In Washington State, the Nurse Practice Act (NPA) establishes the rules and responsibilities for the nursing profession. The law also authorizes the Washington State Board of Nursing (the Board) to take disciplinary action when violations occur.
The following overview of the NPA and other relevant laws in Washington will help you better understand what is and isn't allowed of nurses in the state. If you're facing disciplinary action, be aware we at the Lento Law Firm's Professional License Defense Team offer Washington nurse license defense services. Find out more about how we can protect your career and your license by calling us at 888-535-3686 or submitting your information through our online contact form.
Permitted Activities for a Registered Nurse in Washington
The NPA establishes the professional nursing activities a registered nurse in Washington may engage in. Under the law, a registered nurse may perform general nursing tasks. As ordered and/or supervised by a qualified medical professional (such as a doctor or an advanced registered nurse practitioner), they may perform such tasks as administering:
- Treatments
- Medications
- Tests
- Inoculations
A registered nurse is also authorized to delegate certain tasks as they see fit. They may only delegate tasks which are already in their scope of practice, and they must supervise anyone to whom they delegate such tasks.
Permitted Activities for an Advanced Registered Nurse Practitioner in Washington
The Washington NPA states that an advanced registered nurse practitioner in Washington may provide general nursing care. Additionally, they can perform certain acts that cannot be performed by those without the necessary license. Specifically, they can:
- Perform certain advanced and specialized nursing tasks as recognized by both nursing and medical professionals
- Prescribe “legend drugs” (more information on what constitutes a legend drug in Washington State here), Schedule V controlled substances, and Schedule II through Schedule IV controlled substances in accordance with applicable laws
- Perform all tasks a registered nurse may legally perform
Permitted Activities for an Advanced Practice Registered Nurse
According to the law, an advanced practice registered nurse may generally perform the same types of acts and tasks as an advanced registered nurse practitioner in Washington. However, the law's wording is vague in regard to the “advanced levels of nursing as recognized jointly by the medical and nursing professions” an advanced practice registered nurse may perform.
Thus, it's important for anyone in this position to understand how their specialized training and certifications prepare them to handle certain nursing tasks. If an advanced practice registered nurse is unsure of whether they have the authority to perform a particular task, they should notify a supervisor accordingly. Per the law, all types of nurses in Washington should consider their own abilities and capacities when assessing whether they are qualified to fulfill certain specific duties.
The Uniform Disciplinary Act for the Regulation of Health Professions Defines Unprofessional Conduct for Washington State Nurses
In Washington, the Uniform Disciplinary Act is a general law applying to numerous types of medical professionals, including nurses. The law defines the following as examples of unprofessional conduct for which a nurse or other such medical professional may face disciplinary action:
- An act of “moral turpitude, dishonesty, or corruption” that reasonably relates to the individual's profession, even if the act doesn't technically constitute a crime
- Misrepresenting or concealing a relevant fact when seeking a license
- False, fraudulent, or otherwise misleading forms of advertising
- Carelessness, negligence, or incompetence that either results in patient injury or puts patients at unreasonable risk of being injured
- Using, possessing, prescribing, or distributing legend drugs or controlled substances in a way inconsistent with accepted and necessary therapeutic purposes
- Violating any state or federal law applying to a license holder's specific medical profession
- Aiding and abetting an unlicensed individual attempting to practice nursing (or another form of medicine)
- Violating any health agency's established rules
- Practicing beyond the scope of one's practice based on the legal definition
- Engaging in misrepresentation or fraud in any capacity related to one's profession
- Failing to monitor auxiliary staff to such a degree that the health or safety of patients is jeopardized
- Knowingly performing tasks that involve contact with or exposure to the public while having a contagious or infectious disease that renders one a danger to patients
- Promoting an unnecessary or inefficacious drug, treatment, or other such product or service for personal gain
- Being convicted of a felony or gross misdemeanor related to one's profession (Note: Guilty pleas and pleas of nolo contendere qualify as convictions for the purposes of this law)
- Offering a “secret” cure or treatment method for an illness and refusing to share information about said treatment method with the licensing or disciplinary authority
- Misusing alcohol, legend drugs, or controlled substances
- Accepting gifts or gratuities from representatives or vendors of health-related products beyond what is reasonably accepted within the profession
- Not providing a patient with the necessary written notice when providing a stem cell therapy that isn't currently approved by the FDA
- Performing conversion therapy on a patient under 18 years of age
- Not following proper procedures regarding allowing students to perform pelvic exams on patients who are unconscious or anesthetized
- Performing any procedure that constitutes female genital mutilation under the law
- Implanting a patient with one's own gametes or reproductive material
Being accused of any form of unprofessional conduct can have significant implications for your nursing career both in Washington State and elsewhere. If you're facing disciplinary action, our Professional License Defense Team at the Lento Law Firm is prepared to offer the representation you deserve now.
Failing to Cooperate With a Disciplinary Authority May Result in Disciplinary Action for Nurses
The Uniform Disciplinary Act also prohibits nurses and other medical professionals from failing to cooperate with a disciplinary authority. This can involve:
- Not providing the authority with documents upon request
- Not responding to a complaint with a written statement thoroughly addressing the matter that prompted disciplinary proceedings
- Failing to respond to subpoenas the disciplinary authority issued
- Not allowing representatives of the authority to access a medical facility for the purposes of practice reviews in a reasonable and timely manner
- Not complying with a disciplinary authority's order
- Not complying with a disciplinary authority's stipulation for informal disposition
Complying with requests from the Board during disciplinary proceedings is very important. Because failure to comply with such requests or orders constitutes justification for disciplinary action in and of itself, the consequences you might face for failure to comply with a request could be in addition to any disciplinary action you might have already faced.
