The following credentials are issued to nurses in Washington state.

(1) ((Active status license for LPN or RN. A))Licensed practical nurse (LPN) license.

(a) An LPN license is issued upon completion of licensure requirements. ((The license holder may))Licensure requirements for LPNs are found under WAC 246-840-025, 246-840-030, 246-840-033, 246-840-045, 246-840-090, 246-840-091, and 246-840-092.

(b) Only persons holding this license have the right to use the title licensed practical nurse ((or registered nurse)) and the use of its abbreviation, LPN ((or RN)).

(2) Registered nurse (RN) license.

(a) An RN license is issued upon completion of licensure requirements. Licensure requirements for RNs are found under WAC 246-840-025, 246-840-030, 246-840-045, 246-840-090, 246-840-091, and 246-840-092.

(b) Only persons holding this license have the right to use the title registered nurse and its abbreviation, RN.

(d) A student who has ((graduated from a basic professional nursing course))completed an associate degree nursing education program approved by the board or its equivalent and who is pursuing a baccalaureate degree in nursing, an advanced degree in nursing or an advanced certification in nursing must hold an active Washington RN license before participating in the practice of nursing as required to fulfill the learning objectives in a clinical course.

(((2)))(3) Advanced registered nurse practitioner (ARNP) license.

(a) An ARNP license ((may be))is issued ((to an individual who meets the requirements of the commission as contained in WAC 246-840-300 through 246-840-365))upon completion of licensure requirements. Licensure requirements for ARNPs are found under WAC 246-840-300 through 246-840-367.

(b) Only persons holding this license have the right to use the title (("))advanced registered nurse practitioner((" or the))and its abbreviation (("ARNP" or)), ARNP. This includes any title or abbreviation which indicates that the individual is ((entitled))authorized to practice at an advanced and specialized role as a NP, CNM, CRNA, or CNS.

(d) The license allows practice as an ARNP in the state of Washington.

(e) The ARNP's scope of practice is defined by a national certifying body approved by the ((commission))board.

Registered ((nursing and practical nursing))nurse (RN) and licensed practical nurse (LPN) applicants' educated in a ((commission))board-approved Washington state nursing education program and applying for initial licensure ((must))by examination shall:

(1) ((Successfully complete a commission))Have completed a board-approved Washington state nursing education program. ((For applicants from a commission approved registered nurse program who are applying for a practical nurse license:

(a) Complete all course work required of commission approved practical nurse programs as listed in WAC 246-840-575(2). Required courses not included in the registered nurse program may be accepted if the courses were obtained through a commission approved program.

(b) Be deemed as capable to safely practice within the scope of practice of a practical nurse by the nurse administrator of the candidate's program.

(2) Successfully pass the commission approved licensure examination as provided in WAC 246-840-050. Testing may be allowed upon receipt of a certificate of completion from the administrator of the nursing education program.

(3) Submit the following documents:

(a) A completed licensure application with the required fee as defined in WAC 246-840-990))LPN applicants who have completed part of a board-approved RN education program shall follow WAC 246-840-033.

(((b)))(2) Have an official transcript sent directly from the applicant's nursing education program to the ((commission. The transcript must include course names and credits accepted from other programs. Transcripts must be received within ninety days of the applicant's first taking of the examination))board. Transcripts must be received no later than 90 days after the applicant's first attempt at the board-approved licensure examination. The transcript must ((show)):

(((i)))(a) Include the applicant's dates of enrollment, course names, earned credits, date of graduation, and the credential conferred, if applicable. If credits have been accepted from other programs, the transcript must identify those programs.

(b) Show that the applicant has graduated from ((an))a board-approved nursing education program or that the applicant has successfully completed the prelicensure portion of an approved graduate-entry ((registered nursing))RN program((; or

(ii) That the applicant has completed all course work required in a commission approved practical nurse program as listed in WAC 246-840-575(2))).

(((c) Applicants from a commission approved registered nurse program who are applying for a practical nurse license must also submit an attestation sent from the nurse administrator of the candidate's nursing education program indicating that the applicant is capable to safely practice within the scope of practice of a practical nurse.))(3) Pass the board-approved licensure examination as provided in WAC 246-840-050. The board may authorize testing upon receipt of a certificate of completion issued by the nurse administrator of the nursing education program.

(4) Submit a completed licensure application with the required fee as specified in WAC 246-840-990.

