Written Protocol · RN
Pennsylvania Standing Order for Registered Nurses
Recognized but not required in every case. The Standing Order is the written instrument Pennsylvania 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.
RNs (general licensure, not an APRN) are not subject to physician-supervision or collaborative-agreement requirements in Pennsylvania under the Professional Nursing Law — RN practice is independent within the scope of professional nursing, distinct from the CRNP/CNM/CNS collaborative-agreement regimes above.
What a voluntary Registered Nurse agreement covers in Pennsylvania
Pennsylvania requires no written agreement for registered nurses. These are the clauses a practice includes when it chooses to put one in writing. The Pennsylvania State Board of Nursing governs registered nurses here.
Registered Nurse administers immunizing agents and does skin testing under a written order from a licensed Physician, which may be a standing order applicable to individuals or groups.
A committee representing nurses, physicians and administration of the agency or institution sets written policies and procedures that identify the agents Registered Nurse may administer, contraindications and principles for treating anaphylactic reactions, and makes them available to Registered Nurse.
- The Standing Order also carries 1 scope and 1 education clauses, authored in the document itself.
Statutes and rules these clauses cite
- 49 Pa. Code § 21.16 (Immunizations)regulation
RN immunization and skin testing require a written order from a licensed physician, which may be a standing order applicable to individuals or groups, plus written policies and procedures set by a committee of nurses, physicians and administration of the agency or institution (agents, contraindications, anaphylaxis principles, instruction and supervised practice).
What Pennsylvania 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 Pennsylvania; 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 APRN/PA categories above.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same physician-only ownership regime governs any clinical PC an RN might practice through, but non-clinical businesses (staffing, home health) fall outside that regime entirely and carry no ownership restriction.
For medical-aesthetics (med-spa) businesses, an RN performs delegated laser/injectable procedures under physician delegation (a Medical Director) rather than independent RN authority — ownership and clinical-delegation authority are separate questions.
Sources for the supervision rules (1)
- 63 P.S. § 211 et seq. — Professional Nursing Law
About Pennsylvania's rules
Pennsylvania has no independent-practice pathway for CRNPs — SB 25-style full-practice-authority bills have been introduced every session without passing. PA (physician assistant) reform via Acts 78/79 of 2021 removed prior Board pre-approval of written agreements and the flat 100%-countersignature rule after the first year, but a written agreement and supervision remain mandatory. PA is a CPOM state: only licensed physicians may own a medical professional corporation.
Other clinicians in Pennsylvania: see the state overview.