Wash. Rev. Code » Title 18 · Chapter 18.79
Revised Code of Washington

Wash. Rev. Code § 18.79.040 (2026)

"Registered nursing practice" defined—Exceptions

✓ current as of May 2026
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(1) "Registered nursing practice" means the performance of acts requiring substantial specialized knowledge, judgment, and skill based on the principles of the biological, physiological, behavioral, and sociological sciences in either:
(a) The observation, assessment, diagnosis, care or counsel, and health teaching of individuals with illnesses, injuries, or disabilities, or in the maintenance of health or prevention of illness of others;
(b) The performance of such additional acts requiring education and training and that are recognized by the medical and nursing professions as proper and recognized by the board to be performed by registered nurses licensed under this chapter and that are authorized by the board through its rules;
(c) The administration, supervision, delegation, and evaluation of nursing practice. However, nothing in this subsection affects the authority of a hospital, hospital district, in-home service agency, community-based care setting, medical clinic, or office, concerning its administration and supervision;
(d) The teaching of nursing;
(e) The executing of medical regimen as prescribed by a licensed physician and surgeon, dentist, osteopathic physician and surgeon, podiatric physician and surgeon, physician assistant, or advanced registered nurse practitioner, or as directed by a licensed midwife within his or her scope of practice.
(2) Nothing in this section prohibits a person from practicing a profession for which a license has been issued under the laws of this state or specifically authorized by any other law of the state of Washington.
(3) This section does not prohibit (a) the nursing care of the sick, without compensation, by an unlicensed person who does not hold himself or herself out to be a registered nurse, (b) the practice of licensed practical nursing by a licensed practical nurse, or (c) the practice of a nursing assistant, providing delegated nursing tasks under chapter 18.88A RCW.
[ 2025 c 58 s 5004; 2020 c 80 s 15; 2012 c 13 s 1; 2003 c 140 s 1; 1995 1st sp.s. c 18 s 50; 1994 sp.s. c 9 s 404.]

Notes:

Expiration date—2025 c 58 ss 5004, 5005, 5006, 5010, 5012, 5013, 5014, 5016, 5017, 5018, 5019, 5020, 5024, 5029, 5030, 5043, 5044, 5045, 5047, 5048, 5049, 5051, 5052, 5053, and 5055: "Sections 5004, 5005, 5006, 5010, 5012, 5013, 5014, 5016, 5017, 5018, 5019, 5020, 5024, 5029, 5030, 5043, 5044, 5045, 5047, 5048, 5049, 5051, 5052, 5053, and 5055 of this act expire June 30, 2027." [ 2025 c 58 s 5171.]
Explanatory note—2025 c 58: See note following RCW 1.16.050.
Effective date—2020 c 80 ss 12-59: See note following RCW 7.68.030.
Intent—2020 c 80: See note following RCW 18.71A.010.
Effective date—2003 c 140: "This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect immediately [May 7, 2003]." [ 2003 c 140 s 13.]
Conflict with federal requirements—Severability—Effective date—1995 1st sp.s. c 18: See notes following RCW 74.39A.030.
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RCW 18.79.040

"Registered nursing practice" defined—Exceptions. (Effective June 30, 2027.)

(1) "Registered nursing practice" means the performance of acts requiring substantial specialized knowledge, judgment, and skill based on the principles of the biological, physiological, behavioral, and sociological sciences in either:
(a) The observation, assessment, diagnosis, care or counsel, and health teaching of individuals with illnesses, injuries, or disabilities, or in the maintenance of health or prevention of illness of others;
(b) The performance of such additional acts requiring education and training and that are recognized by the medical and nursing professions as proper and recognized by the board to be performed by registered nurses licensed under this chapter and that are authorized by the board through its rules;
(c) The administration, supervision, delegation, and evaluation of nursing practice. However, nothing in this subsection affects the authority of a hospital, hospital district, in-home service agency, community-based care setting, medical clinic, or office, concerning its administration and supervision;
(d) The teaching of nursing;
(e) The executing of medical regimen as prescribed by a licensed physician and surgeon, dentist, osteopathic physician and surgeon, podiatric physician and surgeon, physician assistant, or advanced practice registered nurse, or as directed by a licensed midwife within his or her scope of practice.
(2) Nothing in this section prohibits a person from practicing a profession for which a license has been issued under the laws of this state or specifically authorized by any other law of the state of Washington.
(3) This section does not prohibit (a) the nursing care of the sick, without compensation, by an unlicensed person who does not hold himself or herself out to be a registered nurse, (b) the practice of licensed practical nursing by a licensed practical nurse, or (c) the practice of a nursing assistant, providing delegated nursing tasks under chapter 18.88A RCW.
[ 2024 c 239 s 2; 2020 c 80 s 15; 2012 c 13 s 1; 2003 c 140 s 1; 1995 1st sp.s. c 18 s 50; 1994 sp.s. c 9 s 404.]

