Protocol · RN · Washington
Practice Protocol for Registered Nurses in Washington
Registered Nurses practice independently in Washington. A practice protocol is voluntary; here is what one covers and what the state does require.
RNs (general licensure, not an ARNP) are not subject to physician-supervision or collaborative-agreement requirements in Washington; RN practice under RCW 18.79.040 is defined without a physician-oversight condition.
What a voluntary Registered Nurse protocol covers in Washington
Washington requires no written protocol for registered nurses. These are the clauses a practice includes when it chooses to put one in writing. The Washington State 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 RCW 18.79. Washington 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 Washington 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 Washington; they administer medications only as ordered by an authorized prescriber.
Written agreement
Not required
Unconditional — general RN licensure is never subject to physician supervision or a collaborative agreement, unlike the ARNP/PA categories above.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — General RN licensure does not require a healing-arts PSC under RCW 18.100 — non-clinical businesses an RN might own (staffing agency, home health agency) fall under general corporation/LLC law and carry no ownership restriction.
For medical-aesthetics (med-spa) businesses performing delegated medical procedures, RN ownership of the business entity does not remove the need for physician delegation and oversight of the procedures themselves.
Sources for the supervision rules (1)
About Washington's rules
Washington is a full-independence state for ALL FOUR ARNP roles (NP, CRNA, CNM, CNS) under RCW 18.79, not just NPs — confirmed current via WAC 246-840-300/420 and Board of Nursing guidance. PAs are separate: HB 2041 (eff. Jan. 1, 2025) replaced supervision-only with a 4,000-hour supervision→collaboration tier (RCW 18.71A.120) with no numeric ratio cap.
Other clinicians in Washington: see the state overview.