All NCSNs are required to renew their certification in order to demonstrate that they have kept current with new practices, methodologies, equipment, medications, and terminology in the specialty of school nursing. School Nurse certification is granted for a period of five (5) years at which time the certificant must either retake and pass the Certification Examination for School Nurses or meet current continuing education and recertification requirements.

Continuing competence is defined as: the ongoing commitment of a registered nurse to integrate and apply the knowledge, skills, and judgment with the attitudes, values, and beliefs required to practice safely, effectively, and ethically in a designated role, patient population and/or setting.

NBCSN conducts a job analysis every 5 years to confirm that the Nationally Certified School Nurse credential and examination correctly reflect the most current and up-to-date school nursing practice. Recertification is required every 5 years.

“Continuing certification refers to the requirements that promote lifelong learning, maintain the currency of professional knowledge, and promote patient safety. The rationale for requiring continuing certification is based on the degradation of the fundamental knowledge and skills required for certification over time” (Spence,, 2021).

As an applicant is required to be a registered nurse to be certified, it follows that continual renewal of that license is required for recertification.

Continued employment in the practice of school nursing, school nurse administration, school nurse education, research, consultation, or other engagement in the field of school nursing that contributes to the specialty’s body of knowledge or enhances the quality of school nursing practice continues to expand the school nurse’s knowledge and improve the breadth and quality of services nationally certified school nurses provide.

Courses and professional activities are designed to enhance the school nurse’s current knowledge and skills and to provide new knowledge and skills to help the school nurse provide the most appropriate, safe, and up-to-date care to the school community.

Recertification can be obtained by taking the current NBCSN Exam in lieu of the 75 continuing education hours. Since the exam JTA is done to determine current practice, and the exam is developed from the JTA, passing the exam shows that the candidate is current in the knowledge, skills and abilities required of a NCSN.

Spence, D., Wicks, T., Wojnakowski, M. and Plaus, K. (2021). Benchmarking study on continuing certification in healthcare and allied health fields: program variables, commonalities, and trends. Journal for Nursing Regulation, 12(2), 34-40.

Please watch this video tutorial on how to complete the NCSN-E and NCNS application.

Process for Recertification

Certified school nurses are notified one (1) year in advance of the expiration of their certification. Candidates for recertification must meet current eligibility requirements and submit appropriate documentation to demonstrate that criteria are met.
These include:

  • A copy of the applicant’s current RN license.
  • Evidence of at least 75 hours of continuing education or approved professional activity credits related to school nursing practice.
  • Employment in school health or related services,
  • a minimum of 2,000 hours of clinical practice in the area of school nursing during the past five (5) years, at least 750 of which must be in the prior three years, defined further below, OR
  • take and pass the current NCSN examination.
  • Payment of required fees.

It is the responsibility of the candidate to maintain active/current address and contact information with the NBCSN. Deadlines missed due to forwarded and lost mail are the responsibility of the candidate and may incur late fees or forfeited recertification status

Requests received within 90 days after the candidate’s recertification date will incur a late fee of $100, which must be paid in addition to the application fee. There are no refunds of fees. No request for an extension will be granted beyond 90 days after the recertification date. After the 90 days, the NCSN credential will be revoked and a candidate may only be reinstated by taking and passing the Certification Examination for School Nurses.

Clinical Practice Requirements for Recertification

Clinical Practice in school nursing means employed or contracted to provide a direct or indirect professional contribution to the health and education of students and their families in public or private school settings.

Direct clinical practice in school nursing is defined as involvement in the nursing process in a school setting where the nursing actions and judgments are focused on a particular student, family, school community, or group of students of their families where there is continuing professional responsibility and accountability for the outcomes of these actions.
Indirect clinical practice in school nursing is defined as involvement that:

  1. includes clinical supervision of school nurses, education and clinical supervision of baccalaureate/master’s nursing students in school health, administration of school health services, research, consultation or other engagement in the field of school nursing that contributes to the specialty’s body of knowledge or enhances the quality of school nursing practice; and
  2. entails continuing professional responsibility and accountability for the outcomes of the involvement.

Not eligible as clinical practice in school nursing includes:

  1. one-to-one nursing as the nurse’s sole responsibility within a school;
  2. employment in the direct sales, marketing or distribution of school nursing-related products or services in pharmaceutical, technology or other school health-related industries;
  3. community health screenings;
  4. work in a camp setting; and
  5. jobs unrelated to school nursing.

