Texas School Nurses Organization

November 2020

Big picture

Mission Statement & Vision Statement

To enhance whole student wellness in support of health and learning by advancing school nursing practice.

Student access to health and learning. All day. Every day.

This newsletter takes NASN’s Framework for 21st Century School Nursing Practice approach.


President's Message


I can’t believe November is here already. I will be your president for another week and then Karen Schwind will be installed. She is an awesome nurse and I feel very confident that she will lead TSNO is a great direction.

I am sad that we aren’t all meeting in Houston this weekend for annual conference but I believe the TSNO EC made the correct decision in cancelling it. Our annual business meeting will be held via zoom on November 11th beginning at 5:00 pm. It should take more than 30 minutes. We do need to make some changes to our bylaws but we will have to put this off until we can all meet together again. We will announce the location of the 2021 conference at the end of the business meeting. Hope you all can jump on-line for it.

Zoom invites will be sent via email!

I wish you all could have attended the zoom webinar put on by ProjectADAM. It was very informative and helpful. Watch the newsletter each month for further zoom webinar ideas.

One of the big questions right now involves the K-12 testing that Governor Abbott has endorsed. It is an ‘opt in’ program, meaning that your superintendent has to request to do the testing in their district. The COVID rate in your area will determine how often you will be asked to test. Each district will need a district coordinator that will be responsible for sending in an accurate inventory count weekly. They say it doesn’t have to be a nurse performing the testing but whoever it is will have to watch a short video to become certified. TEA and TDEM are supposed to supply the districts with the needed PPEs but told us that they are already experiencing a shortage with gloves. TSNO was not asked for input prior to this program being implemented and we were only asked to attend a zoom conference after it had been announced. We tried to stress how overwhelmed and overworked the nurses were this year and the fact that some districts had nurses at multiple school and some districts didn’t even have a nurse. Their solution to this was that anyone on the campus can be trained to do the testing. Maybe next time they will ask for our input before deciding to do something.

We can only hope.

I have enjoyed serving as your President the past two years. I feel I have grown in my profession and changed the way I look at many things. Being on the board of TSNO is an eye-opening experience and if I can do it, anyone can. If you would like to be more involved with TSNO just email one of the board members and let them know. We are always in need of nurses willing to serve.



Big picture
Big picture
Big picture

The Texas Board of Nursing is responsible for regulating the practice of nursing within the State of Texas for Vocational Nurses, Registered Nurses, and Registered Nurses with advanced practice authorization. The standards of practice establish a minimum acceptable level of nursing practice in any setting for each level of nursing licensure or advanced practice authorization. Failure to meet these standards may result in action against the nurse's license even if no actual patient injury resulted.

(1) Standards Applicable to All Nurses. All vocational nurses, registered nurses and registered nurses with advanced practice authorization shall:

(A) Know and conform to the Texas Nursing Practice Act and the board's rules and regulations as well as all federal, state, or local laws, rules or regulations affecting the nurse's current area of nursing practice;

(B) Implement measures to promote a safe environment for clients and others;

(C) Know the rationale for and the effects of medications and treatments and shall correctly administer the same;

(D) Accurately and completely report and document:

(i) the client's status including signs and symptoms;

(ii) nursing care rendered;

(iii) physician, dentist or podiatrist orders;

(iv) administration of medications and treatments;

(v) client response(s); and

(vi) contacts with other health care team members concerning significant events regarding client's status;

(E) Respect the client's right to privacy by protecting confidential information unless required or allowed by law to disclose the information;

(F) Promote and participate in education and counseling to a client(s) and, where applicable, the family/significant other(s) based on health needs;

(G) Obtain instruction and supervision as necessary when implementing nursing procedures or practices;

(H) Make a reasonable effort to obtain orientation/training for competency when encountering new equipment and technology or unfamiliar care situations;

(I) Notify the appropriate supervisor when leaving a nursing assignment;

(J) Know, recognize, and maintain professional boundaries of the nurse-client relationship;

(K) Comply with mandatory reporting requirements of Texas Occupations Code Chapter 301 (Nursing Practice Act), Subchapter I, which include reporting a nurse:

(i) who violates the Nursing Practice Act or a board rule and contributed to the death or serious injury of a patient;

(ii) whose conduct causes a person to suspect that the nurse's practice is impaired by chemical dependency or drug or alcohol abuse;

(iii) whose actions constitute abuse, exploitation, fraud, or a violation of professional boundaries; or

(iv) whose actions indicate that the nurse lacks knowledge, skill, judgment, or conscientiousness to such an extent that the nurse's continued practice of nursing could reasonably be expected to pose a risk of harm to a patient or another person, regardless of whether the conduct consists of a single incident or a pattern of behavior.

(v) except for minor incidents (Texas Occupations Code §§301.401(2), 301.419, 22 TAC §217.16), peer review (Texas Occupations Code §§301.403, 303.007, 22 TAC §217.19), or peer assistance if no practice violation (Texas Occupations Code §301.410) as stated in the Nursing Practice Act and Board rules (22 TAC Chapter 217).

