Nursing

AN ACT Relating to the regulation of nursing; amending RCW 1
18.79.020, 18.79.020, 18.79.030, 18.79.030, 18.79.160, 18.79.160, 2
18.79.180, 18.79.180, 18.79.240, 18.79.240, 18.79.250, and 18.79.250; 3
providing an effective date; and providing an expiration date.4
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:5
Sec. 1. RCW 18.79.020 and 2023 c 123 s 17 are each amended to 6
read as follows: 7
Unless a different meaning is plainly required by the context, 8
the definitions set forth in this section apply throughout this 9
chapter. 10
(1) "Board" means the Washington state board of nursing.11
(2) "Department" means the department of health.12
(3) "Secretary" means the secretary of health or the secretary's 13
designee. 14
(4) "Diagnosis," in the context of nursing practice, means the 15
identification of, and discrimination between, the person's physical 16
and psychosocial signs and symptoms that are essential to effective 17
execution and management of the nursing care regimen.18
(5) "Diploma" means written official verification of completion 19
of an approved nursing education program. 20
H-2623.3
HOUSE BILL 2339
State of Washington 69th Legislature 2026 Regular Session
By Representatives Simmons and Macri
Prefiled 01/08/26. Read first time 01/12/26. Referred to Committee
on Health Care & Wellness.
p. 1 HB 2339
(6) "Nurse" or "nursing," unless otherwise specified as a 1
practical nurse or practical nursing, means a registered nurse or 2
registered nursing. 3
(7) "Advanced registered nurse practitioner" means a person who 4
is licensed to practice advanced registered nursing under this 5
chapter.6
(8) "Certified nurse practitioner" means an advanced registered 7
nurse practitioner who has obtained specialty certification in the 8
nurse practitioner designation through a board-approved certifying 9
body.10
(9) "Certified nurse midwife" means an advanced registered nurse 11
practitioner who has obtained specialty certification in the 12
certified nurse midwife designation through a board-approved 13
certifying body.14
(10) "Certified registered nurse anesthetist" means an advanced 15
registered nurse practitioner who has obtained specialty 16
certification in the certified registered nurse anesthetist 17
designation through a board-approved certifying body.18
(11) "Clinical nurse specialist" means an advanced registered 19
nurse practitioner who has obtained specialty certification in the 20
clinical nurse specialist designation through a board-approved 21
certifying body.22
Sec. 2. RCW 18.79.020 and 2023 c 123 s 17 are each amended to 23
read as follows: 24
Unless a different meaning is plainly required by the context, 25
the definitions set forth in this section apply throughout this 26
chapter. 27
(1) "Board" means the Washington state board of nursing.28
(2) "Department" means the department of health.29
(3) "Secretary" means the secretary of health or the secretary's 30
designee. 31
(4) "Diagnosis," in the context of nursing practice, means the 32
identification of, and discrimination between, the person's physical 33
and psychosocial signs and symptoms that are essential to effective 34
execution and management of the nursing care regimen.35
(5) "Diploma" means written official verification of completion 36
of an approved nursing education program. 37
p. 2 HB 2339
(6) "Nurse" or "nursing," unless otherwise specified as a 1
practical nurse or practical nursing, means a registered nurse or 2
registered nursing. 3
(7) "Advanced practice registered nurse" means a person who is 4
licensed to practice advanced practice registered nursing under this 5
chapter.6
(8) "Certified nurse practitioner" means an advanced practice 7
registered nurse who has obtained specialty certification in the 8
nurse practitioner designation through a board-approved certifying 9
body.10
(9) "Certified nurse midwife" means an advanced practice 11
registered nurse who has obtained specialty certification in the 12
certified nurse midwife designation through a board-approved 13
certifying body.14
(10) "Certified registered nurse anesthetist" means an advanced 15
practice registered nurse who has obtained specialty certification in 16
the certified registered nurse anesthetist designation through a 17
board-approved certifying body.18
(11) "Clinical nurse specialist" means an advanced practice 19
registered nurse who has obtained specialty certification in the 20
clinical nurse specialist designation through a board-approved 21
certifying body.22
Sec. 3. RCW 18.79.030 and 2023 c 123 s 19 are each amended to 23
read as follows: 24
(1) It is unlawful for a person to practice or to offer to 25
