Substitute House Bill 2339 amends multiple sections of chapter 18.79 RCW governing the regulation of nursing. The bill changes definitions and title usage for advanced nursing roles, updates licensure and application procedures, authorizes interim permits pending examination results, and revises the chapter’s exemptions and scope-of-practice provisions including limited authority related to controlled substances for certified registered nurse anesthetists (CRNAs). The bill passed the House February 16, 2026 (Yeas 94, Nays 3) and the Senate March 5, 2026 (Yeas 49, Nays 0). Specifically, the act amends RCW 18.79.020 and 18.79.030 to revise definitions and to specify who may use nursing titles and abbreviations; amends RCW 18.79.160 to require an attested written application on a department form, any other official records the board specifies, that licensed practical nurse applicants show they are over age 18, and that applicants not be in violation of chapter 18.130 RCW or this chapter; directs the board to adopt criteria for evaluating educational credentials. RCW 18.79.180 is amended to authorize interim permits from verification of program completion until examination results are known, with the permit expiring if the exam is failed. RCW 18.79.240 and 18.79.250 are amended to enumerate activities not prohibited by the chapter, to define terms such as “select,” “order,” and “protocol,” to allow APRNs to prescribe legend drugs and Schedule V substances and to permit Schedule II–IV activity to the extent allowed by scope, and to grant a limited, facilityand request‑dependent authority for CRNAs who had not obtained prescriptive authority prior to July 1, 2026, to select, order, or administer Schedules II–IV when directly administering anesthesia. These are amendments to existing law that effect procedural changes (application form requirements, interim permit rules, board rulemaking), substantive scope-of-practice changes (prescribing and administration authorities), and exemptions. The text available includes alternate or overlapping amendment language for some sections (for example, different usages of “advanced registered nurse practitioner” versus “advanced practice registered nurse” and two versions of RCW 18.79.250), and portions of the act and some section texts are missing or truncated, so it is unclear which alternate provisions are final or the full content of all amended sections. Sections 2, 4, 6, 8, 10, and 12 are shown to take effect June 30, 2027, and sections 1, 3, 5, 7, 9, and 11 to expire June 30, 2027.

If enacted, the bill will change how nurses get licensed and what some advanced nurses can do in patient care. Applicants will need to submit a sworn department form and any other records the nursing board requires, practical nurse applicants must prove they are over 18, and applicants must be in compliance with relevant law when they apply; the board will set education evaluation criteria. New interim permits let nursing school graduates begin practicing until exam results arrive, but those permits end and cannot be renewed if the exam is failed. Hospitals and clinics will need to adopt facility protocols and processes for certain advanced practice activities, and student volunteers will be allowed to give unpaid care only under direct supervision and after showing competence and current malpractice insurance. The groups most affected are the Department of Health and the Washington State Board of Nursing (which will need to create forms, rules, and process interim permits), nursing applicants (who may face new documentation steps and short-term practice options), advanced practice nurses and CRNAs (who may gain or have clarified limited authority to select, order, or administer certain controlled anesthetic drugs under facility protocols and specified requests), and health care facilities (which will shoulder protocol, supervision, and liability adjustments). The bill could speed entry of new nurses into practice but also shift operational and oversight costs to the board and facilities and create potential compliance and controlled-substance risk that facilities must manage. It is unclear from the provided text which of several alternate wording versions is final and how the sections that take effect or expire on June 30, 2027 interact, so some implementation details remain uncertain.