Protocol · RN · Maryland
Practice Protocol for Registered Nurses in Maryland
Registered Nurses practice independently in Maryland. A practice protocol is voluntary; here is what one covers and what the state does require.
RNs (general licensure, not an APRN) are not subject to a physician-supervision or collaborative-practice-agreement requirement in Maryland. RNs practice under a physician's orders, standing orders, or delegation, consistent with the Maryland Nurse Practice Act — categorically different from the APRN-specific collaboration frameworks above.
What a voluntary Registered Nurse protocol covers in Maryland
Maryland requires no written protocol for registered nurses. These are the clauses a practice includes when it chooses to put one in writing. The Maryland Board of Nursing governs registered nurses here.
The Registered Nurse ("RN") shall practice under the orders, standing orders, or delegation of the Physician, consistent with the Maryland Nurse Practice Act, Health Occupations Article, Title 8. Maryland law does not require a collaboration agreement for this Registered Nurse's general scope of practice; the Physician shall instead be available to the Registered Nurse for consultation regarding clinical and patient care issues arising under any order or delegation.
- A voluntary protocol also carries 2 scope, 2 education and 2 registration clauses, authored in the document itself.
What Maryland does require
The supervision and prescribing rules that apply to registered nurses regardless of any protocol.
Proximity
Not codified
Supervision ratio
Not codified — no cap on file
Chart review
Not codified
Meeting cadence
Not codified
Prescriptive authority
No agreement needed to prescribe · no controlled-substance authority
RNs do not have independent prescriptive authority in Maryland; they administer medications pursuant to the orders of a licensed prescriber.
Written agreement
Not required
Unconditional — general RN licensure has never been subject to a physician collaboration/supervision agreement in Maryland.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — General RN licensure; the physician-only professional-corporation regime does not apply to non-clinical businesses an RN might own
Sources for the supervision rules (1)
- Md. Health Occupations Code Title 8 — Nurses (RN scope)
About Maryland's rules
Maryland's APRN categories are not uniform: CRNPs and CNMs gained full practice authority in 2015 (after an 18-month new-graduate mentorship), CRNAs remain fully supervised with no prescriptive authority at all (Maryland is one of about 11 states granting CRNAs none), and only the psychiatric-mental-health population focus of CNS practice is independent. Maryland does not recognize PLLCs; professional entities use physician-only professional corporations, so multi-disciplinary ownership questions remain open.
Other clinicians in Maryland: see the state overview.