wa-law.org > bill > 2025-26 > HB 2339 > Original Bill
Unless a different meaning is plainly required by the context, the definitions set forth in this section apply throughout this chapter.
"Board" means the Washington state board of nursing.
"Department" means the department of health.
"Secretary" means the secretary of health or the secretary's designee.
"Diagnosis," in the context of nursing practice, means the identification of, and discrimination between, the person's physical and psychosocial signs and symptoms that are essential to effective execution and management of the nursing care regimen.
"Diploma" means written official verification of completion of an approved nursing education program.
"Nurse" or "nursing," unless otherwise specified as a practical nurse or practical nursing, means a registered nurse or registered nursing.
"Advanced registered nurse practitioner" means a person who is licensed to practice advanced registered nursing under this chapter.
"Certified nurse practitioner" means an advanced registered nurse practitioner who has obtained specialty certification in the nurse practitioner designation through a board-approved certifying body.
"Certified nurse midwife" means an advanced registered nurse practitioner who has obtained specialty certification in the certified nurse midwife designation through a board-approved certifying body.
"Certified registered nurse anesthetist" means an advanced registered nurse practitioner who has obtained specialty certification in the certified registered nurse anesthetist designation through a board-approved certifying body.
"Clinical nurse specialist" means an advanced registered nurse practitioner who has obtained specialty certification in the clinical nurse specialist designation through a board-approved certifying body.
Unless a different meaning is plainly required by the context, the definitions set forth in this section apply throughout this chapter.
"Board" means the Washington state board of nursing.
"Department" means the department of health.
"Secretary" means the secretary of health or the secretary's designee.
"Diagnosis," in the context of nursing practice, means the identification of, and discrimination between, the person's physical and psychosocial signs and symptoms that are essential to effective execution and management of the nursing care regimen.
"Diploma" means written official verification of completion of an approved nursing education program.
"Nurse" or "nursing," unless otherwise specified as a practical nurse or practical nursing, means a registered nurse or registered nursing.
"Advanced practice registered nurse" means a person who is licensed to practice advanced practice registered nursing under this chapter.
"Certified nurse practitioner" means an advanced practice registered nurse who has obtained specialty certification in the nurse practitioner designation through a board-approved certifying body.
"Certified nurse midwife" means an advanced practice registered nurse who has obtained specialty certification in the certified nurse midwife designation through a board-approved certifying body.
"Certified registered nurse anesthetist" means an advanced practice registered nurse who has obtained specialty certification in the certified registered nurse anesthetist designation through a board-approved certifying body.
"Clinical nurse specialist" means an advanced practice registered nurse who has obtained specialty certification in the clinical nurse specialist designation through a board-approved certifying body.
It is unlawful for a person to practice or to offer to practice as a registered nurse in this state unless that person has been licensed under this chapter or holds a valid multistate license under chapter 18.80 RCW. A person who holds a license to practice as a registered nurse in this state may use the titles "registered nurse" and "nurse" and the abbreviation "R.N." No other person may assume those titles or use the abbreviation or any other words, letters, signs, or figures to indicate that the person using them is a registered nurse.
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It is unlawful for a person to practice or to offer to practice as an advanced registered nurse practitioner in this state unless that person has been licensed under this chapter.
A person who holds a license to practice as an advanced registered nurse practitioner in this state may use the title "advanced registered nurse practitioner" and the abbreviation "A.R.N.P."
A person licensed to practice advanced practice registered nursing in the state as:
A certified nurse practitioner may use the title "certified nurse practitioner" and the abbreviation "C.N.P.";
A certified nurse midwife may use the title "certified nurse midwife" and the abbreviation "C.N.M.";
A certified registered nurse anesthetist may use the title "certified registered nurse anesthetist" and the abbreviation "C.R.N.A."; or
A certified clinical nurse specialist may use the title "clinical nurse specialist" and the abbreviation "C.N.S."
No other person may assume those titles or use those abbreviations or any other words, letters, signs, or figures to indicate that the person using them is an advanced registered nurse practitioner .
