Advisory Opinions
Overview
The broadly written laws and rules allow nurses to practice to their full scope of practice in any setting. It is impossible for the Washington Board of Nursing (WABON) to provide a comprehensive listing of the duties that licensed nurses are permitted to perform since nursing practice is reflective of the dynamic changes occurring in healthcare and society. The Revised Code of Washington (RCW) 18.79 and Washington Administrative Code (WAC) 246-840 provide the statutory and legal basis of nursing practice. The nursing commission provides advisory opinions, interpretive statements, and guidance documents related to specific areas of nursing practice.
These documents are approved by WABON and offer information and general guidance regarding the practice of professional nursing in the State of Washington. However, they do not constitute legal advice. You should contact your legal advisor to obtain advice with respect to any particular issue or problem.
If you have a question related to nursing practice in the state of Washington, please use the tools provided by the scope of practice decision tree and the approved documents below.
Other Guidance Documents
- Nursing Assistant Registered and Nursing Assistant Certified Scope of Practice Comparison (PDF)
- Job Titles: Can a RN work as a LPN? Can a LPN work as a NA? (PDF)
- LPN and Medical Assistant Scope of Practice Comparison (PDF)
- Medication Organizer Device, Letter from Secretary of Health (PDF)
- Medication Organizer Device (PDF)
- Questions of Assignment (PDF)
- Field Trips and Medication Administration (PDF)
- Staff Model for the Delivery of School Health Services (PDF)
- Who may administer, read and interpret a Tuberculin Skin Test (TST) in Washington state (PDF)
- RN authority with COVID-19 CLIA-waived tests in school settings (PDF)
- Non-Nurse Licensure Compact (NLC) State Comparison Summary School Registered Nurse Delegation – Out-of-State Field Trips (.docx)
Additional Advisory Resources
For further guidance, please contact nursingpractice@doh.wa.gov or arnppractice@doh.wa.gov for advanced nursing practice questions.
| Document ID | Name | Approved Date | Nurse Type | Nursing Group Type | |
|---|---|---|---|---|---|
| NCAO 1.01 | Perioperative Registered Nurse First Assistant (RNFA) | RN, LPN, ARNP | Surgical Settings, Perioperative Nursing, Surgical Nursing | ||
| NCAO 2.01 | Camp Nursing | RN, LPN, NA, UAP | Camp Nursing, Non-Traditional Health Care Setting, School Nursing, Nursing Delegation | ||
| NCAO 3.00 | Neonatal Intubation and Related Procedures | RN, LPN, ARNP | All Settings | ||
| NCAO 5.02 | Portable Orders for Life Sustaining Treatment (POLST) – Scope of Practice for the Registered Nurse (RN), Licensed Practical Nurse (LPN), and Nursing Assistant-Registered/Nursing Assistant-Certified (NA-R/NAC) | RN, LPN, ARNP, NA, UAP | All Settings, POLST | ||
| NCAO 7.10 | Administration of Sedating, Analgesic, and Anesthetic Agents | RN, LPN | All Settings, Medication Management, Medication Administration | ||
| NCAO 8.10 | Prevention and Treatment of Opioid-Related Overdoses | RN, LPN, ARNP, NA, UAP, NT | All Settings | ||
| NCAO 9.00 | Public Health Nurses: Dispensing Medications/Devices for Prophylactic and Therapeutic Treatment of Communicable Diseases and Reproductive Health | RN, LPN | All Settings, Public Health Nursing, Medication Management, Standing Orders | ||
| NCAO 10.00 | Completion of Death Certificates by Advanced Registered Nurse Practitioners | RN, LPN | All Settings | ||
| NCAO 11.01 | Compounding and Reconstituting Medications | RN, LPN | All Settings, General, Medication Management | ||
| NCAO 12.00 | Medical Acupuncture | ARNP | All Settings, Holistic Nursing, Complementary Nursing, Alternative Nursing | ||
| NCAO 13.02 | Registered Nurse and Licensed Practical Nurse Scope of Practice | RN, LPN | All Settings, General SOP | ||
| NCAO 14.10 | Delegation of Blood Glucose Monitoring | RN, LPN, NA, UAP | Nursing Delegation, Community-Based Nursing, Home Care Nursing | ||
| NCAO 15.01 | Registered Nurse Delegation in School Settings | RN, LPN, NA, UAP | School Nursing, Nursing Delegation, Non-Traditional Health Care Setting | ||
| NCAO 16.01 | Opioid Use Disorder Medication Assisted Treatment – Nurse Care Managers and Scope of Practice | RN, ARNP | Nurse Case Managers, Nurse Care Coordinators, Behavioral Health Nursing, Medication Management, Substance Use Disorder, Controlled Substances, Mental Health, Medication Assisted Treatment Facilities, Behavioral Health Facilities, Psychiatric Hospitals, Mental Health Facilities, Substance Use Disorder Facilities | ||
| NCAO 17.01 | Administration of Cannabis/Marijuana Products in School Settings | RN, LPN | School Nursing, Nursing Delegation, Non-Traditional Health Care Setting | ||
| NCAO 18.00 | Advanced Registered Nurse Practitioner Scope of Practice: Repetitive Transcranial Magnetic Stimulation (rTMS) | ARNP | All Settings, Mental Health, Behavioral Health | ||
| NCAO 19.00 | Role of the Nurse in Supervised Injection Services (SIS) Facilities | RN, LPN, ARNP | Nurse Case Managers, Nurse Care Coordinators, Behavioral Health Nursing, Medication Management, Substance Use Disorder, Controlled Substances, Mental Health, Medication Assisted Treatment | ||
| NCAO 20.03 | Death with Dignity (Aid-in-Dying): Role of the Nurse | RN, LPN, ARNP | All Settings, POLST | ||
| NCAO 21.00 | Mobile Anesthesia: Scope of Practice for Advanced Registered Nurse Practitioners | ARNP | |||
| NCAO 22.00 | Naloxone Prescribing Clarification | RN, LPN, ARNP, NA, UAP | All Settings | ||
| NCAO 23.01 | Determining, Pronouncing, and Certifying Death | RN, LPN, ARNP, NA, UAP | All Settings, POLST | ||
| NCAO 24.00 | Infusion Therapy Management | RN, LPN, ARNP | All Settings, Medication Management, Medication Administration | ||
| NCAO 25.00 | Nursing Telehealth Practice: Registered Nurse, Licensed Practical Nurse, Nursing Technician, and Nursing Assistant | RN, LPN, NA, UAP, NT | All Settings | ||
| NCAO 26.00 | Telehealth Advanced Practice Nursing Care Services | ARNP | All Settings | ||
| NCAO 27.00 | Cosmetic/Aesthetic Dermatologic Procedures | RN, LPN, ARNP | All Settings | ||
| NCAO 28.01 | Standing Orders | RN, LPN, ARNP | All Settings | ||
| NCAO 29.01 | Verbal Orders | RN, LPN, ARNP | All Settings | ||
| NCAO 30.00 | Seizure Disorder Management: Nursing Care Coordination | RN, LPN, NA, UAP | All Settings | ||
| NCAO 31.00 | Endoscopy – Role of the Licensed Practical Nurse | LPN | All Settings |