New Jersey Agency FAQs

New Jersey Department of Education; General Information 

New Jersey Board of Nursing Decision Making Model Algorithm Guidelines for Determining Scope of Nursing Practice and Making Delegation Decisions 

New Jersey Core Curriculum Content Standards; Comprehensive Health and Physical Education 

New Jersey Comprehensive Health and Physical Education; Core Curriculum Content Standards; Health and Family Life Education 

New Jersey Department of Health, Vaccine Preventable Disease Program; Questions and Answers on Immunization Regulations Pertaining to Children Attending School/ Higher Education 

Certification and Employment

1. How can I become a certified school nurse (CSN)?
Information on certification can be found on the Certification page of this website.

2. What’s the difference between a registered nurse (RN) and a certified school nurse?
A certified school nurse is specially trained to address both the health and educational needs of students in grades P-12. The specialty nursing has been described as part public health, part pediatrics, and part emergency nursing. New Jersey school nurses must complete a bachelor’s degree and take specific courses in dealing with students with special needs, substance abuse, school law and policy, and community health. They also complete a field experience working with a certified school nurse. Certified school nurses-instructional also take courses in teaching health and must complete a classroom-based instructional experience. Certified school nurses non-instructional complete all the requirements except the health teaching requirement.

3. What is the difference between national school nurse certification and New Jersey certification?
Certification issued by the New Jersey Department of Education is required for employment as a school nurse in a New Jersey public school. The National Board for Certification of School Nurses, Inc. (NBCSN) is an independently incorporated organization established for the purpose of developing and implementing the voluntary certification process of school nurses. The NBCSN is an independent organization; however, NBCSN works in collaboration with the National Association of School Nurses, and communication between the two organizations is a priority. For more information, visit NBCSN.org.

4. Where can I find information on fees for certification?
The New Jersey Department of Education establishes the process and fees for certification

5. What do school nurses do? What is a typical day for a school nurse?
School nurses provide a wide range of services to students and school personnel. In addition to mandated screenings of vision, hearing, and height/weight, school nurses administer medications, monitor students with chronic health conditions such as asthma or diabetes, administer first aid, train school staff on a variety of health issues, and serve on school and district committees to address student behavior and achievement. Nurses communicate with healthcare providers, develop individualized healthcare plans, create emergency treatment plans, and collaborate with parents to provide care and support student attendance. School nurses conduct screening programs for preschool and kindergarten admission and administer pre-participation physicals for middle and high school athletes. They counsel pregnant students, assist students and their families to secure appropriate healthcare, and provide formal and informal health teaching. In addition, school nurses support school personnel with health problems and organize programs focused on managing hypertension, losing weight, and stress management.

6. How can I find a job as a certified school nurse?
School nurses are hired by local boards of education. Some districts advertise in local newspapers. Others post open positions at NJHire. One of the best ways to secure a job is to serve as a school nurse substitute.

7. What is the salary of a school nurse?
Certified school nurses are considered teaching staff members. Salaries are locally negotiated and school nurses must be employed on the same salary guide as teachers and counselors.

8. Will I have a secretary or health aide to assist with office procedures?
This is a local decision based on the size of the school, the ages of the students, and the acuity level of students in the building.

9. I would like to "try out" school nursing before investing in courses. How can I become a substitute school nurse?
Serving as a school nurse substitute is a good way to learn about school policies and procedures. To obtain a school nurse substitute certificate, you must hold a valid New Jersey registered nurse license. Contact your county office of education for information on obtaining a school nurse substitute certificate.

10. What will I be paid as a school nurse substitute?
Substitute school nurse wages are locally negotiated and vary based on size of school, acuity levels, and the number of days you are needed.

11. What are the continuing education requirements for school nurses?
Certified school nurses are required to complete 30 hours of continuing education every two years in order to renew their registered nurse license. Since they are considered teaching staff members, they are also required to complete 100 clock hours of professional development every five years. The New Jersey Board of Nursing permits school nurses to use an array of professional activities to meet these requirements.

12. I am a licensed practical nurse. Can I become a certified school nurse in New Jersey?
No. Only registered nurses with a bachelor’s degree and specific coursework are eligible to become certified school nurses in New Jersey.