Notes:

Effective date—2024 c 239: See note following RCW 18.79.030.
Effective date—2020 c 80 ss 12-59: See note following RCW 7.68.030.
Intent—2020 c 80: See note following RCW 18.71A.010.
Effective date—2003 c 140: "This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect immediately [May 7, 2003]." [ 2003 c 140 s 13.]
Conflict with federal requirements—Severability—Effective date—1995 1st sp.s. c 18: See notes following RCW 74.39A.030.
Notes of Decisions
Cited in 5 cases (2 in the last 5 years), 1998–2025 · leading case: McKenna v. Harrison Mem'l Hosp., 960 P.2d 486 (Wash. Ct. App. 1998).
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McKenna v. Harrison Mem'l Hosp., 960 P.2d 486 (Wash. Ct. App. 1998). “035 (definition of practice of podiatric medicine and surgery); RCW 18.79.040 (definition of registered nursing practice); RCW 18.”
Kasey Cahan, Appellant/cross-respondent V. Franciscan Health Sys., Respondent/cross-appellant (Wash. Ct. App. 2021). · cites it 3× “” RCW 18.79.040(1); see also WAC 246-840-705(3) (“The [RN] functions in an independent role when utilizing the nursing process .”
Stephens v. UW Med. (W.D. Wash. 2025). · cites it 3× “Plaintiff also cites to RCW 18.79.040 and RCW 18.79.260. (See Dkt.”
State v. Vietz, 973 P.2d 501 (Wash. Ct. App. 1999). “79 describes various nursing classifications and sets forth different licensing requirements for registered nurses, RCW 18.79.040; advanced registered nurse practitioners, RCW 18.”
Frausto v. Yakima HMA, LLC (Wash. 2017). “040(1)(a). "Diagnosis" has been defined in the registered nursing context as "the identification of, and discrimination between, the person's physical and psychosocial signs and symptoms.”
— Wash. Rev. Code § 18.79.040(1) — 1 case
Kasey Cahan, Appellant/cross-respondent V. Franciscan Health Sys., Respondent/cross-appellant (Wash. Ct. App. 2021). “” RCW 18.79.040(1); see also WAC 246-840-705(3) (“The [RN] functions in an independent role when utilizing the nursing process .”
— Wash. Rev. Code § 18.79.040(1)(a) — 2 cases
Frausto v. Yakima HMA, LLC (Wash. 2017). “040(1)(a). "Diagnosis" has been defined in the registered nursing context as "the identification of, and discrimination between, the person's physical and psychosocial signs and symptoms.”
Kasey Cahan, Appellant/cross-respondent V. Franciscan Health Sys., Respondent/cross-appellant (Wash. Ct. App. 2021). “” RCW 18.79.040(1); see also WAC 246-840-705(3) (“The [RN] functions in an independent role when utilizing the nursing process .”
— Wash. Rev. Code § 18.79.040(1)(e) — 1 case
Kasey Cahan, Appellant/cross-respondent V. Franciscan Health Sys., Respondent/cross-appellant (Wash. Ct. App. 2021). “” RCW 18.79.040(1); see also WAC 246-840-705(3) (“The [RN] functions in an independent role when utilizing the nursing process .”
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