Dept of Education Logo
Dept of Education Logo
Home | About Us | Accountability/Assessment | Certification | Data Collection & Reports | Innovations | Legislation/Hearings/Rules | NH Schools | Professional Development | Employment Opportunities | Contact Us | Search | Calendar
Department of Education - an official New Hampshire Government website
Smaller text size Reset text size Larger text size
skip navigation
students artwork
Subject indexABCDEFGHIJKLMNOPQRSTUVWXYZ0 thru 9

Delegation of Nursing Care in Schools


To whom can a school nurse delegate nursing related activities?

According to the NH Board of Nursing (NHBON) rule NUR 404, delegation is permitted to both licensed and unlicensed individuals under certain circumstances.

Ed 311.02 Acrobat Reader aligns with that Board of Nursing rule and no longer prohibits delegation of medication administration. It is important that the school nurse who delegates a task be familiar and in compliance with the regulations of NUR 404.01-404.07 and the policies and procedures of his/her employer. Note that it is not appropriate to delegate to someone who cannot accept delegation according to their scope of practice. For instance, a school nurse should not delegate medication administration to an LNA. Be familiar with the scope of practice of RNs as well as LPNs, LNAs, and MNAs if those personnel work in your school setting (see scope of practice information).

Can an LPN or LNA work in a public school setting?

Yes, but they must work under the supervision of the school registered nurse as per RSA 200:31.The school registered nurse would delegate nursing related tasks and activities to them under NUR 404.

Can public school nurses delegate the administration of epinephrine auto injectors to school staff or volunteers, when a student has a prescription of this medication, in the event that an RN or LPN is not available?

Yes. School Nurses may delegate the administration of epinephrine auto-injectors as per Ed 311.02 and in accordance with the NUR 404 rule. Epi pens are intended for use by lay persons. Note that LNAs may not administer medications.

Can public school RNs or LPNs delegate the administration of epinephrine that has been obtained under RSA 318:42 and is stocked by the school for treatment of anaphylactic reactions?

No. RSA 318:42 only permits a school RN or LPN to possess this drug and then administer as appropriate. Delegation of epinephrine is only permitted when a student has a prescription for epinephrine.

Can school nurses delegate the task of instilling medications into G and J tubes?

Yes. According to NHBON rule NUR 404, delegation is permitted under certain circumstances. It is important that the school nurse who delegates this task be familiar and in compliance with the regulations of NUR 404.01-404.07 and the policies and procedures of his/her employer.

Can school nurses delegate the task of administering insulin and glucagon?

According to NHBON rule NUR 404.06 (b), any nurse who delegates a task must take into account factors such as the stability of the client's situation and whether the nursing needs of the client are changing. Ed 311.02 allows public school nurses to delegate injectables such as insulin and glucagon but NUR 404.06 (b) narrows the option because the person performing the injection must make clinical judgments about dosages and related issues. There may be special circumstances when those working closely with a student are appropriate delegates and in those circumstances, the School Nurse would follow the NUR 400 provisions. It is important to remember that the nurse must always act in accordance with the policies and procedures of his/her employer.

Can a school nurse delegate the task of administering rectal medications?

Similarly, a school nurse may delegate administration of drugs such as rectal medications. Again, Nur 404 and Ed 311.02 would need to be followed. Privacy and comfort issues must also be considered, especially in the school setting.

Acrobat Reader Symbol Acrobat Reader format. You can download a free reader from Adobe.


New Hampshire Department of Education
101 Pleasant Street | Concord, NH | 03301-3494
Telephone: (603) 271-3494 | TDD Access: Relay NH 711