CERTIFICATION OF ENROLLMENT
HOUSE BILL 2416
Chapter 239, Laws of 2024
68th Legislature
2024 Regular Session
ADVANCED REGISTERED NURSE PRACTITIONERS—LEGAL TITLE CHANGE
EFFECTIVE DATE: June 30, 2027—Except for section 21, which takes
effect June 6, 2024.
Passed by the House March 5, 2024 CERTIFICATE
Yeas 96 Nays 0
I, Bernard Dean, Chief Clerk of the
House of Representatives of the
LAURIE JINKINS State of Washington, do hereby
Speaker of the House of certify that the attached is HOUSE
Representatives BILL 2416 as passed by the House of
Representatives and the Senate on
the dates hereon set forth.
Passed by the Senate March 1, 2024
Yeas 49 Nays 0 BERNARD DEAN
Chief Clerk
DENNY HECK
President of the Senate
Approved March 25, 2024 1:58 PM FILED
March 26, 2024
Secretary of State
JAY INSLEE State of Washington
Governor of the State of Washington
 HOUSE BILL 2416
AS AMENDED BY THE SENATE
Passed Legislature - 2024 Regular Session
State of Washington 68th Legislature 2024 Regular Session
By Representatives Graham and Riccelli; by request of Washington
State Board of Nursing
Read first time 01/18/24. Referred to Committee on Health Care &
Wellness.
1 AN ACT Relating to changing the legal title for advanced practice
2 nurses; amending RCW 18.79.030, 18.79.040, 18.79.050, 18.79.060,
3 18.79.070, 18.79.110, 18.79.160, 18.79.170, 18.79.180, 18.79.200,
4 18.79.230, 18.79.240, 18.79.250, 18.79.256, 18.79.260, 18.79.270,
5 18.79.290, 18.79.400, 18.79.800, and 18.79.810; creating a new
6 section; and providing an effective date.
7 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
8 Sec. 1. RCW 18.79.030 and 2023 c 123 s 19 are each amended to
9 read as follows:
10 (1) It is unlawful for a person to practice or to offer to
11 practice as a registered nurse in this state unless that person has
12 been licensed under this chapter or holds a valid multistate license
13 under chapter 18.80 RCW. A person who holds a license to practice as
14 a registered nurse in this state may use the titles "registered
15 nurse" and "nurse" and the abbreviation "R.N." No other person may
16 assume those titles or use the abbreviation or any other words,
17 letters, signs, or figures to indicate that the person using them is
18 a registered nurse.
19 (2) It is unlawful for a person to practice or to offer to
20 practice as an advanced practice registered nurse ((practitioner)) or
21 as a nurse practitioner in this state unless that person has been
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 1 licensed under this chapter. A person who holds a license to practice
2 as an advanced practice registered nurse ((practitioner)) in this
3 state may use the titles "advanced practice registered nurse
4 ((practitioner))," "nurse practitioner," and "nurse" and the
5 abbreviations "((A.R.N.P.)) A.P.R.N." and "N.P." No other person may
6 assume those titles or use those abbreviations or any other words,
7 letters, signs, or figures to indicate that the person using them is
8 an advanced practice registered nurse ((practitioner)) or nurse
9 practitioner.
10 (3) It is unlawful for a person to practice or to offer to
11 practice as a licensed practical nurse in this state unless that
12 person has been licensed under this chapter or holds a valid
13 multistate license under chapter 18.80 RCW. A person who holds a
14 license to practice as a licensed practical nurse in this state may
15 use the titles "licensed practical nurse" and "nurse" and the
16 abbreviation "L.P.N." No other person may assume those titles or use
17 that abbreviation or any other words, letters, signs, or figures to
18 indicate that the person using them is a licensed practical nurse.
19 (4) Nothing in this section shall prohibit a person listed as a
20 Christian Science nurse in the Christian Science Journal published by
21 the Christian Science Publishing Society, Boston, Massachusetts, from
22 using the title "Christian Science nurse," so long as such person
23 does not hold himself or herself out as a registered nurse, advanced
24 practice registered nurse ((practitioner)), nurse practitioner, or
25 licensed practical nurse, unless otherwise authorized by law to do
26 so.
