School nurses straddle two statutory and regulatory frameworks, health and education. Because school nurses practice nursing in an educationally focused system, they face unique legal, policy, funding and supervisory issues that may also have ethical dimensions. These issues may include:

• Unsafe school nurse to student ratios,

• Accountability for care delegated to Unlicensed Assistive Personnel (UAP),

• School administrator request to amend documentation,

• School administrator assignment of nursing tasks to UAP without the input of the school nurse, and

• Parent/guardian request for medical treatment for his/her student, which is inconsistent with school nurse scope of practice (Brent, 2013).

As such, school nurses must have not only the skills to communicate within both the healthcare and education arenas, but also the requisite knowledge and skills to interpret applicable laws, regulations and professional standards, as well as apply ethical theories and principles (ANA & NASN, 2011).