(((1))) Registered nurse (RN) and licensed practical nurse (LPN) applicants educated in a traditional nursing education program approved by another United States ((nursing board))(U.S.) jurisdiction and applying for initial licensure by examination shall:

(((a) Successfully complete))(1) Have completed a nursing education program in another U.S. ((state))jurisdiction, which((:

(i) Is approved by the nursing board in that state; and

(ii) Substantially meets requirements for nursing education approved in Washington state. The board retains authority to evaluate and determine the sufficiency of academic preparation for all applicants.

(b) Successfully pass the board-approved licensure examination as provided in WAC 246-840-050.

(i) A completed licensure application with the required fee as defined in WAC 246-840-990.

(ii)))substantially meets requirements for nursing education approved in Washington state. The board retains authority to evaluate and determine the sufficiency of academic preparation for all applicants. LPN applicants who have completed part of an approved RN nursing education program shall follow WAC 246-840-033.

(2) Have an official transcript sent directly from the applicant's nursing education program to the board. ((The transcript must include course names and credits accepted from other programs. The transcript must show:

(A) The applicant has graduated from an approved nursing program or has successfully completed the prelicensure portion of an approved graduate-entry registered nursing program; or

(B) That the applicant has completed all course work required in a board-approved practical nurse program as listed in WAC 246-840-539.

(iii) An applicant from a board-approved registered nurse program who is applying for a practical nurse license shall also submit an attestation sent from the nurse administrator of the applicant's nursing education program indicating that the applicant is capable to safely practice within the scope of practice of a practical nurse.

(2) An applicant from an out-of-state board-approved registered nurse program who is applying for a practical nurse license shall:

(a) Complete all course work required of board-approved practical nurse programs as listed in WAC 246-840-539. Required courses not included in the registered nurse program may be accepted if the courses were obtained through a board-approved program.

(b) Be deemed as capable to safely practice within the scope of practice of a practical nurse by the nurse administrator of the applicant's nursing education program.))Transcripts must be received no later than 90 days after the applicant's first attempt at the board-approved licensure examination.

The transcript must:

(a) Include the applicant's dates of enrollment, course names, earned credits, date of graduation, and the credential conferred, if applicable. If credits have been accepted from other programs, the transcript must identify those programs; and

(b) Show that the applicant has graduated from a nursing education program approved by another U.S. jurisdiction or that the applicant has completed the prelicensure portion of an approved graduate-entry RN program. The nursing education program must substantially meet the requirements of nursing education approved in Washington state at the time of graduation as determined by the board.

(3) Pass the board-approved licensure examination as provided in WAC 246-840-050.

(4) Submit a completed licensure application with the required fee as specified in WAC 246-840-990.

Applicants who have completed part of an approved registered nursing (RN) education program and are applying for licensure as a licensed practical nurse (LPN) shall:

(1) Have completed all course work required of board-approved practical nursing education programs listed in WAC 246-840-539. Required courses not included in the RN education program may be accepted if the courses were obtained through a board-approved program. The board retains authority to evaluate and determine the sufficiency of academic preparation for all applicants.

(2) Have completed a board-approved professional vocational relationship course.

(3) Have an official transcript sent directly from the applicant's nursing education program to the board. Transcripts must be received no later than 90 days after the applicant's first attempt at the board-approved licensure examination. The transcript must:

(b) Show that the applicant has completed all course work required in a board-approved practical nurse program listed in WAC 246-840-539. If the applicant is from a traditional nursing education program approved by another U.S. jurisdiction, the program must substantially meet the requirements of board-approved nursing education in Washington state.

(4) Have an attestation sent from the nurse administrator of the applicant's RN education program indicating that the applicant is capable of safely practicing within the scope of practice of an LPN.

(5) Pass the board-approved licensure examination for LPNs as provided in WAC 246-840-050. If the applicant is from a board-approved Washington state nursing education program, the board may authorize testing upon receipt of a certificate of completion issued by the nurse administrator of the nursing education program.

(6) Submit a completed licensure application with the required fee as specified in WAC 246-840-990.

(((1))) Registered nurse (RN) and licensed practical nurse (LPN) applicants educated ((in a jurisdiction which is not a member of the National Council of State Boards of Nursing))outside United States (U.S.) jurisdictions and applying for initial licensure ((must))shall:

(((a) Successfully complete a basic))(1) Have completed a nursing education program ((approved in that country))outside U.S. jurisdictions.

(((i)))(a) The nursing education program must ((be equivalent to the minimum standards prevailing for nursing education programs approved by the commission))substantially meet the requirements for nursing education approved in Washington state. The board retains authority to evaluate and determine the sufficiency of academic preparation for all applicants.

