The nursing laws and rules allow a competent and appropriately trained licensed practical nurse from performing laser therapy for cosmetic purposes under the direction of an authorized health care practitioner or under the direction and supervision of a registered nurse. Laser treatment requires a prescription from an authorized health care practitioner. The nurse should use the Scope of Practice Decision Tree to determine if these activities are within the nurse's legal and individual scope of practice. The nursing laws and rules do not require an authorized health care practitioner or RN to be on the premises when a LPN provides nursing care or performs medical regimens. However, the Medical Quality Assurance Commission WAC 246-919-605 Use of Laser, Light, Radiofrequency, and Plasma (LLRP) Devices as Applied to the Skin includes language and requirements for physicians. The physician rules allow delegation to a properly trained and licensed professional and require a physician to be on the immediate premises during the patient's initial treatment. The authorized health care practitioner may provide treatment following an established treatment plan during temporary absences of the prescribing physician provided there is a local back-up physician who will be available by telephone and see the patient within sixty minutes. The Nursing Care Quality Assurance Commission recommends the nurse follow the WAC 246-919-605 for physicians when carrying out laser treatment procedures under the direction of an authorized health care practitioner.