SHB 2339
SignedHouse
Nursing
Concerning the regulation of nursing. (CORRECTED COPY)
How does a bill become law?
- Introduced: The bill is filed and assigned a number.
- Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
- Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
- Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
- Governor: The Governor reviews the bill and decides whether to sign or veto it.
- Signed: The bill has been signed into law.
AI Analysis
This bill updates Washington State’s nursing practice laws by replacing the term 'advanced registered nurse practitioner' with 'advanced practice registered nurse' and revising related titles, abbreviations, and licensing language to align with national standards and improve consistency. It does not change scope of practice but updates how providers identify themselves and how the law refers to them.
- Replaces the term 'advanced registered nurse practitioner' with 'advanced practice registered nurse' throughout the nursing practice chapter, including in definitions and licensing provisions.
- Updates title and abbreviation usage: 'A.R.N.P.' becomes 'A.P.R.N.', and 'nurse practitioner' is no longer a standalone title—only 'certified nurse practitioner' and other specific titles are authorized.
- Clarifies that only licensed individuals may use protected titles and abbreviations (e.g., R.N., L.P.N., A.P.R.N., C.N.P., C.N.M., C.R.N.A., C.N.S.), with exceptions for Christian Science nurses under specific conditions.
- Maintains existing exemptions for student practice, volunteer activities, emergency care, and out-of-state nurses under specific circumstances, while updating references to align with the new terminology.
- Reaffirms that certified registered nurse anesthetists (CRNAs) who did not obtain prescriptive authority before July 1, 2026, may still select, order, or administer Schedule II–IV controlled substances only under strict protocols and facility-specific guidelines for anesthesia-related procedures.
Who is affected
- Nurses (registered, licensed practical, and advanced practice) — Nurses licensed or seeking licensure in Washington must now use updated titles and abbreviations (e.g., 'advanced practice registered nurse' instead of 'advanced registered nurse practitioner') and follow revised licensing rules.
- Patients receiving nursing care — Patients may benefit from clearer communication about provider credentials and continuity of care, especially as the bill standardizes titles and clarifies scope-of-practice rules for advanced practice nurses.
- Nursing education programs and institutions — Educational programs must ensure their curricula and graduates meet updated licensing definitions and requirements, especially for advanced practice nursing programs.
- Healthcare employers and facilities — Healthcare facilities and employers must align policies, job descriptions, and credentialing processes with the updated titles and scope-of-practice language in state law.
Pro/Con Analysis
Stronger case for benefits
Potential Benefits (3)
Aligning Washington’s terminology with national standards (e.g., American Nurses Association, National Council of State Boards of Nursing) improves consistency across state lines, facilitating licensure portability, continuing education recognition, and national workforce mobility for nurses.
HealthcareRef: Sec. 2, 4 (replacing 'advanced registered nurse practitioner' with 'advanced practice registered nurse' and updating abbreviations)Strengthening title protection reduces consumer confusion and potential misrepresentation, enhancing patient safety by ensuring only qualified individuals may use protected designations — this improves transparency and accountability in provider identification.
HealthcareRef: Sec. 3(2), Sec. 4(2) (clarifying protected titles and abbreviations, including exceptions for Christian Science nurses)Explicitly updating exemption language to reflect the new terminology ensures legal clarity for students, volunteers, and traveling providers, reducing ambiguity in enforcement and supporting continuity of care during emergencies or in underserved areas.
HealthcareRef: Sec. 10, Sec. 12 (reaffirming exemptions for student practice, volunteer activities, emergency care, and out-of-state nurses)
Potential Concerns (3)
The terminology change may cause temporary confusion among patients and providers during the transition period, especially for patients who are familiar with the term 'nurse practitioner' and may misinterpret or distrust the new title — though the bill explicitly states that scope of practice does not change, the rebranding could erode trust if not accompanied by clear public education.
HealthcareRef: Sec. 2, 4 (replacing 'advanced registered nurse practitioner' with 'advanced practice registered nurse' and updating abbreviations)Removal of 'nurse practitioner' as a standalone title may disrupt continuity of care and patient recognition, especially in rural or underserved areas where patients have long-standing relationships with NP providers; some patients may not distinguish between 'nurse practitioner' and 'certified nurse practitioner' and may误以为 their provider has changed credentials.
HealthcareRef: Sec. 3(2)(d), Sec. 4(2)(d) (removing 'nurse practitioner' as a standalone protected title, requiring use of 'certified nurse practitioner' or other specific titles)The elimination of 'nurse practitioner' as a general descriptor may complicate interprofessional communication and referral pathways, especially in electronic health records and billing systems that rely on standardized abbreviations like 'N.P.' — this could increase administrative burden during system updates.
HealthcareRef: Sec. 3(2)(c), Sec. 4(2)(c) (retaining only specific titles: C.N.P., C.N.M., C.R.N.A., C.N.S.)
Who Is Most Affected
Nurses licensed under the old title 'advanced registered nurse practitioner' will need to update business cards, signage, email signatures, and electronic profiles to use 'advanced practice registered nurse' and specific titles (e.g., C.N.P.). This is a low-cost, low-risk administrative adjustment with no material impact on income or scope of practice — mostly neutral.
Patients may benefit from clearer, more standardized provider titles that reduce confusion about qualifications, especially in emergency or telehealth settings. However, some may experience brief confusion during the transition if they are accustomed to the term 'nurse practitioner' — overall net neutral to slightly positive.
Nursing schools must update syllabi, course titles, and graduation documentation to reflect 'advanced practice registered nurse' instead of 'advanced registered nurse practitioner' — a minor curriculum adjustment with no significant cost increase. No major impact on graduates’ licensure outcomes.
Healthcare facilities must revise job postings, credentialing forms, and EHR fields to use updated titles — this requires IT and HR effort but no change in staffing, compensation, or scope-of-practice compliance. Minimal fiscal impact.
The Washington State Board of Nursing and Department of Health will need to update forms, websites, and licensing portals — a routine administrative update with no significant cost increase. No change in regulatory burden or enforcement complexity.