S-1293               _______________________________________________

                                                   SENATE BILL NO. 4107

                        _______________________________________________

State of Washington                              49th Legislature                              1985 Regular Session

By Senators Talmadge, Zimmerman, Moore, Pullen, Kreidler, Williams, McManus and Johnson

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

AN ACT Relating to privileged communications for registered nurses; adding a new chapter to Title 5 RCW; and creating a new section.

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 changed significantly in recent years with the result that many registered nurses provide primary health care without the direct supervision of physicians, or provide care to patients in a variety of settings under protocols or the general supervision of physicians that do not involve the physical presence of a physician or a pre-existing relationship between a physician and a patient;

          (3) Confidentiality is critical to enable the registered nurse to adequately treat 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 and 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" means a registered nurse licensed under chapter 18.88 RCW.

          (2) "Protocol" means a regimen carried out by a registered nurse and prescribed by a licensed physician under chapter 18.71 RCW, a licensed osteopathic physician under chapter 18.57 RCW, a licensed dentist under chapter 18.32 RCW, or a licensed podiatrist under chapter 18.22 RCW, which is consistent with  chapter 18.88 RCW, and the laws governing practice by the providers listed.

          (3) "Primary care" means a level of health care which 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 a protocol that does not require the physical presence or direct supervision of a physician may be examined in a civil or criminal action as to any information acquired in attending a patient, if the information was necessary to enable the registered nurse to prescribe for, treat, or otherwise act for the patient, unless:

          (1) The patient consents to disclosure;

          (2) 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 information relates to the future commission of a crime or the sexual or physical abuse of a child; or

          (4) The patient brings charges against the registered nurse in any civil, criminal, administrative, or peer review proceeding.

NEW SECTION. Sec. 4.     Sections 2 and 3 of this act shall constitute a new chapter in Title 5 RCW.