practice as a registered nurse in this state unless that person has 26
been licensed under this chapter or holds a valid multistate license 27
under chapter 18.80 RCW. A person who holds a license to practice as 28
a registered nurse in this state may use the titles "registered 29
nurse" and "nurse" and the abbreviation "R.N." No other person may 30
assume those titles or use the abbreviation or any other words, 31
letters, signs, or figures to indicate that the person using them is 32
a registered nurse. 33
(2)(a) It is unlawful for a person to practice or to offer to 34
practice as an advanced registered nurse practitioner ((or as a nurse 35
practitioner)) in this state unless that person has been licensed 36
under this chapter. 37
(b) A person who holds a license to practice as an advanced 38
registered nurse practitioner in this state may use the title ((s)) 39
p. 3 HB 2339
"advanced registered nurse practitioner ((,))" (("nurse practitioner," 1
and "nurse")) and the abbreviation((s)) "A.R.N.P." ((and "N.P."))2
(c) A person licensed to practice advanced practice registered 3
nursing in the state as:4
(i) A certified nurse practitioner may use the title "certified 5
nurse practitioner" and the abbreviation "C.N.P.";6
(ii) A certified nurse midwife may use the title "certified nurse 7
midwife" and the abbreviation "C.N.M.";8
(iii) A certified registered nurse anesthetist may use the title 9
"certified registered nurse anesthetist" and the abbreviation 10
"C.R.N.A."; or11
(iv) A certified clinical nurse specialist may use the title 12
"clinical nurse specialist" and the abbreviation "C.N.S."13
(d) No other person may assume those titles or use those 14
abbreviations or any other words, letters, signs, or figures to 15
indicate that the person using them is an advanced registered nurse 16
practitioner ((or nurse practitioner)). 17
(3) It is unlawful for a person to practice or to offer to 18
practice as a licensed practical nurse in this state unless that 19
person has been licensed under this chapter or holds a valid 20
multistate license under chapter 18.80 RCW. A person who holds a 21
license to practice as a licensed practical nurse in this state may 22
use the titles "licensed practical nurse" and "nurse" and the 23
abbreviation "L.P.N." No other person may assume those titles or use 24
that abbreviation or any other words, letters, signs, or figures to 25
indicate that the person using them is a licensed practical nurse.26
(4) Nothing in this section shall prohibit a person listed as a 27
Christian Science nurse in the Christian Science Journal published by 28
the Christian Science Publishing Society, Boston, Massachusetts, from 29
using the title "Christian Science nurse," so long as such person 30
does not hold himself or herself out as a registered nurse, advanced 31
registered nurse practitioner, ((nurse practitioner)) certified nurse 32
practitioner, certified nurse midwife, certified registered nurse 33
anesthetist, certified clinical nurse specialist , or licensed 34
practical nurse, unless otherwise authorized by law to do so.35
Sec. 4. RCW 18.79.030 and 2024 c 239 s 1 are each amended to 36
read as follows: 37
(1) It is unlawful for a person to practice or to offer to 38
practice as a registered nurse in this state unless that person has 39
p. 4 HB 2339
been licensed under this chapter or holds a valid multistate license 1
under chapter 18.80 RCW. A person who holds a license to practice as 2
a registered nurse in this state may use the titles "registered 3
nurse" and "nurse" and the abbreviation "R.N." No other person may 4
assume those titles or use the abbreviation or any other words, 5
letters, signs, or figures to indicate that the person using them is 6
a registered nurse. 7
(2)(a) It is unlawful for a person to practice or to offer to 8
practice as an advanced practice registered nurse or as a nurse 9
practitioner in this state unless that person has been licensed under 10
this chapter. 11
(b) A person who holds a license to practice as an advanced 12
practice registered nurse in this state may use the title ((s)) 13
"advanced practice registered nurse ((,))" (("nurse practitioner," and 14
"nurse")) and the abbreviation((s)) "A.P.R.N." ((and "N.P."))15
(c) A person licensed to practice advanced practice registered 16
nursing in the state as:17
(i) A certified nurse practitioner may use the title "certified 18
nurse practitioner" and the abbreviation "C.N.P.";19
(ii) A certified nurse midwife may use the title "certified nurse 20
midwife" and the abbreviation "C.N.M.";21
(iii) A certified registered nurse anesthetist may use the title 22
