Written Protocol · RN
Virginia Protocol for Registered Nurses
Recognized but not required in every case. The Protocol is the written instrument Virginia 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 a physician-supervision or collaborative-practice-agreement requirement in Virginia. § 54.1-3000 defines 'professional nursing' (RN) with no physician supervision/collaboration language, in explicit contrast to 'practical nursing' (LPN), which the statute defines as performed 'under the direction or supervision of a licensed medical practitioner, a professional nurse... or other licensed health professional.' Current Board of Nursing regs (18VAC90-19, successor to repealed 18VAC90-20) likewise impose supervision only on LPNs, not RNs.
What a voluntary Registered Nurse agreement covers in Virginia
Virginia requires no written agreement for registered nurses. These are the clauses a practice includes when it chooses to put one in writing. The Virginia Board of Nursing governs registered nurses here.
Physician may authorize Registered Nurse to administer vaccines to adults under a protocol when no prescriber is physically present.
Source: Va. Code § 54.1-3408(I)
A standing protocol for tuberculin testing describes the categories of persons to be tested and provides for medical evaluation of those who test positive.
Source: Va. Code § 54.1-3408(G)
- The Protocol also carries 1 education clauses, authored in the document itself.
Statutes and rules these clauses cite
- Va. Code § 54.1-3408(G)statute
A prescriber may, by oral or written order or standing protocol following Department of Health policies, authorize RNs, or LPNs under RN supervision, to possess and administer tuberculin PPD in the prescriber's absence; the prescriber ensures the nurse has adequate training.
- Va. Code § 54.1-3408(I)statute
A prescriber may authorize, under a protocol, administration of vaccines to adults by pharmacists, registered nurses, or licensed practical nurses under RN supervision when no prescriber is physically present.
What Virginia 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
No RN prescriptive-authority provision exists in Virginia law; § 54.1-3000 only lets RNs administer medications 'as prescribed by any person authorized by law to prescribe.'
Written agreement
Not required
Unconditional — general RN licensure is never subject to physician supervision or a practice agreement in Virginia, unlike the APRN/PA categories above.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — General RN licensure does not require a healing-arts Professional Corporation (§ 13.1-543) or PLLC (§ 13.1-1102) in the first place — RNs (unlike APRNs) are not enumerated as an eligible owner under either statute, but also don't independently render the kind of licensed clinical services those statutes govern. Non-clinical businesses an RN might own (home health agency, staffing agency) fall under general Stock Corporation/LLC law, not the healing-arts regime, and carry no ownership restriction.
For medical-aesthetics (med-spa) businesses performing delegated medical procedures such as Botox or laser, RN ownership of the entity does not remove the requirement for physician delegation and oversight of the procedures themselves; ownership and clinical delegation authority are separate questions. The delegation regulation commonly cited for laser is 18VAC85-20-91; confirm it before relying on it.
Sources for the supervision rules (3)
- Va. Code § 54.1-3000 — Definitions (Professional vs. Practical Nursing)
- 18VAC90-19 — Regulations Governing the Practice of Nursing
- Va. Code §§ 13.1-543, 13.1-1102 — Professional Corporation / PLLC ownership eligibilitysecondary
About Virginia's rules
No provider type below has a codified chart-review percentage, countersignature rule, or numeric proximity radius — all are left to the practice agreement. CPOM (ownership) is governed by Title 13.1's PC/PLLC statutes, which explicitly list APRNs (NP/CRNA/CNM/CNS) as eligible independent owners but do not enumerate PAs — the PA ownership pathway is an inference from that omission, not a confirmed holding. Virginia has no independent corporate-practice-of-medicine common-law doctrine (a 1992 AG opinion, secondary-sourced only).
Other clinicians in Virginia: see the state overview.