13. I hear some schools hire “supplemental RNs” to work with the school nurse. What does this mean?
Supplemental nurses are registered nurses that work under the supervision of certified school nurses. The duties of the supplemental nurse are outlined in N.J.A.C. 6A:16-2.3.

14. What kind of hours will I be expected to work?
Working hours are set at the local level and are based on the age of the students, the grades in the school, the number of schools covered by the nurse, the size of the school, and the number of nurses employed by the district. Some districts may also employ school nurses during the summer for specialized programs.

15. Will I be eligible for a pension?
Certified school nurses are teaching staff members under the law and are eligible for the same pension and benefits negotiated by the local collective bargaining unit.

16. Will I be eligible for tenure?
As a teaching staff member, certified school nurses are eligible for tenure with successful employment with a school district. (N.J.S.18A:28-5 is amendments  Requirements for tenure. page 5-6).

17. Will I be required to teach health education?
Only those nurses holding the school nurse instructional certificate are eligible to teach health education. Most often, school nurses are not required to teach a regular instructional load at the middle and high school level but may be asked to teach certain content as time and caseload allow. Some nurses teach on a regular basis at the elementary level. These assignments are often dictated by the size of the school and the acuity levels of the students.

18. Are charter schools required to hire a certified school nurse?
Yes, charter schools must hire a certified school nurse and comply with all school health services mandates as outlined in N.J.A.C. 6A:16. These rules apply to the provision of programs and services for all students in kindergarten through grade 12 by New Jersey public school districts, charter schools, jointure commissions, educational services commissions and approved private schools for the disabled acting under contract to provide educational services on behalf of New Jersey public school districts.

19. Are private schools required to hire a certified school nurse?
There are two kinds of private schools. Approved private schools for the disabled must hire a certified school nurse and comply with all regulations outlined in N.J.A.C. 6A:16 (see above). Private and parochial schools are not required to hire a certified school nurse but may participate in the Nonpublic School Nursing Services Program as described in N.J.A.C. 6A:16-2.5.


1. Why are school nurses not permitted to administer over-the-counter medications such as aspirin or Tylenol without a doctor’s order?
In accordance with New Jersey law, only licensed physicians or advanced practice nurses (APNs) are permitted to make a medical diagnosis or prescribe medications. Certified school nurses are registered nurses (RNs) and thus must have a physician’s order to administer any over-the counter medication or prescription medication. In some districts, school physicians may authorize standing orders and protocols that permit school nurses to administer certain medications. School nurses should refer to their district policies and protocols.

2. Are teachers or other school personnel permitted to administer medications to students?
No, teachers and other school personnel are not appropriately licensed to administer medications. However, New Jersey law permits specially trained school personnel to administer certain emergency medications as described in question 3 (below).

3. Under what conditions can the school nurse delegate to other school personnel the administration of certain emergency medications?
N.J.S.A.18A:40-12.6 permits delegation for the emergency administration of epinephrine and N.J.S.A. 18A:40-12.12-12.14 permits the delegation of Glucagon. For more information, refer to the Guidelines for the Care of Students with Diabetes in the School Setting and the Training Protocols for the Emergency Administration of Epinephrine.

4. Are students permitted to carry their own inhalers while at school and at school-sponsored activities such as sporting events?
Yes, N.J.S.A 18A:40-12.3 permits the self-administration of medication by a pupil for asthma or other potentially life-threatening illnesses or a life-threatening allergic reaction. School nurses must ensure that the student’s asthma treatment plan (action plan) is current and reflects the student’s needs.

5. Are students permitted to carry and administer insulin?
Yes, N.J.S.A 18A:40-12.15 permits students to manage their diabetes during the school day and at school-sponsored events. School nurses are required to complete an Individualized healthcare Plan (IHP) for students with diabetes. For more information, refer to the Guidelines for the Care of Students with Diabetes in the School Setting

6. Where can I find guidance on managing the diabetic student in school?
Refer to the Guidelines for the Care of Students with Diabetes in the School Setting developed by the New Jersey Department of Education.

7. Where can I find guidance on managing students with potential life-threatening allergies?
The Guidelines for the Management of Life-Threatening Food Allergies in School was released by the NJDOE in September 2008.

