Practice Agreement · RN
Registered Nurse Practice Agreement in Hawaii
Hawaii law does not require a Registered Nurse to hold a named agreement with a physician. Practices still use one to define the working relationship; here is what it covers and what the state does require.
RNs (general licensure, not an APRN) are not subject to physician-supervision or collaborative-agreement requirements in Hawaii — RN scope under HRS Ch. 457 carries no physician-oversight language, in contrast to the PA framework above.
What a Registered Nurse practice agreement covers in Hawaii
Governed by the Hawaii Board of Nursing. Each numbered item is a statutory requirement the agreement must satisfy.
The Registered Nurse ("RN") shall practice under the orders, standing orders, or delegation of the Physician, consistent with Haw. Rev. Stat. Chapter 457. Hawaii law does not require a supervision or 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.
- The agreement on file also carries 2 scope, 2 education, 2 registration clauses, generated in the document itself.
Statutes and rules cited
- Haw. Rev. Stat. § 461-1statute
Defines 'collaborative agreement' and enumerates specific pharmacist functions performable under a Board-approved collaborative agreement (e.g., initiating emergency contraception drug therapy, dispensing an opioid antagonist).
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the agreement has to carry, from the state's supervision rules.
Proximity
Not codified — left to the agreement
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Covered by the practice agreement · no controlled-substance authority
RNs do not have independent prescriptive authority in Hawaii.
Written agreement
Not required
Unconditional — general RN licensure is never subject to physician supervision or a collaborative agreement in Hawaii.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional corporation under HRS § 415A-9 for nursing services; non-clinical businesses an RN might own (staffing agency, wellness business) fall outside § 415A-9 and carry no ownership restriction.
Legal sources for these rules (1)
About Hawaii's rules
Hawaii grants APRNs (NP/CRNA/CNM/CNS) full independent practice with no collaborative-agreement requirement (HRS § 457-8.5); prescriptive authority is a separate application, not automatic. Hawaii has no general corporate-practice-of-medicine statute — HRS § 415A-9 requires professional-corporation shareholders to be licensed, but doesn't clearly resolve multi-discipline (e.g. physician+APRN) ownership.
Other clinicians in Hawaii: see the state overview.