"certified registered nurse anesthetist" and the abbreviation 23
"C.R.N.A."; or24
(iv) A certified clinical nurse specialist may use the title 25
"clinical nurse specialist" and the abbreviation "C.N.S."26
(d) No other person may assume those titles or use those 27
abbreviations or any other words, letters, signs, or figures to 28
indicate that the person using them is an advanced practice 29
registered nurse ((or nurse practitioner)). 30
(3) It is unlawful for a person to practice or to offer to 31
practice as a licensed practical nurse in this state unless that 32
person has been licensed under this chapter or holds a valid 33
multistate license under chapter 18.80 RCW. A person who holds a 34
license to practice as a licensed practical nurse in this state may 35
use the titles "licensed practical nurse" and "nurse" and the 36
abbreviation "L.P.N." No other person may assume those titles or use 37
that abbreviation or any other words, letters, signs, or figures to 38
indicate that the person using them is a licensed practical nurse.39
p. 5 HB 2339
(4) Nothing in this section shall prohibit a person listed as a 1
Christian Science nurse in the Christian Science Journal published by 2
the Christian Science Publishing Society, Boston, Massachusetts, from 3
using the title "Christian Science nurse," so long as such person 4
does not hold himself or herself out as a registered nurse, advanced 5
practice registered nurse, ((nurse practitioner )) certified nurse 6
practitioner, certified nurse midwife, certified registered nurse 7
anesthetist, certified clinical nurse specialist , or licensed 8
practical nurse, unless otherwise authorized by law to do so.9
Sec. 5. RCW 18.79.160 and 2025 c 58 s 5012 are each amended to 10
read as follows: 11
(1) An applicant for a license to practice as a registered nurse , 12
advanced registered nurse practitioner, or licensed practical nurse 13
shall submit to the board: 14
(a) An attested written application on a department form; and15
(b) ((An official transcript demonstrating graduation and 16
successful completion of an approved program of nursing; and17
(c))) Any other official records specified by the board.18
(2) ((An applicant for a license to practice as an advanced 19
registered nurse practitioner shall submit to the board:20
(a) An attested written application on a department form;21
(b) An official transcript demonstrating graduation and 22
successful completion of an advanced registered nurse practitioner 23
program meeting criteria established by the board; and24
(c) Any other official records specified by the board.25
(3))) An applicant for a license to practice as a licensed 26
practical nurse shall also submit to the board((:27
(a) An attested written application on a department form;28
(b) Written official evidence that the applicant is over the age 29
of eighteen;30
(c) An official transcript demonstrating graduation and 31
successful completion of an approved practical nursing program, or 32
its equivalent; and33
(d) Any other official records specified by the board )) written 34
official evidence that the applicant is over the age of 18.35
(((4))) (3) At the time of submission of the application, the 36
applicant for a license to practice as a registered nurse, advanced 37
registered nurse practitioner, or licensed practical nurse must not 38
be in violation of chapter 18.130 RCW or this chapter.39
p. 6 HB 2339
(((5))) (4) The board shall establish by rule the criteria for 1
evaluating the education of all applicants. 2
Sec. 6. RCW 18.79.160 and 2024 c 239 s 7 are each amended to 3
read as follows: 4
(1) An applicant for a license to practice as a registered nurse , 5
advanced practice registered nurse, or licensed practical nurse shall 6
submit to the board: 7
(a) An attested written application on a department form; and8
(b) ((An official transcript demonstrating graduation and 9
successful completion of an approved program of nursing; and10
(c))) Any other official records specified by the board.11
(2) ((An applicant for a license to practice as an advanced 12
practice registered nurse shall submit to the board:13
(a) An attested written application on a department form;14
(b) An official transcript demonstrating graduation and 15
successful completion of an advanced practice registered nurse 16
program meeting criteria established by the board; and17
(c) Any other official records specified by the board.18
(3))) An applicant for a license to practice as a licensed 19
practical nurse shall also submit to the board((:20
(a) An attested written application on a department form;21
(b) Written official evidence that the applicant is over the age 22