8. Where can I find guidance on managing students with asthma?
The Pediatric/Adult Asthma Coalition of New Jersey provides materials and Asthma Treatment Plans. Information is also available from the Centers for Disease Control and Prevention.


1. Where can I find a job description for a school nurse and a non-certified nurse?
The certified school nurse description is located in N.J.A.C. 6A:16-2.3(b) and (c).
The non-certified nurse description is located in N.J.A.C. 6A:16-2.3(d).
Access these regulations

The district board of education must have an approved job description that outlines the requirements of the certified school nurse and any supplemental nurse positions.

2. Where can I get a copy of the current New Jersey School Health Guidelines?
The School Nurse Practice Document (formerly known as the Guidelines) have been updated 2018.  This is a culmination of years of work that addresses the standards of nursing practice in New Jersey as reflected in code. It was written by school nurses for school nurses.  Promoting Health and Learning: School Nursing Practice in New Jersey’s Public Schools  It can also be accessed on the NJSSNA website.

3. Where can I get a copy of screening standards for hearing and vision?
Current screening requirements include height, weight, blood pressure, visual acuity, auditory acuity, and scoliosis. N.J.A.C. 6A:16-2.2 (k) details when these screening procedures must occur. The NJDOE does not establish how to conduct these screenings and when to refer students for follow-up care. Those protocols must be established by the school physician in consultation with the certified school nurse. 

4. What is the role of the school physician?
School physicians must hold a current license as a doctor of medicine or osteopathy issued by the New Jersey Board of Medical Examiners. The role of the school physician is described in N.J.A.C. 6A:16-2.3(a). School physicians authorize standing orders, review physical exams, and advise the school nurse on protocols and procedures.

5. Where can I find the health forms I am required to use?

State of New Jersey Health History and Appraisal (A-45) form (County offices of education may also have “paper” copies of the A-45 available.)

Annual Athletic Preparticipation Physical Evaluation form part A&B (English) and part A (Spanish); questions about these forms should be directed to the NJDOE.

Asthma Treatment (Action) Plan from the the Pediatric/Adult Asthma Coalition of New Jersey.

Asthma Action Plan from the NJDOE.

Other forms and updates can be found on the NJDOE website.

6. When will New Jersey have an electronic health record system?
A universal electronic health record is still under development. Until it is approved, New Jersey continues to require the A-45, State of New Jersey Health History and Appraisal form, which is the only form approved by the Commissioner and required by the Department of Health and Senior Services.

7. I just got a call from the Health Department saying it will monitor my immunization records. What does this mean and what do I need to do to prepare?
Your local or county health department auditor will examine your student health records to determine the school’s compliance with NJ state immunization mandates. All records must be made available (A-45 forms) to the inspector during the scheduled visit.

8. I have been asked to accompany students on a field trip. Since I am the only school nurse, what happens if there is an emergency at my school while I am away?
School districts should have policies and procedures for nursing coverage at schools when the nurse is absent (including field trips). The school could hire a substitute school nurse or arrange for a school nurse from another school in the district to cover multiple buildings. In addition, school districts should develop policies that address parental notification when a school nurse is unavailable and how routine and emergency services will be provided on those occasions. The certified school nurse should be part of the planning process since the nurse is aware of the medical needs in the building.

9. My school wants me to accompany students on an overnight field trip out-of-state. I am not licensed to practice in that state. Can I provide services to my students on the trip?
School nurses asked to accompany students on out-of-state trips should check with the Board of Nursing in that state to determine if he/she may provide specific nursing services to students from his/her school while on the trip.

10. When I am absent, my school does not get a sub nurse. The principal calls the parents of students with medications and treatments and tells them they either have to come in and administer the med or treatment themselves or keep their child home for the day. Is this legal?
Considering the number of students exhibiting medical problems and requiring medications and treatments during the school day, the district should make every attempt to recruit and secure a cadre of substitute nurses for such occasions. When that is impossible, according to the New Jersey Department of Education "Frequently Asked Questions on Student Services;" "students who have been classified as eligible for special education or who have a 504 plan that includes medications cannot be denied access to educational opportunities based on their need for medication during the school day. It is recommended that children who require accommodations because they are on medication should have a 504 plan. The school must make every effort to provide reasonable accommodations for these students.” When developing a student’s Individualized Healthcare Plan and Emergency Plan, special circumstances should be discussed with the parents and the child’s healthcare provider. The plan for providing medications and treatments in the absence of a school nurse should be included in the district’s policy/procedures as well.