It is unlawful for a person to practice or to offer to practice as a licensed practical nurse in this state unless that person has been licensed under this chapter or holds a valid multistate license under chapter 18.80 RCW. A person who holds a license to practice as a licensed practical nurse in this state may use the titles "licensed practical nurse" and "nurse" and the abbreviation "L.P.N." No other person may assume those titles or use that abbreviation or any other words, letters, signs, or figures to indicate that the person using them is a licensed practical nurse.
Nothing in this section shall prohibit a person listed as a Christian Science nurse in the Christian Science Journal published by the Christian Science Publishing Society, Boston, Massachusetts, from using the title "Christian Science nurse," so long as such person does not hold himself or herself out as a registered nurse, advanced registered nurse practitioner, certified nurse practitioner, certified nurse midwife, certified registered nurse anesthetist, certified clinical nurse specialist, or licensed practical nurse, unless otherwise authorized by law to do so.
It is unlawful for a person to practice or to offer to practice as a registered nurse in this state unless that person has been licensed under this chapter or holds a valid multistate license under chapter 18.80 RCW. A person who holds a license to practice as a registered nurse in this state may use the titles "registered nurse" and "nurse" and the abbreviation "R.N." No other person may assume those titles or use the abbreviation or any other words, letters, signs, or figures to indicate that the person using them is a registered nurse.
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It is unlawful for a person to practice or to offer to practice as an advanced practice registered nurse or as a nurse practitioner in this state unless that person has been licensed under this chapter.
A person who holds a license to practice as an advanced practice registered nurse in this state may use the title "advanced practice registered nurse" and the abbreviation "A.P.R.N."
A person licensed to practice advanced practice registered nursing in the state as:
A certified nurse practitioner may use the title "certified nurse practitioner" and the abbreviation "C.N.P.";
A certified nurse midwife may use the title "certified nurse midwife" and the abbreviation "C.N.M.";
A certified registered nurse anesthetist may use the title "certified registered nurse anesthetist" and the abbreviation "C.R.N.A."; or
A certified clinical nurse specialist may use the title "clinical nurse specialist" and the abbreviation "C.N.S."
No other person may assume those titles or use those abbreviations or any other words, letters, signs, or figures to indicate that the person using them is an advanced practice registered nurse .
It is unlawful for a person to practice or to offer to practice as a licensed practical nurse in this state unless that person has been licensed under this chapter or holds a valid multistate license under chapter 18.80 RCW. A person who holds a license to practice as a licensed practical nurse in this state may use the titles "licensed practical nurse" and "nurse" and the abbreviation "L.P.N." No other person may assume those titles or use that abbreviation or any other words, letters, signs, or figures to indicate that the person using them is a licensed practical nurse.
Nothing in this section shall prohibit a person listed as a Christian Science nurse in the Christian Science Journal published by the Christian Science Publishing Society, Boston, Massachusetts, from using the title "Christian Science nurse," so long as such person does not hold himself or herself out as a registered nurse, advanced practice registered nurse, certified nurse practitioner, certified nurse midwife, certified registered nurse anesthetist, certified clinical nurse specialist, or licensed practical nurse, unless otherwise authorized by law to do so.
An applicant for a license to practice as a registered nurse, advanced registered nurse practitioner, or licensed practical nurse shall submit to the board:
b.
Any other official records specified by the board.
2.
An applicant for a license to practice as a licensed practical nurse shall also submit to the board
written official evidence that the applicant is over the age of 18.
At the time of submission of the application, the applicant for a license to practice as a registered nurse, advanced registered nurse practitioner, or licensed practical nurse must not be in violation of chapter 18.130 RCW or this chapter.
The board shall establish by rule the criteria for evaluating the education of all applicants.
An applicant for a license to practice as a registered nurse, advanced practice registered nurse, or licensed practical nurse shall submit to the board:
b.
Any other official records specified by the board.
2.
