The nursing laws and rules requires general supervision of a licensed practical nurse. The nursing law and rule does not require the registered nurse or an authorized health care practitioner to be on the premises when a licensed practical nurse provides care in any setting. A facility or supervisor may require direct or immediate supervision for specific activities or if there are concerns about the licensed practical nurse's competency. An exception exists in the physician rules that require a physician to be on the immediate premises during the patient's initial treatment when a nurse is performing laser therapy: WAC 246-919-605 Use of Laser, Light, Radiofrequency, and Plasma (LLRP) Devices as Applied to the Skin.