School Nurse Fired After Refusing Assignment: “I’d Rather Lose My Job Than My License”

A Pennsylvania district said it fired an LPN for missing too much work. A new investigation finds the story is more complicated, and the questions it raises reach far beyond one school.

A lengthy, extensively sourced investigation by nurse journalist Jana Price, MBA, BSN, BA, RN, CEN, TCRN, of Nurse on the Record, first published on Nurse.org, finds the case left the biggest legal questions unanswered.

Moriah Benjamin, an LPN at Millville Area School District, was terminated this spring after the district cited persistent absenteeism and neglect of duty. As a probationary employee, a new hire still in her initial trial period under the district’s union contract, Benjamin could be dismissed without recourse and had no paid sick leave, meaning every absence the district counted against her was unpaid. She doesn’t dispute missing work. She disputes what her final absence meant. “I’d rather lose my job than my license,” she testified at the hearing.

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The district’s Certified School Nurse (CSN), the credentialed role Pennsylvania requires for school health services, had a long-scheduled personal day on April 17. Administrators couldn’t find a substitute, leaving Benjamin, an LPN, as the district’s only nurse.

Pennsylvania LPNs cannot practice independently. State regulations require an LPN to work as part of a health-care team and to communicate with a licensed professional nurse for guidance when a patient’s needs exceed the practical nursing scope of practice, surpass the LPN’s own skill, or when a patient’s condition changes. In a school setting, that supervision runs through the Certified School Nurse. The night before, Benjamin texted the district’s Director of Student Services that she couldn’t safely cover both school buildings alone and wouldn’t risk her license. The administrator responded that her license wasn’t at risk and that “other districts operate like this all the time.”

Benjamin logged her absence in the district’s reporting system that night, hours ahead of the call-off deadline. Unable to find coverage, Millville delayed the start of school by two hours. Within weeks, the district moved to terminate her.

• Feb 9: Benjamin is hired as a probationary LPN.
• Feb-Apr: She misses 11 of 55 workdays; the board retroactively approves the absences as unpaid leave.
• Apr 16-17: She declines to cover two buildings without CSN supervision; school opens two hours late.
• Apr 27: The board approves her to work the district’s Extended School Year summer program, per board minutes.
• May 4: The superintendent recommends her termination.
• May 9: The charges are narrowed to persistent absenteeism and neglect of duty.
• May 28: At her request, a public hearing is held; the board votes to terminate her.

Benjamin represented herself at the hearing, unable to afford an attorney beyond a brief consultation. The job she was defending paid roughly $28,000 a year with no benefits. She told the school board she took it anyway because she loved school nursing. “The money was horrible, if I’m being honest,” she testified. “I took pride in what I did.”

According to Price’s review of the hearing transcripts, the central factual dispute was never resolved: whether Benjamin was told a Certified School Nurse would be available to supervise her that day.

The district testified it had arranged backup through neighboring Benton Area School District. But under Benjamin’s questioning, the administrator who made those arrangements acknowledged she did not recall telling Benjamin a CSN would be available, then later told the hearing officer she had. What Benjamin says she actually received was the phone number of another LPN.

The hearing also never examined the state guidance at the heart of Benjamin’s refusal. A 2022 memo from the Pennsylvania Department of Education states that supplemental RNs and LPNs are meant to assist Certified School Nurses, not replace them, and “may not be assigned a student caseload.” The school board voted to uphold the termination without issuing findings on the scope-of-practice question.

Price interviewed Pennsylvania school nurses whose experiences diverged sharply. A former Millville LPN described days she was the only nurse in the district with no CSN reachable by phone, including one day she had to choose between two simultaneous student emergencies in different buildings. A Certified School Nurse who had worked as an RN in another district described the opposite. She often worked alone in her building, but her supervising nurse was always reachable. “There was never a time I felt alone,” she said.

The contrast frames the question Benjamin’s case leaves open for every school nurse working through the shortage: when districts can’t staff to the legal standard, whose responsibility is the gap, and whose license is on the line?

Price says the story began with a short item in Benjamin’s local newspaper reporting that a school nurse’s absence had delayed Millville’s classes. Benjamin then reached out to her directly. What started as “a simple headline in a very small newspaper in Pennsylvania,” Price said on the podcast, became “one of the biggest investigative cases that I have done in my journalism career.”

Part of what drew her in was what the local coverage left out. The paper’s initial story on the April 17 delay carried the superintendent’s account; Benjamin was never contacted. “She was never called, she was never spoken to, she was never asked her side of the story,” Price said. Benjamin later told the paper she felt the first account “was not fairly represented or accurate.”

Price’s investigation, first published on Nurse.org, draws on hundreds of pages of publicly accessible records, including the 95-page hearing transcript, district documents, text messages read into the hearing record, and state guidance, along with interviews with current and former Pennsylvania school nurses. Price is publishing the full hearing transcript alongside her article. The district declined Price’s requests for comment, citing the personnel nature of the matter, and denied her public records requests, which she is appealing.

Nurse.org separately sought comment from Superintendent Joseph Rasmus, members of the Millville Area School Board, the district’s solicitor, and the Pennsylvania Department of Education. None had responded as of publication. This article will be updated if they do.

Read the full investigation and listen to Price’s podcast interview with Benjamin below.

The investigation

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