(((ii)))(b) Any deficiencies in the nursing education program (((theory and clinical practice in medical, psychiatric, obstetric, surgical and pediatric nursing))), as described in WAC 246-840-537, 246-840-539, and 246-840-541, may be satisfactorily completed in a ((commission))board-approved nursing education program or program created for internationally educated nurses identified in WAC 246-840-549, 246-840-551 or 246-840-552. Documentation demonstrating that any deficiencies have been satisfactorily completed must be submitted directly to the board from the nursing education program.

(((b)))(2) Obtain ((an))a transcript evaluation ((or certificate)) from a ((commission))board-approved credential evaluation service verifying that the educational program completed by the applicant ((is equivalent to))substantially meets the requirements for nursing education in the state of Washington. The evaluation must include a copy of the applicant's official transcript which must:

(a) Be in English or accompanied by an official English translation;

(b) Include applicant's dates of enrollment, course names, earned credits, date of graduation, and the credential conferred, if applicable. If credits have been accepted from other programs, the transcript must identify those programs;

(c) Document that the nursing education program completed by the applicant substantially meets the requirements for nursing education in Washington state. Course descriptions or syllabi may be required to determine if the education received is substantially equivalent to Washington state standards.

(3) Provide verification to the board directly from the program indicating that the theory and clinical components were taught in English. If the theory and clinical components of the applicant's nursing education program were not taught in English, the applicant must demonstrate English language proficiency by one of the following:

(a) Provide evidence of passing a board-approved English proficiency examination with the minimum passing scores established by the board;

(b) Provide evidence of earning a diploma or degree directly from an educational institution in a U.S. jurisdiction, prior to board approval to take the board-approved licensure examination as described in WAC 246-840-050. The education acquired by the applicant must have been taught in English; or

(c) ((Demonstrate English language proficiency by passing a commission approved English proficiency examination at a commission designated standard, or provide evidence directly from the school of earning a high school diploma or college degree from a United States institution prior to commission approval to take the national licensing examination.

Individuals from Canada (except for Quebec), United Kingdom, Ireland, Australia, New Zealand, American Samoa, Guam, Northern Mariana Island, and U.S. Virgin Islands will have this requirement waived.

(d) Successfully pass the commission))Provide evidence of completing 1,000 hours of employment as a licensed nurse in another country in which English is the primary language spoken. The 1,000 hours of employment must be in the same licensed role as the nurse is applying for licensure in Washington state.

(4) Pass the board-approved licensure examination as provided in WAC 246-840-050.

(((2) Registered nurse and practical nurse applicants must submit the following documents:

(a) A completed licensure application with the required fee as defined in WAC 246-840-990.

(b) Official transcript directly from the nursing education program or licensure agency in the country where the applicant was educated and previously licensed.

(i) Transcript must be in English or accompanied by an official English translation. If the applicant's original documents (education and licensing) are on file in another state or with an approved credential evaluation agency, the applicant may request that the state board or approved credential evaluating agency send copies directly to the commission in lieu of the originals.

(ii) The transcript must:

(A) Include the applicant's date of enrollment, date of graduation and credential conferred.

(B) Describe the course names and credit hours completed.

(C) Document equivalency to the minimum standards in Washington state. Course descriptions or syllabi may be requested to determine equivalency to Washington state standards.

(c) Documentation from a commission approved nursing program showing that any deficiency has been satisfactorily completed.

(d) Documents must show the applicant has passed a commission approved English proficiency examination or the requirement is waived as identified in subsection (1) of this section.))If the applicant passed the examination in a licensing jurisdiction outside the U.S., the applicant shall provide verification of having passed the examination directly from that jurisdiction to the board.

(5) Submit a completed licensure application with the required fee as specified in WAC 246-840-990.

(1) The current series of the National Council of the State Boards of Nursing ((Registered Nurse)) (NCSBN) Registered Nurse ((or))and Practical Nurse Licensing Examination (NCLEX-RN® or NCLEX-PN®) ((shall be))are the official examinations for nurse licensure.

(2) In order to be licensed in this state, all nurse applicants shall take and pass the National Council Licensure Examination (NCLEX-RN® or NCLEX-PN®).

(3) Only applicants who complete the education, experience, and application requirements of WAC 246-840-025, 246-840-030, ((246-840-035))246-840-033, or 246-840-045 will be eligible for the relevant examination.

(4) The ((commission))board will notify applicants who ((have filed the required application documents and met all qualifications of their eligibility))are eligible to take the relevant examination.

(5) Applicants must ((file an examination application))register directly ((to))with the testing service((, along with the testing service's))and pay any required fees.

