Protocol · RN · Massachusetts
Practice Protocol for Registered Nurses in Massachusetts
Registered Nurses practice independently in Massachusetts. A practice protocol is voluntary; here is what one covers and what the state does require.
General RN licensure in MA carries no physician-supervision or collaborative-agreement requirement — RNs practice independently within their scope under M.G.L. c.112 §§74-81C and 244 CMR, distinct from the APRN categories above.
What a voluntary Registered Nurse protocol covers in Massachusetts
Massachusetts requires no written protocol for registered nurses. These are the clauses a practice includes when it chooses to put one in writing. The Massachusetts Board of Registration in Nursing governs registered nurses here.
The Registered Nurse ("RN") shall practice under the orders, standing orders, or delegation of the Physician. Unlike the collaborative arrangement that applies to Nurse Practitioners during their transition-to-practice period, Massachusetts law does not require a written 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 Massachusetts 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 MA; they may administer medications only as prescribed by a provider authorized by law to prescribe.
Written agreement
Not required
Unconditional — general RN licensure is never subject to physician supervision or a collaborative-practice agreement in Massachusetts, unlike the APRN/PA categories above.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional corporation under M.G.L. c. 156A for nursing services rendered through an entity; non-clinical businesses an RN might own (staffing agency, general wellness business) fall outside that regime
For medical-aesthetics (med-spa) businesses performing delegated medical procedures, RN ownership of the business entity does not itself satisfy Massachusetts's strict corporate-practice regime for the clinical entity.
Sources for the supervision rules (2)
- M.G.L. c. 112, §§74–81C — Nurse Practice Act
- 244 CMR — Board of Registration in Nursing regulations (general nursing practice)
About Massachusetts's rules
Full practice authority (Acts 2020, c. 260, § 36; 244 CMR 4.00) lets NPs, PMHNPs and CNMs practice independently in Massachusetts: CNMs immediately, NPs and PMHNPs after a Board-attested transition (244 CMR 4.07). PAs and CRNAs have no independent-practice pathway. Massachusetts's professional-corporation ownership rules (M.G.L. c. 156A) are notably strict, and APRN and PA entity ownership remains unsettled.
Other clinicians in Massachusetts: see the state overview.