People often think of the hospital where they see the nurse work directly with a patient, as in administering an injection (giving a shot). Often the term "nurse" is used loosely in reference to anyone giving care. In reality, what a nurse does is often virtually invisible. A nurse assess the person and the situation, considers what is happening that is good and what is not good, acts to maintain the good and effect the not good, all while talking to the person or their family or reading reports and other records. This is why practicing as a nurse is a serious responsibility to the people in their care and why their practice is regulated.
Nursing practice is regulated by each state. In Washington it is the Nursing Care Quality Assurance Commission that regulates nursing practice. (https://fortress.wa.gov/doh/hpqa1/HPS6/Nursing/default.htm) Following is a brief outline of nursing practice in Washington state.
| Registered Nurse (RN) | Licensed Practical Nurse (LPN) | Nursing Assistant (CNA) |
| An RN is a person who undergoes extensive education and training at the college level and has passed an exam to become licensed. This license confirms competency to practice as a registered nurse. Each RN is responsible to practice independently within their scope as outlined by the nursing commission. An RN uses the term nurse. | An LPN recieves education and training and has passed an exam to become licensed. Each LPN is responsible to practice interdependently or dependently within their scope as outlined by the nursing commission. They must be assigned and supervised by an RN or MD to perform specific activities. An LPN may also use the term nurse. |
A CNA (certified or registered) may assist in the care of individuals as delegated by an RN or under the direction and supervision of an RN or LPN. A CNA may not use the term nurse. |
School Nursing
The National Association of School Nurses defines school nursing as:
The School Nurse Organization of Washington promotes, supports, and represents the school nurse who has a height level of academic preparation. SNOW believes that a baccalaureate degree in nursing from an accredited college or university, and ESA certification is optimum preparation for entry into school nursing.
RN or Certificated RN
Although having School Nurse Certification from the Office of the Superintendent of Public Instruction does not reflect the nurse's expertise, it is the accepted method of assuring a nurse has an understanding of how the public school system works and how nurses contribute to educational outcomes. A nurse with a state certificate may be refered to as certificated.
National certification however is designed to reflect an indepth knowlege of school nursing practice and an advanced level of expertise. To be nationally certified the nurse must meet some minimum requirements and successfully complete a certification examiniation. A nationally certified school nurse is recognized by the initials NCSN.
I have developed a document outlining why I believe all registered nurses in Washington schools should be certificated with few exceptions. Although I have asked for and recieved input from many, the document does not reflect the opionion of any group including the School Nurse Corps, OSPI or ESD123.