27 Sec. 2. RCW 18.79.040 and 2020 c 80 s 15 are each amended to
28 read as follows:
29 (1) "Registered nursing practice" means the performance of acts
30 requiring substantial specialized knowledge, judgment, and skill
31 based on the principles of the biological, physiological, behavioral,
32 and sociological sciences in either:
33 (a) The observation, assessment, diagnosis, care or counsel, and
34 health teaching of individuals with illnesses, injuries, or
35 disabilities, or in the maintenance of health or prevention of
36 illness of others;
37 (b) The performance of such additional acts requiring education
38 and training and that are recognized by the medical and nursing
39 professions as proper and recognized by the ((commission)) board to
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 1 be performed by registered nurses licensed under this chapter and
2 that are authorized by the ((commission)) board through its rules;
3 (c) The administration, supervision, delegation, and evaluation
4 of nursing practice. However, nothing in this subsection affects the
5 authority of a hospital, hospital district, in-home service agency,
6 community-based care setting, medical clinic, or office, concerning
7 its administration and supervision;
8 (d) The teaching of nursing;
9 (e) The executing of medical regimen as prescribed by a licensed
10 physician and surgeon, dentist, osteopathic physician and surgeon,
11 podiatric physician and surgeon, physician assistant, or advanced
12 practice registered nurse ((practitioner)), or as directed by a
13 licensed midwife within his or her scope of practice.
14 (2) Nothing in this section prohibits a person from practicing a
15 profession for which a license has been issued under the laws of this
16 state or specifically authorized by any other law of the state of
17 Washington.
18 (3) This section does not prohibit (a) the nursing care of the
19 sick, without compensation, by an unlicensed person who does not hold
20 himself or herself out to be a registered nurse, (b) the practice of
21 licensed practical nursing by a licensed practical nurse, or (c) the
22 practice of a nursing assistant, providing delegated nursing tasks
23 under chapter 18.88A RCW.
24 Sec. 3. RCW 18.79.050 and 2000 c 64 s 2 are each amended to read
25 as follows:
26 "Advanced practice registered nursing ((practice))" means the
27 performance of the acts of a registered nurse and the performance of
28 an expanded role in providing health care services as recognized by
29 the medical and nursing professions, the scope of which is defined by
30 rule by the ((commission)) board. Upon approval by the ((commission))
31 board, an advanced practice registered nurse ((practitioner)) may
32 prescribe legend drugs and controlled substances contained in
33 Schedule V of the Uniform Controlled Substances Act, chapter 69.50
34 RCW, and Schedules II through IV subject to RCW 18.79.240(1) (r) or
35 (s).
36 Nothing in this section prohibits a person from practicing a
37 profession for which a license has been issued under the laws of this
38 state or specifically authorized by any other law of the state of
39 Washington.
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1 This section does not prohibit (1) the nursing care of the sick,
2 without compensation, by an unlicensed person who does not hold
3 himself or herself out to be an advanced practice registered nurse
4 ((practitioner)), or (2) the practice of registered nursing by a
5 licensed registered nurse or the practice of licensed practical
6 nursing by a licensed practical nurse.
7 Sec. 4. RCW 18.79.060 and 2020 c 80 s 16 are each amended to
8 read as follows:
9 "Licensed practical nursing practice" means the performance of
10 services requiring the knowledge, skill, and judgment necessary for
11 carrying out selected aspects of the designated nursing regimen under
12 the direction and supervision of a licensed physician and surgeon,
13 dentist, osteopathic physician and surgeon, physician assistant,
14 podiatric physician and surgeon, advanced practice registered nurse
15 ((practitioner)), registered nurse, or midwife.
16 Nothing in this section prohibits a person from practicing a
17 profession for which a license has been issued under the laws of this
18 state or specifically authorized by any other law of the state of
19 Washington.
20 This section does not prohibit the nursing care of the sick,
21 without compensation, by an unlicensed person who does not hold
22 himself or herself out to be a licensed practical nurse.
23 Sec. 5. RCW 18.79.070 and 2022 c 240 s 32 are each amended to
24 read as follows:
25 (1) The state ((nursing care quality assurance commission)) board
26 is established, consisting of fifteen members to be appointed by the
27 governor to four-year terms. The governor shall consider nursing
28 members who are recommended for appointment by the appropriate
29 professional associations in the state. No person may serve as a
30 member of the ((commission)) board for more than two consecutive full
31 terms.
32 (2) There must be seven registered nurse members, two advanced
33 practice registered nurse ((practitioner)) members, three licensed
34 practical nurse members, and three public members on the
35 ((commission)) board. Each member of the ((commission)) board must be
36 a resident of this state.
37 (3)(a) Registered nurse members of the ((commission)) board must:
38 (i) Be licensed as registered nurses under this chapter; and
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 1 (ii) Have had at least three years' experience in the active
2 practice of nursing and have been engaged in that practice within two
3 years of appointment.
4 (b) In addition:
5 (i) At least one member must be on the faculty at a four-year
6 university nursing program;
7 (ii) At least one member must be on the faculty at a two-year
8 community college nursing program;
9 (iii) At least two members must be staff nurses providing direct
10 patient care; and
11 (iv) At least one member must be a nurse manager or a nurse
12 executive.
13 (4) Advanced practice registered nurse ((practitioner)) members
14 of the ((commission)) board must:
15 (a) Be licensed as advanced practice registered nurses
16 ((practitioners)) under this chapter; and
17 (b) Have had at least three years' experience in the active
18 practice of advanced practice registered nursing and have been
19 engaged in that practice within two years of appointment.
