School nurse liability: 7 Must-know legal facts

Magnus Health
April 17, 2014
Blog, Student Health
3 Minute Read

School nurse liability: 7 Must-know legal facts

Recently, the National Association of School Nurses (NASN) published the results from their Annual School Nurse survey. In it, data showed that school nurses are eager to learn more about legal issues and how they affect school nurses. So, we did a little bit of research and came up with the top seven must-know legal facts for school nurses. Without further adieu, here they are…


1. Failing to question or challenge an administrator could result in liability.

I’m not saying insubordination is a good thing. What I am saying is that the school nurse is an advocate for student health and safety, which means, according to School Health Alert, if a student’s health or safety is at risk, school nurses have the right – and the duty – to speak up.

2. Most negligence cases against schools frequently relate to injuries.

Although rare, parents and students do sue schools. Whether it’s a broken arm from basketball or a concussion from a game of tag gone awry, negligence cases “are generally based on allegations that actions taken or not taken do not meet the standards of care” (Schwab, 2005). For nurses, this means staying up-do date on continuing education is paramount.

3. School nurses are at a higher risk for liability compared to their colleagues.

You might have caught on to a trend here: school nurse liability. Why? Nurses are special (and not just because of their secret superhero identities). Their jobs are characterized by professional isolation, a wide range of responsibilities, and conflicts between education and health law. To overcome these challenges, nurses are urged to 1) Stay updated on federal and state laws, and 2) Establish working relationships with students’ families (Schwab, 2005).

4. If a nurse attends an out-of-state field trip, they must meet the nursing license and practice laws of that state.

Some nurses may already have a multistate license, while others need to request and receive permission from the state they will be visiting. The National Association of School Nurses (NASN) issued a position statement on school-sponsored trips that urges all nurses to research both state’s laws before making arrangements to travel. Schools can go one step further by implementing policies about student care for school-sponsored trips.

5. Student health records should be kept under lock and key.

There’s no wiggle room here – student records should be secure at all times. If your school uses paper records, the best solution is a secure file cabinet with a physical lock. As for electronic Student Medical Record (SMR) storage, computers and files should have restricted access (and passwords stronger than “1234”) as their metaphorical lock.

6. Not every school staff member should have access to all student health information.

From school administrators to teachers and coaches, there may be several parties, besides the nurse, who need access to student health information. Many of these concerns are valid, such as being aware of children who suffer from ADD. However, according to FERPA, the school official who is accessing the data must have a legitimate educational interest – and only needs to see some student health information, not all of it. Using the previous example, a school official would not (and should not) need to see anything except notes related to the student’s attention deficit disorder.

7. Everything should be documented.

Yes, I mean everything.  According to FERPA, if any approved school staff person (see #6) besides the nurse needs to see student health information, their access should be logged with their name and title, date, and legitimate interest. This ensures everyone reduces their own liability and protects confidential student information.

Looking for more information on FERPA?

>> Download our free research paper on the subject.


Resource: Schwab, Nadine. Legal Issues in School Health Services. 2005. New York: Author’s Choice Press.