HB 2339 is a nursing regulation bill that revises Washington’s nursing chapter to update and clarify definitions, licensing categories, title protections, and scope-of-practice rules. It distinguishes among registered nurses, advanced practice registered nurses, nurse practitioners, certified nurse practitioners, certified nurse midwives, certified registered nurse anesthetists, and certified clinical nurse specialists, and it updates the statutory language governing who may use each title and abbreviation. The bill also revises application and interim-permit provisions, board authority, and various exemptions so the chapter more clearly describes what activities do and do not constitute the practice of nursing.
A major part of the bill addresses what advanced practice nurses may do, including prescribing legend drugs and certain controlled substances within their lawful scope, while preserving limits on activities such as major surgery, death pronouncement, and certain controlled-substance authority. It also adds or refines provisions for certified registered nurse anesthetists, including authority tied to facility protocols and physician/dentist/podiatrist requests, and it clarifies that advanced practice registered nurses may hold themselves out under the protected titles authorized by law. The bill includes effective-date and expiration provisions for some sections, indicating that parts of the act are temporary or phased in.
The bill’s impact on state law is to modernize and reorganize the statutes in chapter 18.79 RCW governing nursing practice and licensure. It affects the Washington State Board of Nursing, the Department of Health, nursing applicants, licensed practical nurses, registered nurses, advanced practice registered nurses, and specialized advanced practice roles. By tightening definitions and title-use rules, the bill strengthens enforcement against unlicensed practice and unauthorized use of nursing credentials, while also clarifying the legal authority of licensed nurses to perform specified clinical functions.
The overall sentiment around the bill appears strongly favorable. It passed the House committee unanimously, passed the House floor with overwhelming support, and then passed the Senate committee and Senate floor with only minimal opposition. The vote pattern suggests broad bipartisan agreement that the nursing statutes needed updating and clarification.
The main points of contention, to the extent they appear in the bill text and vote history, center on the boundaries of advanced practice authority and the regulation of controlled substances. The bill carefully limits what advanced practice nurses and nurse anesthetists may prescribe, order, or administer, and it preserves restrictions on major surgery and death pronouncement. Those limits likely reflect the policy balance between expanding nursing practice authority and maintaining physician oversight or facility-specific protocols, but the recorded votes show little public division over those issues.
The bill amends multiple provisions in chapter 18.79 RCW to update the legal framework for nursing licensure, practice, and title protection in Washington. It changes statutory definitions, licensing requirements, interim permits, and exemptions, and it clarifies the scope of practice for registered nurses, licensed practical nurses, advanced practice registered nurses, and specialized advanced practice roles such as nurse practitioners, nurse midwives, nurse anesthetists, and clinical nurse specialists. It also affects the Department of Health and the Board of Nursing by refining their authority over applications, education criteria, and enforcement against unauthorized practice.
The bill was received positively throughout the legislative process. It advanced out of the House Health Care & Wellness Committee on a 15-0 vote, passed the House 93-2, cleared the Senate Health & Long-Term Care Committee 10-1, and passed the Senate 49-0. That voting pattern indicates broad support for the bill’s modernization of nursing law and relatively limited opposition.
The most notable policy tension involves how far to expand or clarify nursing authority, especially for advanced practice nurses and certified registered nurse anesthetists. The bill authorizes certain prescribing and practice functions but keeps explicit limits on major surgery, death pronouncement, and controlled-substance authority outside the defined scope of practice. Any contention appears to have been about balancing expanded nursing autonomy with patient-safety and oversight concerns, though the near-unanimous votes suggest those concerns did not generate significant legislative resistance.