An applicant for a license to practice as a licensed practical nurse shall also submit to the board
written official evidence that the applicant is over the age of 18.
At the time of submission of the application, the applicant for a license to practice as a registered nurse, advanced practice registered nurse, or licensed practical nurse must not be in violation of chapter 18.130 RCW or this chapter.
The board shall establish by rule the criteria for evaluating the education of all applicants.
The board may issue an interim permit authorizing the applicant to practice registered nursing, advanced registered nursing, or licensed practical nursing, as appropriate, from the time of verification of the completion of the school or training program until notification of the results of the examination. Upon the applicant passing the examination, and if all other requirements established by the board for licensing are met, the department shall issue the applicant a license to practice registered nursing, advanced registered nursing, or licensed practical nursing, as appropriate. If the applicant fails the examination, the interim permit expires upon notification to the applicant, and is not renewable. The holder of an interim permit is subject to chapter 18.130 RCW.
The board may issue an interim permit authorizing the applicant to practice registered nursing, advanced practice registered nursing, or licensed practical nursing, as appropriate, from the time of verification of the completion of the school or training program until notification of the results of the examination. Upon the applicant passing the examination, and if all other requirements established by the board for licensing are met, the department shall issue the applicant a license to practice registered nursing, advanced practice registered nursing, or licensed practical nursing, as appropriate. If the applicant fails the examination, the interim permit expires upon notification to the applicant, and is not renewable. The holder of an interim permit is subject to chapter 18.130 RCW.
In the context of the definition of registered nursing practice and advanced registered nursing practice, this chapter shall not be construed as:
Prohibiting the incidental care of the sick by domestic servants or persons primarily employed as housekeepers, so long as they do not practice registered nursing within the meaning of this chapter;
Preventing a person from the domestic administration of family remedies or the furnishing of nursing assistance in case of emergency;
Prohibiting the practice of nursing by students enrolled in approved schools as may be incidental to their course of study or prohibiting the students from working as nursing technicians;
Prohibiting auxiliary services provided by persons carrying out duties necessary for the support of nursing services, including those duties that involve minor nursing services for persons performed in hospitals, nursing homes, or elsewhere under the direction of licensed physicians or the supervision of licensed registered nurses;
Prohibiting the practice of nursing in this state by a legally qualified nurse of another state or territory whose engagement requires him or her to accompany and care for a patient temporarily residing in this state during the period of one such engagement, not to exceed six months in length, if the person does not represent or hold himself or herself out as a registered nurse licensed to practice in this state;
Prohibiting nursing or care of the sick, with or without compensation, when done in connection with the practice of the religious tenets of a church by adherents of the church so long as they do not engage in the practice of nursing as defined in this chapter;
Prohibiting the practice of a legally qualified nurse of another state who is employed by the United States government or a bureau, division, or agency thereof, while in the discharge of his or her official duties;
Permitting the measurement of the powers or range of human vision, or the determination of the accommodation and refractive state of the human eye or the scope of its functions in general, or the fitting or adaptation of lenses for the aid thereof;
Permitting the prescribing of contact lenses for, or the fitting and adaptation of contact lenses to, the human eye;
Prohibiting the performance of routine visual screening;
Permitting the practice of dentistry or dental hygiene as defined in chapters 18.32 and 18.29 RCW, respectively;
Permitting the practice of chiropractic as defined in chapter 18.25 RCW including the adjustment or manipulation of the articulation of the spine;
Permitting the practice of podiatric medicine and surgery as defined in chapter 18.22 RCW;
Permitting the performance of major surgery, except such minor surgery as the board may have specifically authorized by rule adopted in accordance with chapter 34.05 RCW;
Permitting the prescribing of controlled substances as defined in Schedule I of the Uniform Controlled Substances Act, chapter 69.50 RCW;
Prohibiting the determination and pronouncement of death;
