The competent and appropriately trained licensed practical nurse can perform triage under the direction of an authorized health care practitioner or under the direction and supervision of the registered nurse. The licensed practical nurse does not work “under” authorized health care practitioner's license the registered nurse's license. For example, it would not be within the licensed practical nurse's scope of practice to modify the standing or verbal order without consulting with the registered nurse or other authorized health care practitioner. The licensed practical nurse must consult with an authorized health care practitioner or the registered nurse if the patient's situation is going outside the standing order. Any changes to the standing order must be documented and communicated to an authorized health care practitioner or the registered nurse. The licensed practical nurse cannot provide nursing care independently. The licensed practical nurse must have the training, knowledge, skills and abilities to perform triage competently (RCW) 18.79, (WAC) 245-840 and Advisory Opinion on Telenursing. The licensed practical nurse must be competent to carry specific steps identified in the standing order or verbal order. The licensed practical nurse should use the Scope of Practice Decision Tree to determine if specific activities are within the licensed practical nurse's legal and individual scope of practice. The Nursing Care Quality Assurance Commission's Standing Orders and Verbal Orders Advisory Opinion provides additional guidance and recommendations.