School-sponsored Trips - Equitably Addressing Student Health Needs

School-sponsored Trips - Equitably Addressing Student Health Needs

 

Position Statement

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NASN POSITION

It is the position of the National Association of School Nurses (NASN) to actively support and protect the right of all students, including those with healthcare needs or disabilities, to participate in school-sponsored trips, in accordance with federal regulations (U. S. Department of Education [USDOE]/Office for Civil Rights [OCR], 2020). The registered professional school nurse (hereinafter referred to as school nurse) has the expertise necessary to prepare, plan, educate, and coordinate with staff, families, students, and other healthcare professionals in arranging equitable, inclusive, and appropriate care for all students to be able to attend school-sponsored trips.

BACKGROUND/RATIONALE

School-sponsored trips complement, enhance, and enrich student educational experiences and may take place during regular school hours or extend beyond the traditional school day. These offsite academic or extracurricular activities may include day field trips, intramural or interscholastic competitions to other schools, or overnight trips to different cities, states, or countries. School-sponsored trips require school nursing oversight and expertise with additional planning for students with healthcare needs or disabilities. To participate, some students may need healthcare services during the trip that involve, for example, medical treatments or procedures, health monitoring, medication administration, dietary adjustments, and/or transportation aid (Krol & Penny, 2024).

To address student health and safety needs, it is imperative that school systems collaboratively engage school nurses in a timely manner throughout all phases of planning and implementation of school‐sponsored trips, including the initial trip approval process. School district policies, protocols, and procedures should be developed and maintained with school nursing input, to incorporate parameters involving the planning and provision of healthcare on school-sponsored field trips. Students who require special healthcare support should have individual healthcare plans (IHPs) and/or emergency action plans (EAPs) written by a school nurse, to guide care throughout the school day including during school-sponsored activities (NASN, 2022; Halbert & Yonkaitis, 2019).

The school nurse determines the healthcare support necessary for individual student participation in school-sponsored trips, such as whether a student’s healthcare needs require the presence of a nurse or if care may be legally and safely delegated to unlicensed assistive personnel, in accordance with each state’s nurse practice act (NASN, 2018). School policy may allow a student to self-carry and administer medication themself and/or self-manage their own care, with formal written authorization from parents/guardians, student’s healthcare professionals, and in consultation with the school nurse (McClanahan et al., 2019).

Federal laws protect each student’s right to a free and appropriate education with equal access and participation in any school-sponsored activity, including trips. All schools that receive federal funds are subject to this requirement (USDOE/OCR, 2020). The local education agency is responsible for providing reasonable accommodations, related aids, or services, if needed (including nursing care) for qualified students, consistent with students’ 504 accommodation plans (504) or individualized education programs (IEP). While schools may invite parents/guardians to chaperone on trips, school officials cannot require that a parent/guardian of a child with a health condition or disability attend with their child if parents of students without a health condition or disability are not required to accompany their children.

For school-sponsored trips that take place in a different state, the school nurse needs to review licensing laws, regulations, and scope of practice in the destination state well in advance of travel (Krol & Penny, 2024; Brous, 2019). Each state board of nursing regulates nursing practice, addressing protocols such as medication administration and delegation. U.S. states and territories that participate in the Nurse Licensure Compact (NLC) allow nurses to practice in all compact states/territories under one multistate license (National Council of State Boards of Nursing [NCSBN], 2023a). Some non-compact states may grant a temporary license or visiting nurse status for very short-term practice situations as in the case of a school trip. The school nurse is responsible for abiding by the destination state’s nurse practice act and licensing regulations, including NLC states (NCSBN, 2023a). U.S. state nursing licenses are not recognized in most other countries. For trips occurring outside of the U.S. that may require the provision of nursing care, it is necessary part of trip planning to determine the destination country’s nursing license requirements and scope of practice (National Council of State Boards of Nursing, 2023b).

Equitable, inclusive, and appropriate healthcare for all students while on school-sponsored trips requires school nursing expertise for preparing, planning, educating, and coordinating with staff, families, students, and other healthcare professionals. Commitment to assuring safe healthcare actively supports and protects the right of all students to have equal opportunities for participation in school-sponsored trips.

REFERENCES

Brous, E. (2019). The law and school nursing practice. In J. Selekman, R. Shannon, & C. Yonkaitis (Eds.), School Nursing: A Comprehensive Text (3rd ed., pp. 136-153). F.A. Davis.

Halbert, L. & Yonkaitis, C. (2019). Federal laws protecting students with disabilities. In J. Selekman, R. Shannon, & C. Yonkaitis (Eds.), School nursing: A comprehensive text (3rd ed., pp. 154-171). F.A. Davis.

Krol, M. & Penny, F. (2024). School-sponsored field trips. In C. Resha & V. Taliaferro (Eds.), Legal resource for school health services, (pp. 741-748). SchoolNurse.com

McClanahan, R., Shannon, R. A., & Kahn, P. (2019). School health office management. In J. Selekman, R. Shannon, & C. Yonkaitis (Eds.), School nursing: A comprehensive text (3rd ed., pp. 888-908). F.A. Davis

National Association of School Nurses. (2018). Delegation. https://www.nasn.org/nasn-resources/resources-by-topic/delegation

National Association of School Nurses. (2022). School nursing: Scope and standards of practice (4th ed.). Author.

National Council of State Boards of Nursing. (2023a). Nursing licensure compact. https://nursecompact.com/files/2023_NLC-1pager.pdf

National Council of State Boards of Nursing. (2023b). Global Regulatory Atlas – jurisdictions. https://regulatoryatlas.com/?fbclid=IwAR1KPCJTrCWvDt6NyUIG-Gjb1lH95uCFjkXhDBMcxQHkoewYFHrM07Sy2s

U.S. Department of Education, Office for Civil Rights. (2020). Protecting students with disabilities. https://www2.ed.gov/about/offices/list/ocr/504faq.html

Acknowledgment of Authors:

Wendy Doremus, DNP, MS, RN
Shanyn Toulouse, DNP, MEd, RN, NCSN
Catherine F. Yonkaitis, DNP, RN, NCSN, PHNA-BC
Lori Kelley, MSN, RN, NCSN

Adopted: June 2013
Revised: January 2024

Suggested citation: National Association of School Nurses. (2024). School-sponsored trips – Equitably addressing student health needs (Position Statement). Author.

All position statements from the National Association of School Nurses will automatically expire five years after publication unless reaffirmed, revised, or retired at or before that time.