Prohibiting advanced registered nurse practitioners, approved by the board as certified registered nurse anesthetists and who have not obtained prescriptive authority prior to July 1, 2026, from selecting, ordering, or administering controlled substances as defined in Schedules II through IV of the Uniform Controlled Substances Act, chapter 69.50 RCW, consistent with their board-recognized scope of practice; subject to facility-specific protocols, and subject to a request for certified registered nurse anesthetist anesthesia services issued by a physician licensed under chapter 18.71 RCW, an osteopathic physician and surgeon licensed under chapter 18.57 RCW, a dentist licensed under chapter 18.32 RCW, or a podiatric physician and surgeon licensed under chapter 18.22 RCW; the authority to select, order, or administer Schedule II through IV controlled substances being limited to those drugs that are to be directly administered to patients who require anesthesia for diagnostic, operative, obstetrical, or therapeutic procedures in a hospital, clinic, ambulatory surgical facility, or the office of a practitioner licensed under chapter 18.71, 18.22, 18.36, 18.36A, 18.57, or 18.32 RCW; "select" meaning the decision-making process of choosing a drug, dosage, route, and time of administration; and "order" meaning the process of directing licensed individuals pursuant to their statutory authority to directly administer a drug or to dispense, deliver, or distribute a drug for the purpose of direct administration to a patient, under instructions of the certified registered nurse anesthetist. "Protocol" means a statement regarding practice and documentation concerning such items as categories of patients, categories of medications, or categories of procedures rather than detailed case-specific formulas for the practice of nurse anesthesia;
Prohibiting advanced registered nurse practitioners from ordering or prescribing controlled substances as defined in Schedules II through IV of the Uniform Controlled Substances Act, chapter 69.50 RCW, if and to the extent that doing so is permitted by their scope of practice;
Prohibiting the practice of registered nursing or advanced registered nursing by a student enrolled in an approved school if:
The student performs services without compensation or expectation of compensation as part of a volunteer activity;
The student is under the direct supervision of a registered nurse or advanced registered nurse practitioner licensed under this chapter, a pharmacist licensed under chapter 18.64 RCW, an osteopathic physician and surgeon licensed under chapter 18.57 RCW, or a physician licensed under chapter 18.71 RCW;
The services the student performs are within the scope of practice of: (A) The nursing profession for which the student is receiving training; and (B) the person supervising the student;
The school in which the student is enrolled verifies the student has demonstrated competency through his or her education and training to perform the services; and
The student provides proof of current malpractice insurance to the volunteer activity organizer prior to performing any services.
In the context of the definition of licensed practical nursing practice, this chapter shall not be construed as:
Prohibiting the incidental care of the sick by domestic servants or persons primarily employed as housekeepers, so long as they do not practice practical nursing within the meaning of this chapter;
Preventing a person from the domestic administration of family remedies or the furnishing of nursing assistance in case of emergency;
Prohibiting the practice of practical nursing by students enrolled in approved schools as may be incidental to their course of study or prohibiting the students from working as nursing assistants;
Prohibiting auxiliary services provided by persons carrying out duties necessary for the support of nursing services, including those duties that involve minor nursing services for persons performed in hospitals, nursing homes, or elsewhere under the direction of licensed physicians or the supervision of licensed registered nurses;
Prohibiting or preventing the practice of nursing in this state by a legally qualified nurse of another state or territory whose engagement requires him or her to accompany and care for a patient temporarily residing in this state during the period of one such engagement, not to exceed six months in length, if the person does not represent or hold himself or herself out as a licensed practical nurse licensed to practice in this state;
Prohibiting nursing or care of the sick, with or without compensation, when done in connection with the practice of the religious tenets of a church by adherents of the church so long as they do not engage in licensed practical nurse practice as defined in this chapter;
Prohibiting the practice of a legally qualified nurse of another state who is employed by the United States government or any bureau, division, or agency thereof, while in the discharge of his or her official duties.
