HOUSE BILL REPORT

HB 1721

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

As Passed House:

March 7, 2017

Title: An act relating to obtaining required clinical experience for licensed practical nurses who complete a nontraditional registered nurse program.

Brief Description: Concerning obtaining required clinical experience for licensed practical nurses who complete a nontraditional registered nurse program.

Sponsors: Representatives Cody, Haler, Muri, Goodman and Jinkins; by request of Department of Health and Nursing Care Quality Assurance Commission.

Brief History:

Committee Activity:

Health Care & Wellness: 2/10/17, 2/14/17 [DP].

Floor Activity:

Passed House: 3/7/17, 85-12.

Brief Summary of Bill

  • Repeals the authority allowing a preceptorship for a student who has completed a "nontraditional" nursing program.

HOUSE COMMITTEE ON HEALTH CARE & WELLNESS

Majority Report: Do pass. Signed by 13 members: Representatives Cody, Chair; Macri, Vice Chair; Caldier, Clibborn, DeBolt, Harris, Jinkins, Riccelli, Robinson, Rodne, Slatter, Stonier and Tharinger.

Minority Report: Do not pass. Signed by 4 members: Representatives Schmick, Ranking Minority Member; Graves, Assistant Ranking Minority Member; MacEwen and Maycumber.

Staff: Jim Morishima (786-7191).

Background:

A registered nurse is a person who performs acts requiring substantial specialized knowledge, judgment, and skill based on the principles of the biological, physiological, behavioral, and sociological sciences in:

A licensed practical nurse is a person who performs services requiring the knowledge, skill and judgment necessary for carrying out selected aspects of the designated nursing regimen under the direction and supervision of selected providers, including physicians, midwives, and registered nurses.

To be licensed as a registered nurse, an applicant must complete an education program approved by the NCQAC and pass an exam. Registered nursing education programs normally include a clinical experience component, but a "nontraditional" registered nursing education program does not include such a component. A licensed practical nurse who completes a nontraditional nursing education program may obtain required clinical experience by completing a preceptorship within six months of graduation. The experience must be obtained under the supervision of a registered nurse under the registered nurse's license. The registered nurse must have an unrestricted license with at least two years of clinical practice in the practice setting where the preceptorship will occur.

Summary of Bill:

The authority for a licensed practical nurse who has completed a nontraditional registered nursing education program to obtain required clinical experience through a preceptorship is repealed.

Appropriation: None.

Fiscal Note: Available.

Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.

Staff Summary of Public Testimony:

(In support) There is currently a loophole for licensed practical nurses (LPNs) who complete nontraditional nursing programs. An LPN who completes such a program may obtain required clinical experience without faculty guidance. An LPN is not the same as a registered nurse (RN). Without guidance and molding in clinical experience, an LPN does not know what he or she does not know. In traditional nursing programs, RNs often supervise students, but under faculty supervision. Faculty-guided clinical experience is needed to ensure that LPNs transition successfully into their new roles as RNs. Without faculty involvement, the clinical experience is not a learning experience. Faculty involvement enhances the educational process and ensures patient safety. An RN who is supervising an LPN who has competed a nontraditional education program may not understand what the education program is or that the LPN is practicing under the RN's license. The preceptorship is inconsistent with the Uniform Disciplinary Act because it allows the LPN to practice under the RN's license. Nontraditional nursing programs can be unfair to the students who may have trouble finding a preceptorship. This bill is not about shutting down access. Washington has many paths for LPNs to become licensed RNs, but there should only be one pathway for receiving clinical experience. This is a public safety issue. This bill preserves the Nursing Care Quality Assurance Commissions' role in protecting the public by developing educational standards.

(Opposed) None.

Persons Testifying: Donna Pool, Nursing Care Quality Assurance Commission; John Mueller, CHI Franciscan Health; and Dianna Nauer, Bates Technical College.

Persons Signed In To Testify But Not Testifying: None.