Written Protocol · RN
Missouri Standing Orders for Registered Nurses
Recognized but not required in every case. The Standing Orders is the written instrument Missouri law names for a Registered Nurse working with a physician. Below: the board that governs it, what it contains when one is used, and the supervision rules that apply either way.
General RNs are not subject to § 334.104 collaborative practice arrangements — that statute applies specifically to APRNs. RN scope is defined by Chapter 335 and Board of Nursing rule; RNs practice under their own licensed scope (assessment, care planning, medication administration per order), not a physician-delegation regime.
What a voluntary Registered Nurse agreement covers in Missouri
Missouri requires no written agreement for registered nurses. These are the clauses a practice includes when it chooses to put one in writing. The Missouri State Board of Nursing governs registered nurses here.
Physician and Registered Nurse set out the collaborative practice arrangement in writing, as a written agreement, jointly agreed-upon protocols, or standing orders for the delivery of health care services.
Source: RSMo § 334.104.1
- The Standing Orders also carries 1 scope clauses, authored in the document itself.
Statutes and rules these clauses cite
- RSMo § 334.104.1statute
A physician may enter into collaborative practice arrangements with registered professional nurses in the form of written agreements, jointly agreed-upon protocols, or standing orders, which may delegate authority to administer or dispense drugs and provide treatment.
What Missouri does require
The supervision and prescribing rules that apply to registered nurses regardless of any agreement.
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 Missouri; they administer medications per order from an authorized prescriber.
Written agreement
Not required
Unconditional — general RN licensure is never subject to a collaborative practice arrangement in Missouri, unlike the APRN categories above.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — General RN licensure does not require a healing-arts professional corporation. Non-clinical businesses an RN might own (home health agency, staffing agency) fall under general corporation/LLC law, not the healing-arts regime.
RN licensure does not require Chapter 356 professional-corporation status.
Sources for the supervision rules (2)
- RSMo §§ 335.011–335.096 — The Nursing Practice Act
- RSMo § 335.016 — Definitions
About Missouri's rules
PA/APRN collaboration is governed by nearly-identical §§ 334.104/334.735: a 6-FTE combined ratio cap, 10%/20% chart-review every 14 days, biweekly physician presence, and a 120-hour controlled-substance Rx cap. A pre-2024 numeric 75-mile proximity rule was reportedly rescinded by both boards — current text uses an undefined 'geographic proximity' standard; verify with counsel before relying on any specific mileage figure.
Other clinicians in Missouri: see the state overview.