of eighteen;23
(c) An official transcript demonstrating graduation and 24
successful completion of an approved practical nursing program, or 25
its equivalent; and26
(d) Any other official records specified by the board )) written 27
official evidence that the applicant is over the age of 18.28
(((4))) (3) At the time of submission of the application, the 29
applicant for a license to practice as a registered nurse, advanced 30
practice registered nurse, or licensed practical nurse must not be in 31
violation of chapter 18.130 RCW or this chapter. 32
(((5))) (4) The board shall establish by rule the criteria for 33
evaluating the education of all applicants. 34
Sec. 7. RCW 18.79.180 and 2025 c 58 s 5014 are each amended to 35
read as follows: 36
((When authorized by the board, the department shall )) The board 37
may issue an interim permit authorizing the applicant to practice 38
p. 7 HB 2339
registered nursing, advanced registered nursing, or licensed 1
practical nursing, as appropriate, from the time of verification of 2
the completion of the school or training program until notification 3
of the results of the examination. Upon the applicant passing the 4
examination, and if all other requirements established by the board 5
for licensing are met, the department shall issue the applicant a 6
license to practice registered nursing, advanced registered nursing, 7
or licensed practical nursing, as appropriate. If the applicant fails 8
the examination, the interim permit expires upon notification to the 9
applicant, and is not renewable. The holder of an interim permit is 10
subject to chapter 18.130 RCW. 11
Sec. 8. RCW 18.79.180 and 2024 c 239 s 9 are each amended to 12
read as follows: 13
((When authorized by the board, the department shall )) The board 14
may issue an interim permit authorizing the applicant to practice 15
registered nursing, advanced practice registered nursing, or licensed 16
practical nursing, as appropriate, from the time of verification of 17
the completion of the school or training program until notification 18
of the results of the examination. Upon the applicant passing the 19
examination, and if all other requirements established by the board 20
for licensing are met, the department shall issue the applicant a 21
license to practice registered nursing, advanced practice registered 22
nursing, or licensed practical nursing, as appropriate. If the 23
applicant fails the examination, the interim permit expires upon 24
notification to the applicant, and is not renewable. The holder of an 25
interim permit is subject to chapter 18.130 RCW. 26
Sec. 9. RCW 18.79.240 and 2025 c 58 s 5017 are each amended to 27
read as follows: 28
(1) In the context of the definition of registered nursing 29
practice and advanced registered nursing practice, this chapter shall 30
not be construed as: 31
(a) Prohibiting the incidental care of the sick by domestic 32
servants or persons primarily employed as housekeepers, so long as 33
they do not practice registered nursing within the meaning of this 34
chapter; 35
(b) Preventing a person from the domestic administration of 36
family remedies or the furnishing of nursing assistance in case of 37
emergency; 38
p. 8 HB 2339
(c) Prohibiting the practice of nursing by students enrolled in 1
approved schools as may be incidental to their course of study or 2
prohibiting the students from working as nursing technicians;3
(d) Prohibiting auxiliary services provided by persons carrying 4
out duties necessary for the support of nursing services, including 5
those duties that involve minor nursing services for persons 6
performed in hospitals, nursing homes, or elsewhere under the 7
direction of licensed physicians or the supervision of licensed 8
registered nurses; 9
(e) Prohibiting the practice of nursing in this state by a 10
legally qualified nurse of another state or territory whose 11
engagement requires him or her to accompany and care for a patient 12
temporarily residing in this state during the period of one such 13
engagement, not to exceed six months in length, if the person does 14
not represent or hold himself or herself out as a registered nurse 15
licensed to practice in this state; 16
(f) Prohibiting nursing or care of the sick, with or without 17
compensation, when done in connection with the practice of the 18
religious tenets of a church by adherents of the church so long as 19
they do not engage in the practice of nursing as defined in this 20
chapter; 21
(g) Prohibiting the practice of a legally qualified nurse of 22
another state who is employed by the United States government or a 23
