Practice Agreement · RN
Registered Nurse Practice Agreement in Washington
Washington 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 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 Registered Nurse practice agreement covers in Washington
Governed by the Washington State 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 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.
- The agreement on file also carries 2 scope, 2 education, 2 registration clauses, generated in the document itself.
Statutes and rules cited
- WAC 246-945-350regulation
Washington State Pharmacy Quality Assurance Commission rule setting the mandatory minimum content and filing requirement for a Collaborative Drug Therapy Agreement (CDTA).
- RCW 18.64.011statute
Washington Pharmacy Practice Act definitions, including 'practitioner' and the statutory basis for pharmacist prescriptive authority under a CDTA.
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 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 doesn't remove the need for physician delegation/oversight of the procedures themselves — not independently confirmed against a Washington-specific med-spa rule in this research pass.
Legal sources for these 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.