Nurse Practitioner Scope of Practice: Washington State

I’m headed home to the great State of Washington this week for a visit with the fam.  So, covering Washington State’s NP scope of practice seemed like a natural fit for this post.  Washingtonians are a quirky group of outdoorsy, coffee-loving, rain tolerant folks.  They take pride in everything related to the northwest and it’s spirit of exploration, innovation and adventure.  But do laws regulating nurse practitioners in Washington State reflect these values?

As a nurse practitioner student, I once took an exam with a question asking “Which state has the loosest laws surrounding NP practice?”.  While I wasn’t sure of the answer, I correctly picked Washington State from the multiple choice list.  Yes, Washington State is known for having some of the most relaxed rules and regulations governing nurse practitioners allowing them to practice to the fullest extent of their education.  Let’s take a look at the specifics.

Washington State’s Nurse Practitioner Supervision Laws

There’s not much to discuss regarding NP supervision laws in Washington because, well none exist.  Nurse practitioners in Washington State are permitted to practice without any physician involvement whatsoever.  State law recognizes NP’s as “qualified to assume primary responsibility and accountability for the care of patients.  While Washington’s NP scope of practice regulations state that the nurse practitioner “shall obtain instruction, supervision and consultation as necessary before implementing new or unfamiliar practices“, it does not specifically require that this instruction and supervision be from a physician.

Washington State recognizes nurse practitioners as fully capable of the following:

  • Examining patients and establishing a diagnosis
  • Admitting, managing and discharging patients from a healthcare facility
  • Ordering, performing and interpreting diagnostic tests
  • Managing healthcare by developing and evaluating a plan of care
  • Prescribing therapies and medical equipment
  • Prescribing medications
  • Referring patients to other healthcare providers
  • Performing procedures within the scope of practice

Nurse practitioners in Washington State are among the few in the country to practice with complete independence.

Washington State’s Nurse Practitioner Prescribing Laws

While Washington State allows nurse practitioners to prescribe Schedule II-V substances without any physician involvement, there are a few regulations placed around nurse practitioner’s prescribing abilities.  Namely, NP’s in Washington State must complete 15 hours of continuing education in pharmacology for each license renewal period in order to maintain prescriptive authority.

In keeping with it’s lax NP rules and regulations, Washington State is the only state in the country that allows nurse practitioners to prescribe medical marijuana.

Other Scope of Practice Laws in Washington State

Governed by progressive ideals, NP’s in Washington are allowed to do all the extras.  From signing death certificates to dolling out handicap parking permits and being recognized as official primary care providers, NP’s in WA can do it all.

Nurse practitioners play a pivotal role in providing healthcare to Washingtonians.  Hopefully, like Washington, other states will begin to acknowledge the potential that lies within allowing nurse practitioners to practice to the fullest extent of their abilities.