(L) Provide, without discrimination, nursing services regardless of the age, disability, economic status, gender, national origin, race, religion, health problems, or sexual orientation of the client served;

(M) Institute appropriate nursing interventions that might be required to stabilize a client's condition and/or prevent complications;

(N) Clarify any order or treatment regimen that the nurse has reason to believe is inaccurate, non-efficacious or contraindicated by consulting with the appropriate licensed practitioner and notifying the ordering practitioner when the nurse makes the decision not to administer the medication or treatment;

(O) Implement measures to prevent exposure to infectious pathogens and communicable conditions;

(P) Collaborate with the client, members of the health care team and, when appropriate, the client's significant other(s) in the interest of the client's health care;

(Q) Consult with, utilize, and make referrals to appropriate community agencies and health care resources to provide continuity of care;

(R) Be responsible for one's own continuing competence in nursing practice and individual professional growth;

(S) Make assignments to others that take into consideration client safety and that are commensurate with the educational preparation, experience, knowledge, and physical and emotional ability of the person to whom the assignments are made;

(T) Accept only those nursing assignments that take into consideration client safety and that are commensurate with the nurse's educational preparation, experience, knowledge, and physical and emotional ability;

(U) Supervise nursing care provided by others for whom the nurse is professionally responsible; and

(V) Ensure the verification of current Texas licensure or other Compact State licensure privilege and credentials of personnel for whom the nurse is administratively responsible, when acting in the role of nurse administrator.

(2) Standards Specific to Vocational Nurses. The licensed vocational nurse practice is a directed scope of nursing practice under the supervision of a registered nurse, advanced practice registered nurse, physician's assistant, physician, podiatrist, or dentist. Supervision is the process of directing, guiding, and influencing the outcome of an individual's performance of an activity. The licensed vocational nurse shall assist in the determination of predictable healthcare needs of clients within healthcare settings and:

(A) Shall utilize a systematic approach to provide individualized, goal-directed nursing care by:

(i) collecting data and performing focused nursing assessments;

(ii) participating in the planning of nursing care needs for clients;

(iii) participating in the development and modification of the comprehensive nursing care plan for assigned clients;

(iv) implementing appropriate aspects of care within the LVN's scope of practice; and

(v) assisting in the evaluation of the client's responses to nursing interventions and the identification of client needs;

(B) Shall assign specific tasks, activities and functions to unlicensed personnel commensurate with the educational preparation, experience, knowledge, and physical and emotional ability of the person to whom the assignments are made and shall maintain appropriate supervision of unlicensed personnel.

(C) May perform other acts that require education and training as prescribed by board rules and policies, commensurate with the licensed vocational nurse's experience, continuing education, and demonstrated licensed vocational nurse competencies.

(3) Standards Specific to Registered Nurses. The registered nurse shall assist in the determination of healthcare needs of clients and shall:

(A) Utilize a systematic approach to provide individualized, goal-directed, nursing care by:

(i) performing comprehensive nursing assessments regarding the health status of the client;

(ii) making nursing diagnoses that serve as the basis for the strategy of care;

(iii) developing a plan of care based on the assessment and nursing diagnosis;

(iv) implementing nursing care; and

(v) evaluating the client's responses to nursing interventions;

(B) Delegate tasks to unlicensed personnel in compliance with Chapter 224 of this title, relating to clients with acute conditions or in acute are environments, and Chapter 225 of this title, relating to independent living environments for clients with stable and predictable conditions.

(4) Standards Specific to Registered Nurses with Advanced Practice Authorization. Standards for a specific role and specialty of advanced practice nurse supersede standards for registered nurses where conflict between the standards, if any, exist. In addition to paragraphs (1) and (3) of this subsection, a registered nurse who holds authorization to practice as an advanced practice nurse (APN) shall:

(A) Practice in an advanced nursing practice role and specialty in accordance with authorization granted under Board Rule Chapter 221 of this title (relating to practicing in an APN role; 22 TAC Chapter 221) and standards set out in that chapter.

(B) Prescribe medications in accordance with prescriptive authority granted under Board Rule Chapter 222 of this title (relating to APNs prescribing; 22 TAC Chapter 222) and standards set out in that chapter and in compliance with state and federal laws and regulations relating to prescription of dangerous drugs and controlled substances.


Big picture

Did you know?

The SchoolNurseNet logo has received a facelift! Below is the current logo and the new logo. I hope you like it! It is much cleaner and provides an immediate connection to NASN.

Big picture
Big picture

Congratulations Newly Elected Board Members!


Notes from your NASN Director!

