Protocol · RN · Puerto Rico
Practice Protocol for Registered Nurses in Puerto Rico
Registered Nurses practice independently in Puerto Rico. A practice protocol is voluntary; here is what one covers and what the state does require.
General RN licensure ('Enfermero/a Generalista', Ley 254-2015 Art. 2(e)(3)) is not subject to physician supervision or a collaborative agreement — RNs 'podrán funcionar de manera independiente y tener práctica privada,' direct the nursing care delegated to associate/practical nurses, and work within physician orders/protocols rather than under an APRN-style agreement.
What a voluntary Registered Nurse protocol covers in Puerto Rico
Puerto Rico requires no written protocol for registered nurses. These are the clauses a practice includes when it chooses to put one in writing. The Puerto Rico Board of Nurse Examiners governs registered nurses here.
The Registered Nurse ("RN") shall practice under the orders, standing orders, or delegation of the Physician, consistent with Law 254-2015. Puerto Rico law does not require a collaborative 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 Puerto Rico 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 PR; they administer medications per physician orders/protocols.
Written agreement
Not required
Unconditional — general RN licensure is never subject to physician supervision or a collaborative agreement in PR, unlike the APRN/PA categories above.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Corporación Profesional under Ley 164-2009, Cap. 238 for nursing services; non-clinical businesses an RN might own fall outside this regime entirely.
Sources for the supervision rules (1)
About Puerto Rico's rules
PR's 'Médico Asistente' (PA) credential is NOT the mainland PA profession — it is a bridge pathway mainly for internationally-trained physicians awaiting PR licensure (Ley 71-2017), capped at 2 per supervising physician with zero prescriptive authority. APRNs (NP/CNM/CRNA/CNS) need patient-level collaborative protocols with a physician for nearly all diagnostic/prescriptive functions (Ley 254-2015) despite AANP rating PR 'Reduced Practice.' No dedicated esthetician license currently exists.
Other clinicians in Puerto Rico: see the state overview.