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TO:              Superintendents, Principals, School Nurses, Dale Douglass (MSMA) and Richard Durost (MPA)

FROM:        Susan A. Gendron, Commissioner

DATE:         February 27, 2006

SUBJECT:   Role of Licensed Practical Nurses and Unlicensed School Staff in Performing Health Tasks

      This Informational Letter is intended to provide information concerning questions that have arisen regarding the role and scope of practice of a Licensed Practical Nurse (LPN) and unlicensed school staff performing health tasks in schools. 

      The educational preparation for a LPN is usually one year.  The individual completing a LPN program must successfully pass an examination and be licensed by the Maine Board of Nursing.  A LPN does not have the qualifications to be a certified school nurse and should not be referred to as the “school nurse.” 

      A certified school nurse is now required to have a bachelor’s degree, is licensed as a registered professional nurse with the Maine Board of Nursing, and is certified with the Department of Education.  The certified school nurse should provide direction for school health services and should guide decisions regarding the use of LPNs and other school staff performing health tasks in schools.

      The scope of practice of a LPN, according to the Maine Nurse Practice Act, requires them to work in a “structured health care setting”, working “under the direction of a registered nurse or licensed or otherwise legally authorized physician, podiatrist or dentist.”   The LPN may execute procedures as defined by written protocols developed by a certified school nurse.  It is not within the LPN scope of practice to conduct physical assessments or act independently.  They are not qualified to prepare Individual Health Plans (IHPs), although they may provide input in the development of a student’s IHP.  Therefore, written protocols should be available for all procedures conducted by the LPN and the school nurse must be available to the LPN at all times that the LPN is working within the school.

      An unlicensed person working in the capacity of providing health services in a school (e.g., an educational technician) is considered in the Maine Nurse Practice Act as an Unlicensed Health Care Assistive Personnel (UAP.)  School nurses may provide oversight and coordination of the UAP (Board of Nursing Rule, Chapter 6).  However, the school nurse may not oversee the UAP for “health counseling, teaching or any task that requires independent, specialized nursing knowledge, skill or judgment.”  Again, there should be clear written protocols for all tasks performed by the UAP; and the school nurse must be available to the UAP at all times that the UAP is working within the school.

For additional information, please see “Delegation Document” at

Please contact DeEtte Hall at 624-6688 or if you have questions.