NURSES - AUTHORITY OF LICENSED PRACTICAL NURSES TO ADMINISTER MEDICATIONS

NURSES - AUTHORITY OF LICENSED PRACTICAL NURSES TO ADMINISTER MEDICATIONS.

Licensed practical nurses may not administer drugs or medications, either orally or by injection, to patients under their supervision or care.

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                                                                   March 6, 1959

Honorable Louise S. Taylor
Director, Department of Licenses
General Administration Building
Olympia, Washington                                                                                              Cite as:  AGO 59-60 No. 20

Dear Mrs. Taylor:

            By letter previously acknowledged, you have requested an opinion of this office on the following question:

            "May licensed practical nurses legally administer medications, either orally or by injection, to patients under their care?"

            We must answer your inquiry in the negative for the reasons outlined below.

                                                                     ANALYSIS

            Your question requires reference to, and analysis of, the statutes regarding the practice of medicine and surgery (chapter 18.71 RCW), registered professional nursing (chapter 18.88 RCW), and licensed practical nurses (chapter 18.78 RCW).  RCW 18.71.010 defines the practice of medicine and surgery as follows:

            "(1) The practice of medicine and surgery consists of the use of drugs or medicinal preparations in or upon human beings, severing or penetrating the tissues of human beings and the use of any and all other methods in the treatment of diseases, injuries, deformities or other physical or mental conditions."

             [[Orig. Op. Page 2]]

            RCW 18.71.020 requires a license for the practice of medicine and surgery and provides that practice of this profession, as defined, without obtaining such license is a misdemeanor.  RCW 18.71.030 exempts certain individuals and professions from licensure.  It is sufficient for our purposes to note that neither registered professional nurses nor licensed practical nurses are exempted by this section.

            Chapter 18.88 RCW provides for the licensing of registered nurses.  RCW 18.88.280 specifically limits the practice of registered nurses, reading in part as follows:

            "This chapter shall not be construed as conferring any authority to practice medicine or to undertake the treatment or care of disease, pain, injury, deformity or physical condition in violation of chapter 18.71 [[chapter 18.71 RCW)]]; nor shall it be construed as conferring any authority to practice osteopathy or osteopathy and surgery in violation of chapter 18.57 [[chapter 1857 RCW)]]; . . ." surgery in violation of chapter 18.57; . . ."

            In 1955 the legislature extended the legal scope of the activities of registered nurses by providing that registered nurses, in certain instances, might administer medications and/or give injections.  Thus, RCW 18.88.290 provides:

            "It shall not be a violation of chapter 18.71 RCW or chapter 18.57 RCW, for a registered nurse, at or under the general direction of a licensed practitioner of medicine and surgery, osteopathy, or osteopathy and surgery (within the scope of his license) to administer prescribed drugs, injections, inoculations, tests, or treatment whether or not piercing of tissues is involved."

            Practical nurses are licensed pursuant to the provision of chapter 18.78 RCW.  The practice of practical nursing is defined in RCW 18.78.010 (4) as:

            ". . . 'the performing for compensation or personal profit, services required in the nursing care of the sick, not involving the specialized education, knowledge and skill required in professional nursing.'"

            Practical nurses are particularly enjoined by RCW 18.78.160 from practicing medicine or surgery or practicing as a registered nurse, by the following language:

             [[Orig. Op. Page 3]]

            "This chapter shall not be construed as conferring authority to practice medicine or surgery, or to practice as a registered nurse, or to undertake the treatment or cure of disease, pain, injury, deformity or physical condition; nor shall it be construed as prohibiting the care of the sick when done in connection with the practice of religious tenets of any church by adherents thereof, in caring for adherents thereof or caring for a patient of any drugless doctor."

            An analysis of the foregoing statutory provisions leads us to the conclusion that the use of drugs or medical preparations in or upon human beings and/or the severing or penetrating of human tissues constitutes the practice of medicine and surgery.  Registered professional nurses have been authorized by the legislature, in prescribed instances, to administer drugs and medicines and give injections whereby human tissues are severed or penetrated.  This prerogative has not, however, been extended to practical nurses.  On the contrary, practical nurses are forbidden by statute from engaging in any of the facets of the practice of medicine and surgery, or of the practice of registered nursing.  Accordingly, we must conclude that practical nurses may not administer drugs or medications, either orally or by injection, to patients under their supervision or care.

            We trust that the foregoing will be of assistance to you.

Very truly yours,

JOHN J. O'CONNELL
Attorney General