitor staff
Published: 1/17/2018 7:07:26 PM

Seeking to fight a shortage, legislators are considering a new bill that would dramatically reduce certification requirements for school nurses.

House Bill 1217 would eliminate a broad range of required qualifications recently put into law, a course reversal from efforts to increase the standards. Republican backers and municipal officials argue that the requirements are prohibitive and unnecessary for the role.

Under the present rules in RSA 200:29, which took effect mid-2016, registered nurses must complete a bachelor’s degree in nursing or higher and have three years’ prior experience in pediatric nursing to enter as a school nurse.

They also must demonstrate skill in 16 separate categories, such as the ability to carry out health assessments through data analysis and develop long-term outcome-oriented treatment plans.

HB 1217, proposed by Rep. Gregory Hill, R-Northfield, would sweep away those requirements, opening the job to anyone qualified in the state as a registered nurse – without a bachelor’s degree.

Speaking at an Education Committee hearing Wednesday, Hill argued that the move was meant to correct what he sees as regulatory overreach in 2016. The rules were put in place without a clear public health requirement to do so, and without sufficient input from New Hampshire schools, he argued.

“No case for urgency has been made,” Hill said.

Tim Soucy, public health director for Manchester, said that the new rules have created a cost burden for school nurses, primarily because they mandate that school nurses pass and pay for an additional round of certification under the Department of Education. That, in turn, would hurt the city’s recruitment efforts, he said.

“The law that created this requirement at the state level has been flawed since its inception,” he said. “The current RSA 200:29 will dramatically impact our ability to recruit and hire school nurses. It creates an unnecessary bureaucracy for existing and future nurses, as well as their employers.”

But nursing representatives have objected to plans to scrap the rules, which they say were established with care. The introduction of the rules follows national trends, argued Joan Widmer, executive director for the New Hampshire Nurses’ Association; a 2010 Institute of Medicine report recommended that more nurses be trained at the bachelor’s level.

Widmer disputed the bill’s potential impacts on recruitment, noting that no evidence of shortages in schools has been presented. On the contrary, for those in the nursing trade, a school position with enviable weekend and vacation time is highly sought, she said.

And she said for children in rural areas, school nurses can often be the sole point of health care for children, Widmer said. The extra qualifications are necessary because unlike in hospitals, nurses have to make most of their decisions on their own.

“In a school setting, you’re it – there’s no one else to call,” Widmer said.

And one school nurse argued that pursuing a certification with the Board of Education better integrated nurses into their unique role.

“School nurses are a needed, essential part of a school community,” said Paula MacKinnon, a nurse at Woodbury Middle School in Salem. “Certification does that. It brings us into the fold – it recognizes us as a member of the school committee that has an impact on its students.”

(Ethan DeWitt can be reached at, or on Twitter at @edewittNH.)

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