bureau, division, or agency thereof, while in the discharge of his or 24
her official duties; 25
(h) Permitting the measurement of the powers or range of human 26
vision, or the determination of the accommodation and refractive 27
state of the human eye or the scope of its functions in general, or 28
the fitting or adaptation of lenses for the aid thereof;29
(i) Permitting the prescribing or directing the use of, or using, 30
an optical device in connection with ocular exercises, visual 31
training, vision training, or orthoptics; 32
(j) Permitting the prescribing of contact lenses for, or the 33
fitting and adaptation of contact lenses to, the human eye;34
(k) Prohibiting the performance of routine visual screening;35
(l) Permitting the practice of dentistry or dental hygiene as 36
defined in chapters 18.32 and 18.29 RCW, respectively;37
(m) Permitting the practice of chiropractic as defined in chapter 38
18.25 RCW including the adjustment or manipulation of the 39
articulation of the spine; 40
p. 9 HB 2339
(n) Permitting the practice of podiatric medicine and surgery as 1
defined in chapter 18.22 RCW; 2
(o) Permitting the performance of major surgery, except such 3
minor surgery as the board may have specifically authorized by rule 4
adopted in accordance with chapter 34.05 RCW; 5
(p) Permitting the prescribing of controlled substances as 6
defined in Schedule I of the Uniform Controlled Substances Act, 7
chapter 69.50 RCW; 8
(q) Prohibiting the determination and pronouncement of death;9
(r) Prohibiting advanced registered nurse practitioners, approved 10
by the board as certified registered nurse anesthetists and who have 11
not obtained prescriptive authority prior to July 1, 2026, from 12
selecting, ordering, or administering controlled substances as 13
defined in Schedules II through IV of the Uniform Controlled 14
Substances Act, chapter 69.50 RCW, consistent with their board-15
recognized scope of practice; subject to facility-specific protocols, 16
and subject to a request for certified registered nurse anesthetist 17
anesthesia services issued by a physician licensed under chapter 18
18.71 RCW, an osteopathic physician and surgeon licensed under 19
chapter 18.57 RCW, a dentist licensed under chapter 18.32 RCW, or a 20
podiatric physician and surgeon licensed under chapter 18.22 RCW; the 21
authority to select, order, or administer Schedule II through IV 22
controlled substances being limited to those drugs that are to be 23
directly administered to patients who require anesthesia for 24
diagnostic, operative, obstetrical, or therapeutic procedures in a 25
hospital, clinic, ambulatory surgical facility, or the office of a 26
practitioner licensed under chapter 18.71, 18.22, 18.36, 18.36A, 27
18.57, or 18.32 RCW; "select" meaning the decision-making process of 28
choosing a drug, dosage, route, and time of administration; and 29
"order" meaning the process of directing licensed individuals 30
pursuant to their statutory authority to directly administer a drug 31
or to dispense, deliver, or distribute a drug for the purpose of 32
direct administration to a patient, under instructions of the 33
certified registered nurse anesthetist. "Protocol" means a statement 34
regarding practice and documentation concerning such items as 35
categories of patients, categories of medications, or categories of 36
procedures rather than detailed case-specific formulas for the 37
practice of nurse anesthesia; 38
(s) Prohibiting advanced registered nurse practitioners from 39
ordering or prescribing controlled substances as defined in Schedules 40
p. 10 HB 2339
II through IV of the Uniform Controlled Substances Act, chapter 69.50 1
RCW, if and to the extent that doing so is permitted by their scope 2
of practice; 3
(t) Prohibiting the practice of registered nursing or advanced 4
registered nursing by a student enrolled in an approved school if:5
(i) The student performs services without compensation or 6
expectation of compensation as part of a volunteer activity;7
(ii) The student is under the direct supervision of a registered 8
nurse or advanced registered nurse practitioner licensed under this 9
chapter, a pharmacist licensed under chapter 18.64 RCW, an 10
osteopathic physician and surgeon licensed under chapter 18.57 RCW, 11
or a physician licensed under chapter 18.71 RCW; 12
(iii) The services the student performs are within the scope of 13
practice of: (A) The nursing profession for which the student is 14
receiving training; and (B) the person supervising the student;15
(iv) The school in which the student is enrolled verifies the 16
