Sponsors: Senate Committee on Health & Long-Term Care (originally sponsored by Senators Deccio, Thibaudeau and Winsley).

Brief Summary of Substitute Bill

(As Amended by House Committee)

• Nursing students or recent graduates of a nursing program who are employed by a hospital or nursing home must be registered by the Department of Health in order to perform specific nursing tasks.

Majority Report: Do pass as amended. Signed by 11 members: Representatives Cody, Chair; Morrell, Vice Chair; Pflug, Ranking Minority Member; Bailey, Assistant Ranking Minority Member; Benson, Campbell, Clibborn, Darneille, Moeller, Schual-Berke and Skinner.

Current law allows nursing students to practice nursing without a license when it is incidental to their course of study or when they are employed as nursing aides. Under the Washington Administrative Code nursing students may register with the Department of Health as nursing technicians if they are currently enrolled in a nursing program. Nursing technicians must be supervised by a registered nurse and cannot practice independently. The supervising nurse is responsible for client safety and must be available and physically present at the health care facility. The employer of nursing technicians must verify their status as students, determine their level of education and competency, and ensure that they do not exceed their abilities when they practice.

Nursing technicians are defined as nursing students who are employed by a hospital or nursing home and are either enrolled in a nursing program approved by the Nursing Care Quality Assurance Commission (Commission) and have not graduated, or have graduated from a Commission-approved nursing program within 30 days.

Nursing technicians may perform nursing functions that are within their education, skill, and knowledge as demonstrated to and verified by their nursing program. They may only practice under the direct supervision of a registered nurse with an unrestricted license and two years of experience in the setting where the nursing technician works. They may not: (1) administer chemotherapy, blood or blood products, intravenous medications, scheduled drugs, or central line procedures; (2) assume responsibility for assessments, planning, implementation, or evaluation of patient care; (3) function independently or act as a supervisor; or (4) perform nursing procedures that are beyond their education and experience.

In order to practice as a nursing technician, an individual must be registered by the Department of Health (Department). In addition to providing any registration criteria established by the Department, nursing technician applicants must submit acknowledgments from their nursing program and employer. Nursing technicians are added to the Uniform Disciplinary Act and are subject to discipline by the Commission.

Employers of nursing technicians must document the authorized nursing functions that each nursing technician may perform and may not require the nursing technician to work beyond his or her education and training. In addition, they must train nursing technicians and supervising nurses in the provisions of the bill and document this training. Employers of nursing technicians are responsible for verifying that nursing technicians are recent graduates of a nursing program or continue to be students of a nursing program. The Department may investigate employers of nursing technicians who do not comply with their obligations regarding nursing technicians.

Employers must train nursing technicians and supervising nurses in the provisions of the bill including how to file a complaint. Employers must document training. Fines for violations of the bill are removed.

Effective Date of Amended Bill: The bill contains an emergency clause and takes effect immediately.

Testimony For: This bill will give proper statutory authority for nursing technicians to practice in hospitals and nursing homes. Nursing technicians can be helpful in providing health care and reducing stress to nurses. Hiring nursing technicians helps nursing students gain practical experience and helps employers recruit and retain registered nurses. Penalties will prevent employers from using nursing technicians improperly.

Testified: (In support) Senator Deccio, prime sponsor; Patty Hayes, Department of Health; Deb Murphy, Gloria Dunn, and Michelle Huntley, Washington Health Care Association; and Lisa Thatcher, Washington State Hospital Association.