That said, it's also important to be careful when providing the Board with documents or otherwise fulfilling a Board request. You want to be confident you've supplied the pertinent information or records without supplying anything unnecessary that could potentially have a negative impact on your case.
We at the Lento Law Firm Professional License Defense Team can help in this capacity. If we're representing you, any time the Board contacts you with a request, you can get in touch with us for assistance regarding the best next steps.
Interfering With a Disciplinary Proceeding is a Form of Unprofessional Conduct for Washington State Nurses
The Uniform Disciplinary Act also states that it constitutes unprofessional conduct for a nurse to interfere with a disciplinary investigation or proceeding. Specific acts the law prohibits are:
- Willfully misrepresenting facts to either the Board itself or any of its representatives
- Threatening or harassing patients or other witnesses in an attempt to stop them from providing evidence in a disciplinary proceeding
- Bribing or otherwise attempting to financially induce a patient or witness to stop them from providing evidence in a disciplinary proceeding
When you're called to provide testimony of any kind to the Board or its representatives, doing so accurately and honestly is of paramount importance. Our Professional License Defense Team at the Lento Law Firm can help you ensure you're providing said testimony and information in accordance with the law.
Types of Misconduct That Can Result in Disciplinary Action for a Nurse in Washington
The Board may take disciplinary action when a nurse engages in various forms of misconduct. These forms of misconduct do not completely overlap with the forms of unprofessional conduct under the Uniform Disciplinary Act, which this guide has already covered.
In Washington, specific forms of misconduct nurses are prohibited from engaging in are:
- Not properly evaluating the status of a patient or not properly addressing a patient's needs after assessing their status or condition
- Willfully or repeatedly failing to properly document relevant aspects of a patient's treatment, progress, etc.
- Willfully or repeatedly engaging in various forms of misconduct regarding employee, employer, or client records, such as not making entries, altering entries, attempting to destroy entries, providing entries with false information, etc.
- Engaging in willful or repeated failure to administer medications and/or treatments in a manner that conforms with accepted nursing standards
- Engaging in willful or repeated failure to adhere to an employer's established policies and procedures regarding medication wastage
- Signing a record confirming proper wastage of a controlled substance when one didn't actually witness said wastage
- Willfully or repeatedly contributing to a client's abuse (whether it be physical or emotional)
- Not taking proper steps to protect patients from threats and risk factors like dangerous environments, abuse, etc.
- Delegating responsibilities to someone who one knows lacks the experience, training, or qualifications necessary to handle said responsibilities properly
- Delegating nursing responsibilities but not properly monitoring those to whom said responsibilities were delegated
- Performing or attempting to perform nursing tasks, procedures, techniques, etc., that one knows one isn't qualified for and/or not receiving proper permission and supervision to attempt such techniques
- Violating patient confidentiality except in instances when sharing private patient information is a legal requirement or is necessary for a patient's safety
- Writing prescriptions for drugs without receiving authorization from the commission to do so
- Appropriating personal items, supplies, medication, or equipment belonging to a patient, client, agency, or institution for personal use
- Practicing nursing while under the influence of drugs or alcohol
- Practicing nursing while affected by a mental, physical, or emotional condition that deprives one of being able to practice without unreasonable risk to patients
- Willfully abandoning patients who one knows require continued attention by leaving a nursing assignment but not transferring one's responsibilities to another nurse, medical professional, or other such relevant caregiver
- Conviction or any crime involving physical or sexual abuse (with guilty pleas and pleas of nolo contendere counting as convictions)
- Conviction of any crime related to a patient's property
- Not following mandatory reporting rules
- Attempting to practice nursing with a license that isn't valid in Washington State
- Allowing another person to use one's nursing license
- Not being aware of and/or adhering to the laws covering nursing in Washington
- Aiding, abetting, or otherwise assisting anyone in violating rules or laws pertaining to nursing
- Disclosing or soliciting the contents of a licensing examination
These may not be the only forms of misconduct that can trigger a Board investigation. Per the statute, any failure to adhere to the standards of nursing conduct or practice as defined by Washington State law can constitute a form of misconduct warranting disciplinary action.
Prohibitions Against Sexual Misconduct for Washington State Nurses
The law defining forms of misconduct nurses may not engage in also states they can't engage in any form of sexual misconduct as Washington State law defines it for nurses. The statute specifically prohibits engaging in these acts with current patients, current clients, and “key parties,” whether in a healthcare setting or elsewhere.
Under the law, prohibited forms of sexual misconduct for nurses include:
- Sexual intercourse
- Touching sexualized body parts outside of consistent standards of practice
- Rubbing up against someone for anything other than a legitimate healthcare purpose
- Kissing, hugging, or otherwise touching in a sexual or romantic manner
- Not giving patients privacy when they undress except in unique situations when observing patients is necessary
- Touching or examining genitals without gloves
- Not providing a patient a draping or gown except in emergency situations
- Removing the gown or draping of a patient without their consent in non-emergency situations
- Masturbating or engaging in a similar act in the presence of a patient or other such party
- Ending the professional relationship out of a desire to start a romantic or sexual one
Those are just examples. Reference the law for a complete list of prohibited acts, and contact our Professional License Defense Team at the Lento Law Firm if you're facing disciplinary action because you've been accused of misconduct.
Get Help With Your Washington State Nurse Practice Act Case
An alleged violation of the NPA in Washington State can lead to disciplinary action ranging from a mild warning to revocation of your nursing license. If you've been accused of a violation, take action to protect your career by enlisting the help of the Lento Law Firm's Professional License Defense Team. Get started today by submitting your information through our online form or calling our offices at 888-535-3686.
