End of COVID-19 Emergency Orders and State of Emergency by October 31

On Sept. 8, Gov. Jay Inslee announced the upcoming rescission of all remaining COVID-19 emergency proclamations and state of emergency by Oct. 31.

Commonly Asked Questions - Nurse Technician

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 Nursing Care Quality Assurance Commission (NCQAC) 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 and interpretive statements about specific areas of nursing practice.

These commonly asked questions and answers offer information and general guidance regarding the practice of professional nursing in the State of Washington and 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 contact nursingpractice@doh.wa.gov or arnppractice@doh.wa.gov for questions about advanced nursing practice. 

Prevention and Treatment of Opioid-Related Overdoses
What opioid antagonists are commonly prescribed to reverse the effects of opioid overdose?

Opioid antagonists reverse the effects of an opioid overdose. Naloxone (Narcan®) is the current standard of treatment for opioid overdose. The Food and Drug Administration (FDA) approves administration by intravenous, intramuscular, or subcutaneous routes; a hand-held auto-injector (Evzio®) for intramuscular or subcutaneous injection; and, in 2018, approved the first generic Naloxone Hydrochloride nasal spray. These are legend drugs, and not categorized as a controlled substance. Naloxone has not been shown to produce tolerance or cause physical or psychological pain. It will produce withdrawal symptoms. Severity and duration of the withdrawal relate to the dose of naloxone and the degree and type of opioid dependency. See the Washington State Department of Health Overdose Education and Naloxone Distribution Webpage for more information.

Is the Nursing Technician required to carry naloxone?

RCW 69.41.095 does not require the Nursing Technician to carry an opioid antagonist, such as naloxone. For more information, go to the Washington State Department of Health Overdose Education and Naloxone Distribution Website.

Can the Nursing Technician administer naloxone to a patient who has a prescription for a suspected opioid overdose?

The Nursing Technician may administer an opioid antagonist (such as naloxone) by injection or by the intranasal route. The Nursing Technician must have a valid prescription, either in the Nursing Technician's name, in the name of an entity, in the name of a person/patient, or following a standing order approved by an authorized health care practitioner. For more information, go to the Washington State Department of Overdose Education and Naloxone Distribution Website.

Can the Nursing Technician carry naloxone for emergent administration for suspected overdose and administer it to an unknown person?

RCW 69.41.095 allows the Nursing Technician, or any person, to carry and administer an opioid antagonist (such as naloxone) to a person suspected of experiencing an opioid overdose in any setting. The Nursing Technician must have a valid prescription, either in the Nursing Technician's name, in the name of an entity, in the name of a person/patient, or following a standing order approved by an authorized health care practitioner.

Can the Nursing Technician get a prescription for Naloxone?

The Nursing Technician may get a prescription from a pharmacist with a Collaborative Drug Therapy Agreement (CDTA), or use the Washington State Department of Health Statewide Standing Order to Dispense Naloxone. Anyone can take this standing order to a pharmacy to get a prescription. The Nursing Technician may also get a prescription in their own name from their health care practitioner. For more information, go to the Washington State Department of Health Overdose Education and Naloxone Distribution Website.

Can the Nursing Technician distribute naloxone?

RCW 69.41.095 allows the Nursing Technician with a prescription, or following standing orders, to possess, store, deliver, distribute, or administer an opioid antagonist (such as naloxone) to a person at risk of experiencing an opioid related overdose. For more information, go to the Washington State Department of Health Overdose Education and Naloxone Distribution Website.

Is the Nursing Technician required to have a special certification or specific training to distribute or administer naloxone for a suspected drug opioid overdose?

The Nursing Technician is not required to have a specific training course or certification. Stop Overdose.com offers education, resources, and technical assistance for individuals, professionals, and communities in Washington State who want to learn to prevent and respond to overdose and improve the health of people who use drugs. An employer or institution may have specific training or certification requirements. For more information and training resources, go to the Washington State Department of Health Overdose Education and Naloxone Distribution Website.

Can the Nursing Technician get a prescription to carry and administer naloxone in a non-work setting?

RCW 69.41.095 allows the Nursing Technician to have a prescription for an opioid antagonist (such as naloxone) in the Nursing Technician's name to carry and administer in the non-work setting. The Nursing Technician may carry and administer an opioid antagonist in a suspected opioid overdose whether the person is a family member, friend, stranger, or a patient. For more information, go to the Washington State Department of Health Overdose Education and Naloxone Distribution Website.

Is direct supervision by the Nurse Technician's supervising nurse required for the Nurse Technician to administer naloxone to a patient for a suspected opioid overdose?

RCW 69.41.095 provides an exception to the nursing delegation laws and rules and does not require the Nurse Technician's supervising nurse to provide direct supervision for a Nurse Technician to administer naloxone. The Nurse Technician assistant may administer an opioid antagonist (such as naloxone) to an assigned patient by intranasal spray or injection without direct supervision. This may be done for the patient with a prescription, using an entity's prescription, or using the Nurse Technician's personal naloxone prescription. Any person or entity may lawfully possess, store, deliver, distribute, or administer an opioid overdose reversal medication with a prescription or standing order. For more information, go to the Washington State Department of Health Overdose Education and Naloxone Distribution Website.

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Telemedicine Training Requirements
Is the nursing technician (NT) required to take telemedicine training?

The NT is not required to take telemedicine training. It is not within the scope of practice of the NT to function as the clinical provider for the purpose of diagnosis, consultation, or treatment. The NT must function under the direction and supervision of the registered nurse who agrees to act as a supervisor of the NT. The NT may function in the role of telepresenter to facilitate the visit including supporting communications, clinical (within their scope of practice), and technical workflows through the tele-encounter process.

RCW 43.70.495 requires health care professionals who provide clinical services through telemedicine independently or under the direction of an authorized health care practitioner to complete telemedicine training. “Telemedicine” as defined in RCW 70.41.020(13) means, “the delivery of health care services through the use of interactive audio and video technology, permitting real-time communication between the patient at the originating site and the provider, for the purpose of diagnosis, consultation, or treatment [but] does not include the use of audio-only telephone, facsimile, or email.”