In the context of the definition of registered nursing practice and advanced practice registered nursing, this chapter shall not be construed as:
Prohibiting the incidental care of the sick by domestic servants or persons primarily employed as housekeepers, so long as they do not practice registered nursing within the meaning of this chapter;
Preventing a person from the domestic administration of family remedies or the furnishing of nursing assistance in case of emergency;
Prohibiting the practice of nursing by students enrolled in approved schools as may be incidental to their course of study or prohibiting the students from working as nursing technicians;
Prohibiting auxiliary services provided by persons carrying out duties necessary for the support of nursing services, including those duties that involve minor nursing services for persons performed in hospitals, nursing homes, or elsewhere under the direction of licensed physicians or the supervision of licensed registered nurses;
Prohibiting the practice of nursing in this state by a legally qualified nurse of another state or territory whose engagement requires him or her to accompany and care for a patient temporarily residing in this state during the period of one such engagement, not to exceed six months in length, if the person does not represent or hold himself or herself out as a registered nurse licensed to practice in this state;
Prohibiting nursing or care of the sick, with or without compensation, when done in connection with the practice of the religious tenets of a church by adherents of the church so long as they do not engage in the practice of nursing as defined in this chapter;
Prohibiting the practice of a legally qualified nurse of another state who is employed by the United States government or a bureau, division, or agency thereof, while in the discharge of his or her official duties;
Permitting the measurement of the powers or range of human vision, or the determination of the accommodation and refractive state of the human eye or the scope of its functions in general, or the fitting or adaptation of lenses for the aid thereof;
Permitting the prescribing of contact lenses for, or the fitting and adaptation of contact lenses to, the human eye;
Prohibiting the performance of routine visual screening;
Permitting the practice of dentistry or dental hygiene as defined in chapters 18.32 and 18.29 RCW, respectively;
Permitting the practice of chiropractic as defined in chapter 18.25 RCW including the adjustment or manipulation of the articulation of the spine;
Permitting the practice of podiatric medicine and surgery as defined in chapter 18.22 RCW;
Permitting the performance of major surgery, except such minor surgery as the board may have specifically authorized by rule adopted in accordance with chapter 34.05 RCW;
Permitting the prescribing of controlled substances as defined in Schedule I of the Uniform Controlled Substances Act, chapter 69.50 RCW;
Prohibiting the determination and pronouncement of death;
Prohibiting advanced practice registered nurses, approved by the board as certified registered nurse anesthetists and who have not obtained prescriptive authority prior to July 1, 2026, from selecting, ordering, or administering controlled substances as defined in Schedules II through IV of the Uniform Controlled Substances Act, chapter 69.50 RCW, consistent with their board-recognized scope of practice; subject to facility-specific protocols, and subject to a request for certified registered nurse anesthetist anesthesia services issued by a physician licensed under chapter 18.71 RCW, an osteopathic physician and surgeon licensed under chapter 18.57 RCW, a dentist licensed under chapter 18.32 RCW, or a podiatric physician and surgeon licensed under chapter 18.22 RCW; the authority to select, order, or administer Schedule II through IV controlled substances being limited to those drugs that are to be directly administered to patients who require anesthesia for diagnostic, operative, obstetrical, or therapeutic procedures in a hospital, clinic, ambulatory surgical facility, or the office of a practitioner licensed under chapter 18.71, 18.22, 18.36, 18.36A, 18.57, or 18.32 RCW; "select" meaning the decision-making process of choosing a drug, dosage, route, and time of administration; and "order" meaning the process of directing licensed individuals pursuant to their statutory authority to directly administer a drug or to dispense, deliver, or distribute a drug for the purpose of direct administration to a patient, under instructions of the certified registered nurse anesthetist. "Protocol" means a statement regarding practice and documentation concerning such items as categories of patients, categories of medications, or categories of procedures rather than detailed case-specific formulas for the practice of nurse anesthesia;
Prohibiting advanced practice registered nurses from ordering or prescribing controlled substances as defined in Schedules II through IV of the Uniform Controlled Substances Act, chapter 69.50 RCW, if and to the extent that doing so is permitted by their scope of practice;
Prohibiting the practice of registered nursing or advanced practice registered nursing by a student enrolled in an approved school if:
The student performs services without compensation or expectation of compensation as part of a volunteer activity;
The student is under the direct supervision of a registered nurse or advanced practice registered nurse licensed under this chapter, a pharmacist licensed under chapter 18.64 RCW, an osteopathic physician and surgeon licensed under chapter 18.57 RCW, or a physician licensed under chapter 18.71 RCW;
The services the student performs are within the scope of practice of: (A) The nursing profession for which the student is receiving training; and (B) the person supervising the student;
The school in which the student is enrolled verifies the student has demonstrated competency through his or her education and training to perform the services; and
The student provides proof of current malpractice insurance to the volunteer activity organizer prior to performing any services.