20 (5) Licensed practical nurse members of the ((commission)) board
21 must:
22 (a) Be licensed as licensed practical nurses under this chapter;
23 and
24 (b) Have had at least three years' actual experience as a
25 licensed practical nurse and have been engaged in practice as a
26 practical nurse within two years of appointment.
27 (6) Public members of the ((commission)) board may not be a
28 member of any other health care licensing board or commission, or
29 have a fiduciary obligation to a facility rendering health services
30 regulated by the ((commission)) board, or have a material or
31 financial interest in the rendering of health services regulated by
32 the ((commission)) board.
33 ((In appointing the initial members of the commission, it is the
34 intent of the legislature that, to the extent possible, the governor
35 appoint the existing members of the board of nursing and the board of
36 practical nursing repealed under chapter 9, Laws of 1994 sp. sess.
37 The governor may appoint initial members of the commission to
38 staggered terms of from one to four years. Thereafter, all members
39 shall be appointed to full four-year terms.)) Members of the
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1 ((commission)) board hold office until their successors are
2 appointed.
3 When the secretary appoints pro tem members, reasonable efforts
4 shall be made to ensure that at least one pro tem member is a
5 registered nurse who is currently practicing and, in addition to
6 meeting other minimum qualifications, has graduated from an associate
7 or baccalaureate nursing program within three years of appointment.
8 Sec. 6. RCW 18.79.110 and 2023 c 126 s 8 are each amended to
9 read as follows:
10 (1) The ((commission)) board shall keep a record of all of its
11 proceedings and make such reports to the governor as may be required.
12 The ((commission)) board shall define by rules what constitutes
13 specialized and advanced levels of nursing practice as recognized by
14 the medical and nursing profession. The ((commission)) board may
15 adopt rules or issue advisory opinions in response to questions put
16 to it by professional health associations, nursing practitioners, and
17 consumers in this state concerning the authority of various
18 categories of nursing practitioners to perform particular acts.
19 (2) The ((commission)) board shall approve curricula and shall
20 establish criteria for minimum standards for schools preparing
21 persons for licensing as registered nurses, advanced practice
22 registered nurses ((practitioners)), and licensed practical nurses
23 under this chapter. The ((commission)) board shall approve such
24 schools of nursing as meet the requirements of this chapter and the
25 ((commission)) board, and the ((commission)) board shall approve
26 establishment of basic nursing education programs and shall establish
27 criteria as to the need for and the size of a program and the type of
28 program and the geographical location. The ((commission)) board shall
29 establish criteria for proof of reasonable currency of knowledge and
30 skill as a basis for safe practice after three years' inactive or
31 lapsed status. The ((commission)) board shall establish criteria for
32 licensing by endorsement. The ((commission)) board shall determine
33 examination requirements for applicants for licensing as registered
34 nurses, advanced practice registered nurses ((practitioners)), and
35 licensed practical nurses under this chapter, and shall certify to
36 the secretary for licensing duly qualified applicants. The
37 ((commission)) board shall adopt rules which allow for one hour of
38 simulated learning to be counted as equivalent to two hours of
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 1 clinical placement learning, with simulated learning accounting for
2 up to a maximum of 50 percent of the required clinical hours.
3 (3) The ((commission)) board shall adopt rules on continuing
4 competency. The rules must include exemptions from the continuing
5 competency requirements for registered nurses seeking advanced
6 nursing degrees. Nothing in this subsection prohibits the
7 ((commission)) board from providing additional exemptions for any
8 person credentialed under this chapter who is enrolled in an advanced
9 education program.
10 (4) The ((commission)) board shall adopt such rules under chapter
11 34.05 RCW as are necessary to fulfill the purposes of this chapter.
12 (5) The ((commission)) board is the successor in interest of the
13 board of nursing and the board of practical nursing. All contracts,
14 undertakings, agreements, rules, regulations, decisions, orders, and
15 policies of the former board of nursing or the board of practical
16 nursing continue in full force and effect under the ((commission))
17 board until the ((commission)) board amends or rescinds those rules,
18 regulations, decisions, orders, or policies.
19 (6) The members of the ((commission)) board are immune from suit
20 in an action, civil or criminal, based on its disciplinary
21 proceedings or other official acts performed in good faith as members
22 of the ((commission)) board.
23 (7) Whenever the workload of the ((commission)) board requires,
24 the ((commission)) board may request that the secretary appoint pro
25 tempore members of the ((commission)) board. When serving, pro
26 tempore members of the ((commission)) board have all of the powers,
27 duties, and immunities, and are entitled to all of the emoluments,
28 including travel expenses, of regularly appointed members of the
29 ((commission)) board.
30 Sec. 7. RCW 18.79.160 and 2004 c 262 s 6 are each amended to
31 read as follows:
32 (1) An applicant for a license to practice as a registered nurse
33