student has demonstrated competency through his or her education and 17
training to perform the services; and 18
(v) The student provides proof of current malpractice insurance 19
to the volunteer activity organizer prior to performing any services.20
(2) In the context of the definition of licensed practical 21
nursing practice, this chapter shall not be construed as:22
(a) Prohibiting the incidental care of the sick by domestic 23
servants or persons primarily employed as housekeepers, so long as 24
they do not practice practical nursing within the meaning of this 25
chapter; 26
(b) Preventing a person from the domestic administration of 27
family remedies or the furnishing of nursing assistance in case of 28
emergency; 29
(c) Prohibiting the practice of practical nursing by students 30
enrolled in approved schools as may be incidental to their course of 31
study or prohibiting the students from working as nursing assistants;32
(d) Prohibiting auxiliary services provided by persons carrying 33
out duties necessary for the support of nursing services, including 34
those duties that involve minor nursing services for persons 35
performed in hospitals, nursing homes, or elsewhere under the 36
direction of licensed physicians or the supervision of licensed 37
registered nurses; 38
(e) Prohibiting or preventing the practice of nursing in this 39
state by a legally qualified nurse of another state or territory 40
p. 11 HB 2339
whose engagement requires him or her to accompany and care for a 1
patient temporarily residing in this state during the period of one 2
such engagement, not to exceed six months in length, if the person 3
does not represent or hold himself or herself out as a licensed 4
practical nurse licensed to practice in this state;5
(f) Prohibiting nursing or care of the sick, with or without 6
compensation, when done in connection with the practice of the 7
religious tenets of a church by adherents of the church so long as 8
they do not engage in licensed practical nurse practice as defined in 9
this chapter; 10
(g) Prohibiting the practice of a legally qualified nurse of 11
another state who is employed by the United States government or any 12
bureau, division, or agency thereof, while in the discharge of his or 13
her official duties. 14
Sec. 10. RCW 18.79.240 and 2024 c 239 s 12 are each amended to 15
read as follows: 16
(1) In the context of the definition of registered nursing 17
practice and advanced practice registered nursing, this chapter shall 18
not be construed as: 19
(a) Prohibiting the incidental care of the sick by domestic 20
servants or persons primarily employed as housekeepers, so long as 21
they do not practice registered nursing within the meaning of this 22
chapter; 23
(b) Preventing a person from the domestic administration of 24
family remedies or the furnishing of nursing assistance in case of 25
emergency; 26
(c) Prohibiting the practice of nursing by students enrolled in 27
approved schools as may be incidental to their course of study or 28
prohibiting the students from working as nursing technicians;29
(d) Prohibiting auxiliary services provided by persons carrying 30
out duties necessary for the support of nursing services, including 31
those duties that involve minor nursing services for persons 32
performed in hospitals, nursing homes, or elsewhere under the 33
direction of licensed physicians or the supervision of licensed 34
registered nurses; 35
(e) Prohibiting the practice of nursing in this state by a 36
legally qualified nurse of another state or territory whose 37
engagement requires him or her to accompany and care for a patient 38
temporarily residing in this state during the period of one such 39
p. 12 HB 2339
engagement, not to exceed six months in length, if the person does 1
not represent or hold himself or herself out as a registered nurse 2
licensed to practice in this state; 3
(f) Prohibiting nursing or care of the sick, with or without 4
compensation, when done in connection with the practice of the 5
religious tenets of a church by adherents of the church so long as 6
they do not engage in the practice of nursing as defined in this 7
chapter; 8
(g) Prohibiting the practice of a legally qualified nurse of 9
another state who is employed by the United States government or a 10
bureau, division, or agency thereof, while in the discharge of his or 11
her official duties; 12
(h) Permitting the measurement of the powers or range of human 13
vision, or the determination of the accommodation and refractive 14
state of the human eye or the scope of its functions in general, or 15
the fitting or adaptation of lenses for the aid thereof;16
