Tennessee law triggers anxiety for school nurses who fear they could lose license for treating students

Families' Rights and Responsibilities Act requires school staff to receive parental approval before rendering medical treatment or counseling to students

Some school nurses and other education officials in Tennessee say a new law requiring parental consent before rendering medical or psychological treatment to students has left them scratching their heads in need of clarity.

The new Families' Rights and Responsibilities Act bars government entities or health care providers from treating, operating on, diagnosing, offering prescriptions or rendering psychological counseling to children without first obtaining parental consent, except in emergency situations.

"A violation of this practice is an unlawful practice and is grounds for the offending healthcare provider's licensing authority to suspend, revoke, or refuse to renew the healthcare provider's license or take other disciplinary action allowed by law," the law's text reads.

The measure went into effect in July, just in time for the start of the 2024-2025 school year, leading some nurses to wonder to what extent they can tend to students in non-emergency situations without facing consequences.

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According to local reports, nurses are concerned that the definition of an "emergency" situation is not clearly defined. (BSIP/Universal Images Group via Getty Images)

"School nurses in particular – they weren't consulted on this," JC Bowman, CEO of the Professional Educators of Tennessee, told Fox News Digital on Wednesday.

In his capacity, Bowman represents and interacts with nurses, teachers, and other members of the education community across the Volunteer State. He believes there are good components of the bill, but some areas need work.

"There's a nursing shortage right now, and a couple of nurses that I have talked to… one of the things that they were telling me is, ‘Look I can go right over to HCA and make $100,000. One of them actually left and went to the VA is making like $116,000, and she said ’I'm not doing this anymore' [working as a school nurse]," he said.

"But they come in and become school nurses, and they love the kids. They love the reason for doing it and coming there, but what you're going to see, I think, is the trickle-down effect, where nurses and particular guidance counselors as well, even teachers, are going to start walking away from the field because they don't want to make a mistake… they don't want to inadvertently do something, and then all of a sudden, they're in serious trouble and involved in the court system."

Bowman said he knows other nurses who are looking to leave as well.

Without specific guidelines regarding what constitutes an emergency under the law as it is written, some wonder whether simple measures like offering a student a Band-Aid for a bleeding wound is a step too far and could have repercussions.

State Sen. Ferrell Haile, a Republican who sponsored the bill, could not be reached for comment in time for publication, but previously told FOX 17 in Nashville he doesn't believe concerns that nurses could have their licenses pulled will "play out."

"What we’re looking at is the best interest of the child. Nurses in schools have the best interest of the child," he said.

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A school nurse talks with a student who doesn't feel well. Several states have laws requiring parental permission for non-emergency treatment. (Jack Milton/Portland Press Herald via Getty Images)

Haile also said the legislation aimed to put parents in control of their child's physical and mental health treatments at school, and he is open to changing the law if more questions emerge, the report stated.

State Rep. Jeremy Faison, another Republican, also spoke positively of the bill, saying it "puts into law that parents truly have the right for the direction of their children and their life."

Another local outlet said Tennessee Gov. Bill Lee noted that changes to the law may be warranted.

"You see that happen in the General Assembly a lot," Lee said. "There will be a law passed. The next year, there will be an adjustment made to that law. The next year, there may be another adjustment, because anticipating every outcome is not always possible."

As of now, parents have to sign a waiver, so their child can receive non-emergency care at school.

The same report quoted the Tennessee Association of School Nurses Executive Board as calling for changes to that policy, writing in part, "Our recommendation for lawmakers would be to change the language from active consent to an option to opt out."

Republican State Rep. Kevin Raper, who also co-sponsored the bill, however, believes the wording is fine as is.

"I'm content with how it's worded. Sometimes you can say too much, and then it opens yourself to all kinds of litigation," he said, according to WRCB in Chattanooga.

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Tennessee Gov. Bill Lee speaks on stage on the second day of the Republican National Convention at the Fiserv Forum on July 16, 2024, in Milwaukee, Wisconsin. Lee said some changes to the parental consent law may be warranted, according to local outlets. (Andrew Harnik/Getty Images)

The law also protects parental oversight in other ways, such as requiring consent before any storing of a child's biometric data (e.g. data on facial expressions, blood volume, posture, and other physiological observations) or consent before a government entity makes a video or audio recording of their child, but Bowman says there's also a problem with the lattermost part for ELL (English language learner) students.

"[Videos are a] part of when you check a kid when they come here for English fluency to see if they mastered it. You stay in ELL instruction until you can master certain words and everything else. When we take that test, we record the child to make sure that… you have proof that that child has mastered that language," he explained.

"They actually had to have a specially-called meeting on how to deal with this on ELL kids because they're afraid they're in conflict with state law now because the federal law says you have to do this, but the state law says you have to have parental permission."

If the children's parents don't speak English, it creates another problem with getting consent forms read and signed as needed.

Bowman made clear, however, that he doesn't disagree with the bill entirely. 

"We support parent rights. We want parents engaged in their child's education at every level," he said.

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Other states currently have laws requiring parental consent before school officials can render medical treatment for minor issues, including Florida, Idaho, Texas, Oklahoma, Montana, Iowa and Arizona. 

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