11. I am a new nurse in this building. The previous nurse gave every teacher a list of all students with medical problems. I believe this is a breach of confidentiality. What is the best way to inform teachers of student health issues?
You are correct in not distributing student lists of medical problems. This is no longer acceptable practice. First, you need the individual student’s parent/ guardian permission, in writing, to share any medical information. You should verbally inform individual teachers about the medical concerns of students in their classes. Follow-up by distributing emergency health plans for individual students to those staff members expected to come in contact with the students during the normal school day. Just being informed about a medical concern is not enough. The emergency plan helps to educate appropriate school personnel about signs and symptoms to determine if an emergency exists. It also details actions to take in an emergency. In addition, a 504 plan may be needed if the student requires accommodations for his/ her health issue.

12. Where can I find the latest information on state TB and immunization requirements?
Refer to TB information and state immunization requirements from the NJDOH.

You can also access information on communicable diseases, including TB and immunizations on the NJDOE website.

13. My school physician wrote standing orders. Must they be renewed every year?
Yes, school physician’s standing orders need to be renewed annually by the Board of Education and are effective for one school year.

14. My school has a large number of students absent today. Should we close the school?
During high incidence of infectious diseases (such as influenza) schools should monitor not only the number of students absent but “why” they are absent. This may require school personnel to make follow-up calls to homes/parents to determine if absent students manifest the same symptoms. For guidance on whether to close a school due to absenteeism, consult your local or county health department.

15. My principal wants me to transport sick children home in my personal vehicle. Is this permitted?
There are many reasons why this is not appropriate practice. First, your auto insurance probably does not cover the use of your personal vehicle to transport students and you are not appropriately licensed to drive a district-owned vehicle to transport students since New Jersey statute and regulations require that drivers hold a valid Commercial Driver’s License with appropriate endorsement(s) for the class and type of vehicle operated, issued by the New Jersey Motor Vehicle Commission. In addition, if you are driving a vehicle, you cannot attend to the needs of a sick child. Depending on the age and size of the child, your personal vehicle may not be equipped with appropriate vehicle safety seats. Additionally, should no one be at home, who will care for the sick child? When a child requires transport to a hospital for emergency care, 911/EMS should be activated. Finally, who cares for the students remaining at the school while the school nurse is transporting ill students? School policies should require all parents and guardians to name multiple individuals who can assume responsibility for transportation and care when their child becomes ill at school. If those individuals are not available or accessible, then the child should remain at the school until the parent/guardian or appropriate designee arrives to pick-up the child.

16. Where can I find sample individualized healthcare plans?
Sample individualized care plans can be found in texts or by searching the Internet for evidence-based, reputable sources. For example, the American Diabetes Association provides a sample management plan. Similarly, the NJDOE provides a sample on its website. The Epilepsy Foundation has planning materials. Be mindful that the use of preprinted templates may not fit the individualized needs of a specific student. Additionally, preprinted templates may not take into account New Jersey laws and regulations including the New Jersey Nurse Practice Act, particularly if mention is made to delegate a nursing task.

17. I have a child in my school with special needs that has 1:1 nursing care delivered by a LPN who works for an agency contracted by the district. What is my role in the supervision of the LPN? What is my role in providing care for the student?
When the district contracts with an outside agency to provide specific services for an individualized student, it is the responsibility of the agency that employs the LPN to ensure that he/she has the requisite license, training, and capacity to provide the care as outlined in the child’s IEP. In most cases, the school district contracts with the agency not the individual; thus the agency is responsible for ensuring that the LPN is supervised and able to provide safe and effective care for the student. The LPN provides only those specialized services outlined in the IEP. The certified school nurse is responsible for state and district requirements such as mandated screenings, immunization compliance, and emergency care outside the scope of the specified services in the IEP. The certified school nurse is also responsible for maintaining mandated school health records and has an important role in developing the IHP/IEHP for developing an IHP/IEHP in collaboration with the child’s parents/guardians, healthcare providers, the LPN providing direct care, and other service providers such as physical therapists. The IHP should clearly state who is responsible for providing 1:1 care for the student when the LPN is not available.