(i) Permitting the prescribing or directing the use of, or using, 17
an optical device in connection with ocular exercises, visual 18
training, vision training, or orthoptics; 19
(j) Permitting the prescribing of contact lenses for, or the 20
fitting and adaptation of contact lenses to, the human eye;21
(k) Prohibiting the performance of routine visual screening;22
(l) Permitting the practice of dentistry or dental hygiene as 23
defined in chapters 18.32 and 18.29 RCW, respectively;24
(m) Permitting the practice of chiropractic as defined in chapter 25
18.25 RCW including the adjustment or manipulation of the 26
articulation of the spine; 27
(n) Permitting the practice of podiatric medicine and surgery as 28
defined in chapter 18.22 RCW; 29
(o) Permitting the performance of major surgery, except such 30
minor surgery as the board may have specifically authorized by rule 31
adopted in accordance with chapter 34.05 RCW; 32
(p) Permitting the prescribing of controlled substances as 33
defined in Schedule I of the Uniform Controlled Substances Act, 34
chapter 69.50 RCW; 35
(q) Prohibiting the determination and pronouncement of death;36
(r) Prohibiting advanced practice registered nurses, approved by 37
the board as certified registered nurse anesthetists and who have not 38
obtained prescriptive authority prior to July 1, 2026, from 39
selecting, ordering, or administering controlled substances as 40
p. 13 HB 2339
defined in Schedules II through IV of the Uniform Controlled 1
Substances Act, chapter 69.50 RCW, consistent with their board-2
recognized scope of practice; subject to facility-specific protocols, 3
and subject to a request for certified registered nurse anesthetist 4
anesthesia services issued by a physician licensed under chapter 5
18.71 RCW, an osteopathic physician and surgeon licensed under 6
chapter 18.57 RCW, a dentist licensed under chapter 18.32 RCW, or a 7
podiatric physician and surgeon licensed under chapter 18.22 RCW; the 8
authority to select, order, or administer Schedule II through IV 9
controlled substances being limited to those drugs that are to be 10
directly administered to patients who require anesthesia for 11
diagnostic, operative, obstetrical, or therapeutic procedures in a 12
hospital, clinic, ambulatory surgical facility, or the office of a 13
practitioner licensed under chapter 18.71, 18.22, 18.36, 18.36A, 14
18.57, or 18.32 RCW; "select" meaning the decision-making process of 15
choosing a drug, dosage, route, and time of administration; and 16
"order" meaning the process of directing licensed individuals 17
pursuant to their statutory authority to directly administer a drug 18
or to dispense, deliver, or distribute a drug for the purpose of 19
direct administration to a patient, under instructions of the 20
certified registered nurse anesthetist. "Protocol" means a statement 21
regarding practice and documentation concerning such items as 22
categories of patients, categories of medications, or categories of 23
procedures rather than detailed case-specific formulas for the 24
practice of nurse anesthesia; 25
(s) Prohibiting advanced practice registered nurses from ordering 26
or prescribing controlled substances as defined in Schedules II 27
through IV of the Uniform Controlled Substances Act, chapter 69.50 28
RCW, if and to the extent that doing so is permitted by their scope 29
of practice; 30
(t) Prohibiting the practice of registered nursing or advanced 31
practice registered nursing by a student enrolled in an approved 32
school if: 33
(i) The student performs services without compensation or 34
expectation of compensation as part of a volunteer activity;35
(ii) The student is under the direct supervision of a registered 36
nurse or advanced practice registered nurse licensed under this 37
chapter, a pharmacist licensed under chapter 18.64 RCW, an 38
osteopathic physician and surgeon licensed under chapter 18.57 RCW, 39
or a physician licensed under chapter 18.71 RCW; 40
p. 14 HB 2339
(iii) The services the student performs are within the scope of 1
practice of: (A) The nursing profession for which the student is 2
receiving training; and (B) the person supervising the student;3
(iv) The school in which the student is enrolled verifies the 4
student has demonstrated competency through his or her education and 5
training to perform the services; and 6
(v) The student provides proof of current malpractice insurance 7
to the volunteer activity organizer prior to performing any services.8
(2) In the context of the definition of licensed practical 9
nursing practice, this chapter shall not be construed as:10
(a) Prohibiting the incidental care of the sick by domestic 11
