Protocol · RN · Missouri
Practice Protocol for Registered Nurses in Missouri
Registered Nurses practice independently in Missouri. A practice protocol is voluntary; here is what one covers and what the state does require.
General RNs are not subject to § 334.104 collaborative practice arrangements — that statute applies specifically to APRNs. RN scope is defined by Chapter 335 and Board of Nursing rule; RNs practice under their own licensed scope (assessment, care planning, medication administration per order), not a physician-delegation regime.
What a voluntary Registered Nurse protocol covers in Missouri
Missouri requires no written protocol for registered nurses. These are the clauses a practice includes when it chooses to put one in writing. The Missouri State Board of Nursing governs registered nurses here.
The Registered Nurse ("RN") shall practice under the orders, standing orders, or delegation of the Physician. Unlike the Collaborative Practice Arrangement required of Nurse Practitioners and Physician Assistants, Missouri law does not require such an arrangement 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, 1 education and 2 registration clauses, authored in the document itself.
What Missouri 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 Missouri; they administer medications per order from an authorized prescriber.
Written agreement
Not required
Unconditional — general RN licensure is never subject to a collaborative practice arrangement in Missouri, unlike the APRN categories above.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — General RN licensure does not require a healing-arts professional corporation. Non-clinical businesses an RN might own (home health agency, staffing agency) fall under general corporation/LLC law, not the healing-arts regime.
RN licensure does not require Chapter 356 professional-corporation status.
Sources for the supervision rules (2)
- RSMo §§ 335.011–335.096 — The Nursing Practice Act
- RSMo § 335.016 — Definitions
About Missouri's rules
PA/APRN collaboration is governed by nearly-identical §§ 334.104/334.735: a 6-FTE combined ratio cap, 10%/20% chart-review every 14 days, biweekly physician presence, and a 120-hour controlled-substance Rx cap. A pre-2024 numeric 75-mile proximity rule was reportedly rescinded by both boards — current text uses an undefined 'geographic proximity' standard; verify with counsel before relying on any specific mileage figure.
Other clinicians in Missouri: see the state overview.