Since the LPN is not a school district employee, any supervisory responsibilities assigned to the certified school nurse must be negotiated and included as part of the school nurse’s job description with clear delineation of any delegatory responsibilities.

18. Can a school require a parent to accompany their child on a field trip?
Students who have been classified as eligible for special education or who have a 504 plan which includes medications (or other nursing tasks) cannot be denied access to educational opportunities, including field trips. A school district cannot require a parent to accompany his/her child on a field trip. If a parent is asked to attend and he/she is unable to do so, the school district might:

  • Send a school nurse on the trip;
  • Hire a school nurse substitute to go on the trip;
  • Confer with the parent and the child’s healthcare provider to alter the time, dosage, route or kind of medication on the day of the trip and obtain a written order for the change; or
  • Confer with the parent the healthcare provider to eliminate the medication on the day of the trip and obtain a written order from the healthcare provider for the change.

At no time should a student be denied access to a field trip because the options cited above cannot be fulfilled.

19. Some of our coaches do not work in the school district. Are they still permitted to serve as delegates for epi-pens or Glucagon?
A school nurse may only delegate auto-injecting epinephrine or Glucagon to a district employee who volunteers to serve as a delegate and who is appropriately trained. Coaches under contract to the district, regardless of where they teach during the school day, are considered board-approved district employees and can serve as delegates. Volunteer coaches, parents, student trainers, and athletic officials (umpires, referees) cannot be trained as delegates.

20. How should I dispose of used epi-pens?
Most responding MIC/EMS units will take used auto-injecting epinephrine and place it in the sharps box in the “rig.” If that is not feasible, all school nurse offices should have a “sharps” box for disposal of any needle/lancet mechanism.

21. My school is new and does not have a nebulizer. I understand that funds were available to purchase them for each school. How can we get a nebulizer for our school?
N.J.S.A. 18A: 40-12.7 requires each public and nonpublic school to have and maintain at least one nebulizer in the office of the school nurse. When this law was passed, there was a one-time start-up appropriation to assist in the purchase of nebulizers. The initial funds have been expended and additional funds have not been appropriated. If your school needs assistance to purchase the nebulizer, contact your local state legislator or reach out to the Pediatric/Adult Asthma Coalition of New Jersey.

22. A local doctor/chiropractor wants to provide free screenings for students and staff. Should we take advantage of this?
District policies should address providing school personnel, students and their families with free professional services such as medical screenings. Such offers raise concerns about access to students and confidential information, consent for the exam and the resulting paperwork involved, and follow-up care for those found in need. There is always an ethical concern about possible self-referrals. In addition, the local district already employs school nurses and a school physician to provide specific services to students and staff. Administrators should determine if the proposed services duplicate those already available to the school community. Finally, current medical practice advocates for individuals to receive care at their medical home to ensure continuity and confidentiality.

23. My principal says I cannot leave the building for lunch. Sometimes, I just need to take a walk! He says the school nurse must be present in the building at all times when the school is in session? Is this true?
No, there is no law or regulation that states that a school nurse must be present in the building at all times when school is in session or at all school-sponsored events. If you are covered by the local negotiated teacher’s contract and the contract says you are entitled to non-student contact lunch time, you should be permitted to leave the building and enjoy an uninterrupted lunch period. That being said, it is important to build the capacity of school personnel to respond appropriately during events that may occur while you are out of the building. Being available by cell phone or walkie-talkie can also help when triage needs arise. Your school administrator needs to recognize that a health-promoting school considers the needs of all and that you need a few minutes of respite during the school day in order to function optimally and maintain your own health.

24. What are the confidentiality rules for students with HIV/AIDS? Substance abuse?
Confidentiality of certain health information – such as HIV status and substance abuse counseling and treatment – is regulated by separate statute, which accords a greater restriction to access of information and demands that such information be kept separate from student health records.” “N.J.S.A. 26:5C-5 & N.J.S.A. 6A:16-1.5(c) establish rules of confidentiality and disclosure of records with HIV identifying information. School staff with knowledge of or access to information that identifies a student as having HIV infection or AIDS must be shared only with prior written informed consent of the student age 12 or greater, or of the student’s parent/guardian and only for the purpose of determining an appropriate educational program for the student.” (NJ DOE, 2001).