H-1128              _______________________________________________

                                                    HOUSE BILL NO. 933

                        _______________________________________________

State of Washington                              49th Legislature                              1985 Regular Session

By Representatives Appelwick, Barrett, Armstrong, Lewis, Locke, Wang, Niemi, Padden, Miller, Ballard and Scott

Read first time 2/8/85 and referred to Committee on Judiciary.

AN ACT Relating to privileged communications for registered nurses; and adding new sections to chapter 5.60 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1.     The legislature finds that:

          (1) Registered nurses licensed under chapter 18.88 RCW are accountable to their patients for the quality of health care provided;

          (2) The practice of nursing has undergone change in recent years such that registered nurses in many settings are providing primary health care without the direct supervision of physicians, or are offering care to patients under protocols or under the general supervision of physicians not involving physical presence of a physician or a pre-existing relationship between a physician and a patient in a variety of settings;

          (3) Confidentiality is critical to enable the nurse to treat adequately or act for patients, and the relationship of registered nurse and patient is one which ought to be diligently fostered; and

          (4) It is the policy of the state of Washington to promote proper treatment by registered nurses by facilitating and encouraging full disclosure of relevant information by protecting patients from embarrassment that might result from revelation of intimate details of health care and nursing treatment.

NEW SECTION. Sec. 2.     Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

          (1) "Registered nurse" or "RN" means a registered nurse licensed under chapter 18.88 RCW.

          (2) "Protocol" means a regimen to be carried out by a registered nurse prescribed by a physician licensed under chapter 18.71 RCW, an osteopathic physician licensed under chapter 18.57 RCW, a dentist licensed under chapter 18.32 RCW, or a podiatrist licensed under chapter 18.22 RCW, that is consistent with chapter 18.88 RCW and chapters 18.22, 18.32, 18.57, and 18.71 RCW.

          (3) "Primary care" means a level of health care that includes screening, assessment, diagnosis and treatment for the purpose of promotion of health, early diagnosis of disease or disability, prevention of disease, and generally involves a patient's first contact with the health care system.

NEW SECTION. Sec. 3.     No registered nurse practicing in a primary care setting or under protocols where the physical presence or direct supervision of a physician is not required may be examined in a civil or criminal action as to any information acquired in attending that patient, which information was necessary to enable the registered nurse to prescribe for, treat, or otherwise act for the patient, except that:

          (1) Disclosure may be made in the case of consent to disclosure by the patient;

          (2) The privilege shall be waived if the patient puts at issue in any court or administrative proceeding his or her medical or other condition for which the registered nurse treated or acted for the patient;

          (3) The registered nurse may disclose information acquired if it relates to the future commission of a crime or the sexual or physical abuse of a child; and

          (4) The privilege shall be waived by the patient's bringing charges against the registered nurse in any civil, criminal, administrative, peer review, or other proceeding.

NEW SECTION. Sec. 4.     Sections 1 through 3 of this act are each added to chapter 5.60 RCW.