servants or persons primarily employed as housekeepers, so long as 12
they do not practice practical nursing within the meaning of this 13
chapter; 14
(b) Preventing a person from the domestic administration of 15
family remedies or the furnishing of nursing assistance in case of 16
emergency; 17
(c) Prohibiting the practice of practical nursing by students 18
enrolled in approved schools as may be incidental to their course of 19
study or prohibiting the students from working as nursing assistants;20
(d) Prohibiting auxiliary services provided by persons carrying 21
out duties necessary for the support of nursing services, including 22
those duties that involve minor nursing services for persons 23
performed in hospitals, nursing homes, or elsewhere under the 24
direction of licensed physicians or the supervision of licensed 25
registered nurses; 26
(e) Prohibiting or preventing the practice of nursing in this 27
state by a legally qualified nurse of another state or territory 28
whose engagement requires him or her to accompany and care for a 29
patient temporarily residing in this state during the period of one 30
such engagement, not to exceed six months in length, if the person 31
does not represent or hold himself or herself out as a licensed 32
practical nurse licensed to practice in this state;33
(f) Prohibiting nursing or care of the sick, with or without 34
compensation, when done in connection with the practice of the 35
religious tenets of a church by adherents of the church so long as 36
they do not engage in licensed practical nurse practice as defined in 37
this chapter; 38
(g) Prohibiting the practice of a legally qualified nurse of 39
another state who is employed by the United States government or any 40
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bureau, division, or agency thereof, while in the discharge of his or 1
her official duties. 2
Sec. 11. RCW 18.79.250 and 2025 c 58 s 5018 are each amended to 3
read as follows: 4
An advanced registered nurse practitioner under his or her 5
license may perform for compensation nursing care, as that term is 6
usually understood, of the ill, injured, or infirm, and in the course 7
thereof, she or he may do the following things that shall not be done 8
by a person not so licensed, except as provided in RCW 18.79.260 and 9
18.79.270: 10
(1) Perform specialized and advanced levels of nursing as 11
recognized ((jointly)) by the ((medical and)) nursing ((professions)) 12
profession, as defined by the board; 13
(2) Prescribe legend drugs and Schedule V controlled substances, 14
as defined in the Uniform Controlled Substances Act, chapter 69.50 15
RCW, and Schedules II through IV subject to RCW 18.79.240(1) (r) or 16
(s) within the scope of practice defined by the board;17
(3) Perform all acts provided in RCW 18.79.260;18
(4) Hold herself or himself out to the public or designate 19
herself or himself as an advanced registered nurse practitioner ((or 20
as a nurse practitioner )), certified nurse practitioner, certified 21
nurse midwife, certified registered nurse anesthetist, or certified 22
clinical nurse specialist. 23
Sec. 12. RCW 18.79.250 and 2024 c 239 s 13 are each amended to 24
read as follows: 25
An advanced practice registered nurse under his or her license 26
may perform for compensation nursing care, as that term is usually 27
understood, of the ill, injured, or infirm, and in the course 28
thereof, she or he may do the following things that shall not be done 29
by a person not so licensed, except as provided in RCW 18.79.260 and 30
18.79.270: 31
(1) Perform specialized and advanced levels of nursing as 32
recognized ((jointly)) by the ((medical and)) nursing ((professions)) 33
profession, as defined by the board; 34
(2) Prescribe legend drugs and Schedule V controlled substances, 35
as defined in the Uniform Controlled Substances Act, chapter 69.50 36
RCW, and Schedules II through IV subject to RCW 18.79.240(1) (r) or 37
(s) within the scope of practice defined by the board;38
p. 16 HB 2339
(3) Perform all acts provided in RCW 18.79.260;1
(4) Hold herself or himself out to the public or designate 2
herself or himself as an advanced practice registered nurse ((or as a 3
nurse practitioner )), certified nurse practitioner, certified nurse 4
midwife, certified registered nurse anesthetist, or certified 5
clinical nurse specialist. 6
NEW SECTION. Sec. 13. Sections 2, 4, 6, 8, 10, and 12 of this 7
act take effect June 30, 2027.8
NEW SECTION. Sec. 14. Sections 1, 3, 5, 7, 9, and 11 of this 9
act expire June 30, 2027.10
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