Recertification Application

To apply for recertification by continuing education, 75 hours of continuing education or approved professional activity credits related to school nursing practice must be documented. These activities must be related to the practice of school nursing, sponsored by an approved national or state accrediting agency, and must have been completed during the five years prior to the expiration date on the candidate’s certification. Additionally, beginning January 1, 2020, each CE program must be worth a minimum of 1 credit hour. 

While not required, NBCSN strongly encourages NCSNs include a variety of topics throughout the exam domains when submitting hours of continuing education.

Continuing education (in school nursing) is defined as programs beyond basic nursing preparation that are designed to promote and enrich knowledge, improve skills, and develop attitudes for the enhancement of (school) nursing practice.

Continuing nursing education activities are assessed, planned, implemented, and evaluated in accordance with adult learning principles and professional education standards and ethics. The educational design process includes procedures for protecting educational content from bias, providing learners appropriate information and documentation related to their participation, and maintaining records in a secure and confidential manner. (ANCC)

To count towards recertification renewal, a program must have been approved by one of the credentialing agencies (accredited providers) approved by the NBCSN. They must have met national or state predetermined criteria to approve programs and provide continuing education (CE). The Board recognizes the following credentialing agencies:

  • Nursing specialty organizations listed below, or those accredited by the American Nurses Credentialing Center (ANCC), as
    • American Academy of Nurse Practitioners
    • American Association of Critical Care Nurses
    • American Association of Nurse Anesthetists
    • American College of Nurse Midwives
    • Emergency Nurses Association
    • National Association of School Nurses
    • National Association of Pediatric Nurse Associates and Practitioners
  • Continuing Medical Education credentialing agencies
  • Colleges and Universities accredited by state, regional and federal (as US Dept. of Education) accrediting boards
  • State boards of nursing
  • State departments of health and education whose programs have met the criteria for continuing education through accredited providers
  • National accrediting agencies for licensed professional counselors and social workers
  • Authoritative federal entities, e.g., CDC, FDA

All certificates of attendance must include the name of the approved accreditation or certification body. Organizations such as hospitals, state nursing associations etc., may work with approved/accredited providers to provide continuing education programs and should note the collaboration and the provider/accreditation name on certificates.

Documentation of Approved Credits

  • Continuing Education Credits
    • All contact hours must be in subjects related to school health practice and be approved by a national accrediting agency (as described above), state department of health or education, accredited universities or colleges, etc. These may include workshops, seminars, professional development offerings, and state/national conferences. Online courses, teleconferences, and “webinars” are acceptable, provided they are approved by a national or state accrediting agency.
    • Single–offering courses, seminars, workshops or conferences listed as twenty (20) hours or greater must be accompanied by a course outline or content agenda attached to the recertification application.
    • For conferences with multiple concurrent sessions, each session attended must be identified individually on the certificate or agenda.
    • Self-paced or online CE programs are acceptable for credit if approved by one of the credentialing organizations recognized by the NBCSN.
    • Courses which are considered basic nursing preparation or staff development are not accepted. Activities NOT ACCEPTABLE for continuing education credit include:
      • Basic CPR, first aid, blood-borne pathogens training and other state certification and screening courses, as vision, hearing, Acanthosis Nigricans, spinal assessment, etc.
        • PALS, ATLS, ACLS will be accepted for credit only one time during the five-year recertification period.
      • Basic computer technology courses, such as Windows, Word, Excel and PowerPoint, including computer training for district specific record keeping.
      • In-service programs that provide specific information about the work setting’s philosophy and procedures, including orientation to a work setting, department and district staff development courses, workshops and committee meetings—unless pre-approved
        by an accredited provider as described above.
      • On-the-job training and equipment demonstration.
      • Refresher courses designed to update knowledge.
      • Courses that focus on self-improvement, changes in attitude, self-therapy, self-awareness.
      • Personal weight loss, yoga or personal appearance, etc.
      • Economic courses for financial gain, as investments, retirement, preparing resumes and techniques for job interviews.
      • Liberal art course in music, art, philosophy, etc, when unrelated to patient/client/student care.
      • Courses for lay people.
  • Academic Credits
    • Academic courses must be taken within the framework of a curriculum that leads to an academic degree in nursing or any academic course relevant to nursing practice. An academic course taken for credit may be used to meet NBCSN requirements if a grade of “C” or better or “pass” on a pass/fail system is achieved.
    • Academic courses related to earning an MSN (or an NBCSN approved MEd in School Nursing or School Health) DNP, or PhD in Nursing are eligible for academic credit.
    • Each individual academic credit, from an accredited institution of higher learning will be considered as ten (10) contact hours for quarter courses, or fifteen (15) contact hours for semester courses.
    • A transcript of successful completion of each course must be submitted with recertification documentation.
    • Online academic courses from accredited institutions will be accepted.
    • Prerequisite courses, such as mathematics, government, anatomy, physiology, languages, literature, etc. cannot be accepted to meet any part of the continuing education requirements for a registered nurse.
  • Miscellaneous activities

