Protocol · RN · Ohio
Practice Protocol for Registered Nurses in Ohio
Registered Nurses practice independently in Ohio. A practice protocol is voluntary; here is what one covers and what the state does require.
FULL for general nursing scope (Ohio Rev. Code §4723.01(B)) — confirmed directly via the Ohio Board of Nursing's official scope-of-practice document: physician supervision is NOT required for general RN practice. SUPERVISED_ONLY carve-out for physician-delegated medical-aesthetic procedures — injectables and laser HAIR REMOVAL are two separately-regulated tracks detailed below; general non-ablative vascular-laser delegation for other purposes appears to sit under a separate, unconfirmed rule.
What a voluntary Registered Nurse protocol covers in Ohio
Ohio requires no written protocol for registered nurses. These are the clauses a practice includes when it chooses to put one in writing. The Ohio 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 Ohio Nurse Practice Act, Ohio Rev. Code Chapter 4723. Unlike the Standard Care Arrangement required of Advanced Practice Registered Nurses, Ohio 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 Ohio does require
The supervision and prescribing rules that apply to registered nurses regardless of any protocol.
Proximity
physician-delegated LASER HAIR REMOVAL specifically (Ohio Rev. Code §4731.33) — CURRENT LAW as of 2026-08-14; H.B. 377 changes this eff. 8/25/2026: On-site presence required
OAC Ch. 4731-18 (current version, in effect since 4/30/2023): the delegating physician must provide on-site supervision, defined as the same office suite (not necessarily the same room), and must personally evaluate the patient before initial treatment and again after the initial application before continuing. H.B. 377 (signed 5/27/2026, eff. 8/25/2026) will permit off-site supervision where the nurse has completed a 40-hour board-approved training course and will narrow the pre- and post-evaluation requirement so it no longer applies to nurse delegates. H.B. 377 amends § 4731.33, the hair-removal-specific statute, only; general non-ablative vascular-laser delegation for other purposes (vascular lesions, tattoo removal, skin resurfacing) is governed by a separate provision, OAC 4731-18-03(A), which appears to remain a 2-person, on-site rule and should be checked directly if it matters for a specific use case.
Supervision ratio
physician-delegated LASER HAIR REMOVAL specifically (Ohio Rev. Code §4731.33) — CURRENT LAW as of 2026-08-14; H.B. 377 raises this to 5 eff. 8/25/2026: Up to 2 at a time
A physician may supervise no more than 2 persons at a time for laser-hair-removal delegation under current law, rising to 5 once H.B. 377 takes effect on 8/25/2026. The 2-to-5 change is well corroborated; the precise pre-H.B. 377 statutory location of the figure of 2 is less certain.
Chart review
Not codified
Meeting cadence
Not codified
Prescriptive authority
No agreement needed to prescribe · no controlled-substance authority
Confirmed: general RNs (non-APRN) have no independent prescriptive authority — reserved to APRNs (CNP/CNS/CNM/CRNA) under Ohio Rev. Code §4723.48 and related sections.
Written agreement
Not required
Unconditional for general nursing practice. For cosmetic injectables (Botox/fillers), an Ohio Board of Nursing interpretive guideline requires a documented medical evaluation, established medical regimen, and a valid order from a provider with cosmetic/aesthetic competency — but no codified on-site/off-site PROXIMITY standard for the ordering physician was found either way (distinct from the laser rule below, which does codify one); treat this as a genuine gap, not a confirmed telecommunication-sufficient standard. For laser/light-based device delegation, see the codified Medical Board rule in supervision.proximity below.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — Same no-CPOM-doctrine framework as `pa` (Ohio Rev. Code §4731.226) — an RN may generally own a med-spa business entity, provided the medical-scope portion retains a licensed physician as medical director.
Sources for the supervision rules (7)
- Ohio Rev. Code §4723.01(B) — RN scope of practice
- Ohio Board of Nursing — 'Scopes of Practice: RNs and LPNs' (Nov. 2025, official, read directly)
- Ohio Rev. Code §4731.33 — Laser hair removal delegation, specifically amended by H.B. 377 (via Cornell LII mirror and law-firm secondary sources describing the 4/30/2023 rule version)
- OAC 4731-18-03(A) — General non-ablative vascular-laser delegation (a separate track, apparently unaffected by H.B. 377)
- H.B. 377, signed 5/27/2026, eff. 8/25/2026 — raises the laser-hair-removal delegation ratio to 5 and permits off-site supervision with trainingsecondary
- Ohio Board of Nursing interpretive guideline — 'Cosmetic/Aesthetic Patients Receiving Intramuscular, Subdermal, or Subcutaneously Injected Medications' (title/existence confirmed; full text 404'd on direct fetch, summarized via search snippet only)
- Ohio Rev. Code §4731.226 — Authorized business-entity forms (CPOM)
About Ohio's rules
Ohio recently relaxed CRNA supervision from 'immediate presence' to facility-wide 'collaboration' (H.B. 52, eff. 6/8/2026, now current law), and will loosen RN laser-delegation rules similarly (H.B. 377, eff. 8/25/2026 — NOT yet law as of this file's date). No independent-practice pathway exists for NP/PMHNP/PA despite active pending reform bills (a 2,000-hour NP threshold, PA proximity removal) — none enacted. Ohio has no corporate-practice-of-medicine doctrine (State Medical Board, 2012). Non-nurse midwifery has no current licensure pathway.
Other clinicians in Ohio: see the state overview.