School Nurses Left Off List of Providers Who Can Write Sick Notes in Wisconsin
- Wisconsin law will no longer allow registered nurses to write school excuse notes, limiting that authority to providers with diagnostic scope such as physicians and advanced practice registered nurses.
- The change is intended to improve consistency in absence documentation and align with updated scope of practice distinctions in healthcare.
- The update may impact school nurse workflows and require more coordination with outside providers, potentially affecting how quickly families can obtain excused absences.
A new Wisconsin law will remove registered nurses from the list of healthcare professionals authorized to excuse student absences, drawing attention to scope of practice limitations and the role of school nurses.
Beginning September 1, registered nurses will no longer be allowed to sign school excuse notes. The update narrows the group of providers who can verify medical absences and shifts that responsibility to clinicians with diagnostic authority.
The change comes as part of a broader legislative update tied to the state’s rollout of advanced practice registered nurse licensure.
What’s Changing and Why it Matters
Wisconsin’s new law removes registered nurses from the list of professionals authorized to excuse student absences, limiting that authority to licensed providers with diagnostic scope such as such as physicians, naturopathic doctors, dentists, chiropractors, optometrists, psychologists, physician assistants, and nurse practitioners.
Sen. Rachael Cabral-Guevara said the change is intended to prevent misuse, improve consistency, and ensure school absence notes reflect a formal medical evaluation. The Wisconsin Association of School Nurses supported the update, saying it helps resolve confusion created by a prior change to the state’s school absence law.
How this ties to APRN licensure
The law aligns with Wisconsin’s implementation of a formal licensure system for advanced practice registered nurses, which distinguishes APRNs from registered nurses based on scope of practice.
APRNs have expanded authority to assess, diagnose, and manage patient care independently, while registered nurses generally do not have independent diagnostic authority.
Supporters say the change reflects that distinction by assigning excuse authority to providers with diagnostic training.
What this means for school nurses
For school nurses, the change shifts the absence-excuse process in the school setting. Registered nurses can still assess students, provide care, and coordinate with families and health care providers, but they will no longer be able to independently sign excused absence notes under the new law. That may add another step for families who need official documentation, since they will have to obtain it from one of the licensed providers still authorized to excuse absences.
In areas with limited access to care that extra step could make the process slower or more difficult, especially when a family needs timely documentation for a missed school day. School health guidance also emphasizes that school nursing is a coordinated system linking the school, family, and community providers, which supports the point that this change may increase the need for coordination.
What could change for schools and families
Schools may need to update attendance policies to reflect the new documentation rules and clarify which medical excuses they will accept. Families may need to obtain notes from a licensed provider with authority to diagnose and excuse absences, which could make the process less convenient depending on access to care in their area. During periods of high illness activity, schools and providers could also see more requests for absence documentation.
What this means moving forward
The law takes effect September 1, and its impact will become clearer as schools and health systems adjust to the new documentation rules. Additional guidance at the state or district level may help standardize how absences are handled and reduce confusion during the transition. For nurses, the change is a reminder that legislation can shape day-to-day practice even in administrative areas, and it highlights the importance of understanding scope of practice as APRN roles continue to expand in Wisconsin.
🤔Nurses, how do you think his change could impact school nurses and the students they serve?Share your thoughts below.
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