Applicants and candidates may be requested to demonstrate how the course content promotes expertise in school health or is relevant to the school nursing practice of the certificant. Individuals may be requested to provide additional information or documentation before credit will be granted.

Click here for NBCSN Pre-Approved Online Professional Development

Other Professional Activities for Credit:

Professional activities such as precepting student, presenting CE programs, writing professional nursing articles and being a member of NASN all promote and enhance the professional expertise of the NCSN. The NBCSN recognizes and supports endeavors that promote and enhance the role of the certified school nurse and grants credits for certain professional activities.

The “Credits Earned by Activity Type for NCSN Recertification” table will help you identify specific items, criteria, and credits granted for these professional qualifying activities.

Documentation of all certificates must be maintained by the candidate and submitted with the recertification application. Each certificate must include the date, program title, approved provider number as applicable, name of the accredited provider (NO acronyms will be accepted), and the number of CE hours awarded.

Click here to add/track CE activities

Summary of Recertification Procedure

Complete Application for Recertification by Continuing Education

  • Copy of current RN License.
  • Documentation of a minimum of 2,000 hours of clinical practice in the area of school nursing during the past five years, at least 750 of which must be in the prior three years. (A letter from a supervisor/school district on letterhead.)
  • Copies of all certificates, with required information listed on each certificate.
  • Documentation related to Miscellaneous Activities, if applicable.
  • Required fees (made payable to NBCSN $255.00). Fees are non-refundable.

Complete the online application

Recertification by Continuing Education may be denied for any of the following reasons:

  1. Failure to meet the criteria of 75 hours of continuing education or acceptable credits
  2. Falsification or misrepresentation of continuing education information or any information required to meet eligibility criteria
  3. Failure to apply before the NCSN anniversary date
  4. Failure to provide continuing education or miscellaneous credit information by the deadline specified, when proper documentation or additional information is requested
  5. Failure to submit the recertification fee payment, with late fees if required
  6. Failure to meet the clinical practice requirement

Here is a checklist that you will find helpful. (Click to download.)

If recertification is denied, the recertification application fee will NOT be refunded.

Denial/Revocation of NCSN Credential

See the “Denial/Revocation” Section on our Policies page.

Extensions and Late Fees

Up to 90 days after the recertification date, a $100 late fee will be assessed for processing recertification applications. Unless a request for extension has been submitted to the NBCSN office prior to the end of the 90 days, the certification will be revoked and may only be reinstated by taking and passing the Certification Examination for School Nurses.

NCSN’s applying for an extension due to extenuating circumstances that make it impossible to file the recertification application by the certification anniversary date, a request to the NBCSN Recertification Chair(s) may be made in writing for an extension. If the extension is denied, the applicant can appeal the decision to the NBCSN Appeals Committee who shall review the request and make a decision. The decision of the Appeals Committee shall be final.

NCSNs who many have an extenuating circumstance (such as serving on active military duty, illness, etc.) may extend the recertification period for up to an additional twelve (12) months past the recertification date, or in the case of active military duty, the end of active duty, without incurring late fees or penalties, provided that:

  1. documentation of extenuating circumstance or lists dates of active duty and dates of return to school health employment; and
  2. continuing education units are earned within a period of six (6) years since the date of the original examination or the last recertification date,
  3. A letter of request for extension describing the situation should be addressed to the NBCSN Recertification Chair(s).


See our “Appeals” section, on the Policies page.