Season of Thanksgiving

November has finally arrived, with the treasured traditions of Thanksgiving: We are constantly reminded to be thankful for the positive happenings in our lives. Whether we work in a rural or urban school district, in a public, private, or charter school, what we do each, and every day matters in the lives of our students, families, and school staff in promoting safety, health and well-being. The insidious coronavirus pandemic, however, continues to challenge and stress all school nurses, from direct care to administration. Folks have shared countless stories of school nurses working beyond their normal workload, hoping to narrow the gap in inequality our families may face with housing woes, compromised financial resources, food insecurity, or lack of comprehensive healthcare services. I offer my thanks and admiration for your hard work and sacrifices to balance both the needs of your students and the public health of your community, plus your faithful support and invaluable contributions to TSNO, will always be treasured in my heart. Speaking of balance, I again urge you to spend well-earned “me” time in this season of thanksgiving with your family, friends, and fellow nursing colleagues. You are amazing.

May Peace and Wellness be with you!

In your service,


Francis Luna, MSN, RN, NCSN




TSNO has made great strides as an organization, educating the public about the role of professional school nurse. Part of that process involves legislative advocacy. This doesn't have to happen at the Capitol - school nurses can advocate from right where they are!

Find out about legislative wins from the 86th session and look ahead to what we're working on for the 87th Session, which starts in January.

This is our chance to EDUCATE - ADVOCATE - LEGISLATE for our students and our profession. Get involved!

Becca Harkleroad, RN, NCSN

Advocacy Chair

Texas School Nurses Organization

Big picture

Have you seen the latest NASN Weekly Digest?

President's Message

November is National Diabetes Awareness Month. Did you know that diabetes is one of the most common chronic conditions in school-age youth in the United States, affecting about 193,000 youth under 20 years old? You can find out more from the National Institute of Diabetes and Digestive and Kidney Diseases.

NASN also offers several resources for your school community. We have a webpage devoted entirely to diabetes in children, and we also partner with the Association of Diabetes Care and Education Specialists (ADCES) to make Danatech available to NASN members. With Danatech, you can:

· Research and review diabetes devices and mobile apps.

· Access tech-focused courses, webinars and device training.

· Discover useful tools and evidence-based research, clinical trials and reports.

· Participate in focus groups, polls and discussions helping to shape the future of diabetes care.

Laurie Combe, MN, RN, NCSN

NASN President



Big picture

Good evening,

I am excited to say that my proposal to investigate school nurses' perception of telemedicine for school-based asthma case management received IRB approval from the University of Texas. I am ready to start my study!

Loree LaChance, MHA, MSN, RN, NCSN

DNP student, University of Texas School of Nursing


Big picture

Join us on November 17, 2020 for our very first Virtual Fall Membership Drive.

Speaker: Christy Giddens, BSN, RN, NCSN

Coordinator of Health Services, McKinney ISD

Presentation: Self-Care for the School Nurse

Time: 5:30 pm-7:00 pm

Earn 1.5 hours of CE

Children’s Health Clinical Operations is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. This activity provides 1.5 contact hours.

RSVP by November 13, 2020 to tsnoregion10@gmail.com with your name and email address – this is how you will get your contact hours.

Zoom link will be provided upon your RSVP.

Big picture


AAP Updates Interim Guidance on Child Care During COVID-19

Big picture


Check out the amazing COVID-19 Resources Below

Big picture

Texas K-12 School System COVID Rapid Testing Project Superintendent Kick-Off


Big picture

Summer Camps Are Already Looking For a Few Good Nurses!


Big picture


The Value of Membership

Increase Your Knowledge

Online continuing nursing education in the NASN Learning Center is always discounted for NASN members. In many cases, the activities are free of charge to NASN members.

DANA or Diabetes Advanced Network Access created by the American Association of Diabetes Educators is available to NASN members free of charge. DANA connects school nurses with the devices, expertise and innovations shaping the future of diabetes care.

Titles in the NASN Bookstore including ebooks and manuals are always discounted for NASN members.


Did you know...

The TSNO website has a "Resource" link with so much valuable information in just one click of the mouse! Examples include advocacy tools, AED's, asthma resources, confidentiality, diabetes care manual, federal agency links, food allergies, models, IHP Templates (my personal favorite), position statements, Scope and Standards, and so much more! Check it out at this link:



TSNO Executive Committee


PRESIDENT Lisa Formby - Region 16


PRESIDENT-ELECT Karen Schwind - Region 13


TREASURER Luisa Herrera- Region 19


Secretary Sarah Alexander - Region 15


NASN DIRECTOR Francis Luna - Region X







ADVOCACY CHAIR Becca Harkleroad- Region 13


SCHOOL HEALTH ISSUES Amber Cichockia- Region X


MEMBER SERVICES Denise Kablaitis - Region 13



Membership Coordinator Linda Howard - Region 8


REGION PRESIDENTS Coordinator Deana Bunting - Region 5 deanabunting.tsno@gmail.com

Communications Coordinator Brandy Bowlen - Region IV bbowlen1@kleinisd.net

EXHIBIT LIAISON Amy Huey - Region X ahuey.tsno@gmail.com


Are you IN?

Connect with with TSNO on LinkedIn and grow your professional network!


Big picture