In the context of the definition of licensed practical nursing practice, this chapter shall not be construed as:
Prohibiting the incidental care of the sick by domestic servants or persons primarily employed as housekeepers, so long as they do not practice practical nursing within the meaning of this chapter;
Preventing a person from the domestic administration of family remedies or the furnishing of nursing assistance in case of emergency;
Prohibiting the practice of practical nursing by students enrolled in approved schools as may be incidental to their course of study or prohibiting the students from working as nursing assistants;
Prohibiting auxiliary services provided by persons carrying out duties necessary for the support of nursing services, including those duties that involve minor nursing services for persons performed in hospitals, nursing homes, or elsewhere under the direction of licensed physicians or the supervision of licensed registered nurses;
Prohibiting or preventing the practice of nursing in this state by a legally qualified nurse of another state or territory whose engagement requires him or her to accompany and care for a patient temporarily residing in this state during the period of one such engagement, not to exceed six months in length, if the person does not represent or hold himself or herself out as a licensed practical nurse licensed to practice in this state;
Prohibiting nursing or care of the sick, with or without compensation, when done in connection with the practice of the religious tenets of a church by adherents of the church so long as they do not engage in licensed practical nurse practice as defined in this chapter;
Prohibiting the practice of a legally qualified nurse of another state who is employed by the United States government or any bureau, division, or agency thereof, while in the discharge of his or her official duties.
An advanced registered nurse practitioner under his or her license may perform for compensation nursing care, as that term is usually understood, of the ill, injured, or infirm, and in the course thereof, she or he may do the following things that shall not be done by a person not so licensed, except as provided in RCW 18.79.260 and 18.79.270:
Perform specialized and advanced levels of nursing as recognized by the nursing profession, as defined by the board;
Prescribe legend drugs and Schedule V controlled substances, as defined in the Uniform Controlled Substances Act, chapter 69.50 RCW, and Schedules II through IV subject to RCW 18.79.240(1) (r) or (s) within the scope of practice defined by the board;
Perform all acts provided in RCW 18.79.260;
Hold herself or himself out to the public or designate herself or himself as an advanced registered nurse practitioner , certified nurse practitioner, certified nurse midwife, certified registered nurse anesthetist, or certified clinical nurse specialist.
An advanced practice registered nurse under his or her license may perform for compensation nursing care, as that term is usually understood, of the ill, injured, or infirm, and in the course thereof, she or he may do the following things that shall not be done by a person not so licensed, except as provided in RCW 18.79.260 and 18.79.270:
Perform specialized and advanced levels of nursing as recognized by the nursing profession, as defined by the board;
Prescribe legend drugs and Schedule V controlled substances, as defined in the Uniform Controlled Substances Act, chapter 69.50 RCW, and Schedules II through IV subject to RCW 18.79.240(1) (r) or (s) within the scope of practice defined by the board;
Perform all acts provided in RCW 18.79.260;
Hold herself or himself out to the public or designate herself or himself as an advanced practice registered nurse , certified nurse practitioner, certified nurse midwife, certified registered nurse anesthetist, or certified clinical nurse specialist.
Sections 2, 4, 6, 8, 10, and 12 of this act take effect June 30, 2027.
Sections 1, 3, 5, 7, 9, and 11 of this act expire June 30, 2027.