(6) The executive director of the ((commission))board shall negotiate with the NCSBN for the use of the NCLEX®.

(7) The relevant examination shall be administered in ((accord))accordance with the NCSBN security measures and contract. All appeals of examination procedures and results shall be managed in ((accord))accordance with policies in the NCSBN contract.

Registered nurse (RN) and licensed practical nurse (LPN) applicants ((for))educated in a United States (U.S.) jurisdiction and applying for licensure by interstate endorsement ((may be issued a license without examination provided the applicant meets the following requirements))shall:

(1) ((The applicant))Have graduated and hold((s)) a degree from((:

(a) A state board-approved program))a nursing education program approved by a board of nursing or regulatory authority in a U.S. jurisdiction, preparing candidates for licensure as a nurse((, which)). The nursing education program must substantially meet((s)) requirements for nursing education approved in Washington state at the time of graduation, as determined by the board((; or

(b) A nursing program that is equivalent to board-approved nursing education in Washington state at the time of graduation as determined by the board)). The board retains authority to evaluate and determine the sufficiency of academic preparation for all applicants.

(a) Applicants educated outside U.S. jurisdictions shall follow WAC 246-840-091.

(b) RN applicants who graduated from a nontraditional nursing education program without a clinical component must provide evidence of 1,000 hours of practice as an RN in a U.S. jurisdiction without regulatory discipline.

(2) ((The applicant))Holds one of the following:

(a) A current active nursing license in another ((state or territory, or holds))U.S. jurisdiction.

(b) An inactive or expired license in another ((state or territory))U.S. jurisdiction and successfully completes a board-approved refresher course.

(((a)))(i) An applicant whose license ((was))is inactive or expired ((must))in another U.S. jurisdiction may be issued a limited education authorization by the board to enroll in the clinical portion of the refresher course.

(((b)))(ii) The limited education authorization is valid only while working under the direct supervision of a preceptor and is not valid for employment as a ((registered)) nurse.

(c) An inactive or expired license in another U.S. jurisdiction, and an active license in a Canadian jurisdiction where the applicant has been actively practicing within the last three years. To comply with this option, the applicant must submit verification of an active license and active nursing practice in a Canadian jurisdiction within the last three years.

(3) ((The applicant was originally licensed to practice as a nurse in another state or territory after passing the National Council Licensure Examination (NCLEX).

(4) An applicant graduating from a nursing program outside the U.S. shall demonstrate English proficiency by:

(a) Passing a board-approved English proficiency test if the nursing education is not in one of the following countries: Canada (except for Quebec), United Kingdom, Ireland, Australia, New Zealand, American Samoa, Guam, Northern Mariana Islands, and U.S. Virgin Islands; or

(b) Completing 1,000 hours of employment as a licensed nurse in another state. The 1,000 hours of employment must be in the same licensed role as the nurse is applying for licensure in Washington state. Proof of employment must be submitted to the board; or

(c) Providing evidence directly from the program of earning a high school diploma or college degree from a United States institution.

(5) For RNs: If the applicant is a graduate of a nontraditional nursing education program and:

(a) Was licensed as a practical/vocational nurse prior to licensure as a registered nurse, the applicant shall meet the requirements defined in WAC 246-840-048.

(b) Was not licensed as a practical/vocational nurse prior to licensure as a registered nurse, the applicant shall submit evidence of at least 1,000 hours of practice as a registered nurse without discipline of the registered nurse license by any other state or territory.

(6) All applicants must submit the following documents:

(a) A completed licensure application with the required fee as defined in WAC 246-840-990.

(b)))Provide verification that the applicant was originally licensed to practice as a nurse in another U.S. jurisdiction after passing the relevant board-approved licensure examination as described in WAC 246-840-050.

(4) Have an official transcript sent directly from the applicant's nursing education program to the board if the education cannot be verified from the original board of nursing, regulatory authority, or board-approved evaluation ((agency))service.

(((i)))(a) The transcript must ((contain adequate documentation demonstrating that the applicant graduated from an approved nursing program or successfully completed the prelicensure portion of an approved graduate-entry registered nursing program.

(ii) The transcripts must include course names and credits accepted from other programs.

(c) Verification of an original registered or practical nurse license from the state or territory of original licensure. The verification must identify that issuance of the original licensure included passing the NCLEX.

(d) For an applicant educated outside the United States and in territories or countries not listed in subsection (4)(a) of this section, successful results of a board-approved English proficiency exam, or, evidence of 1,000 hours worked as a nurse.

(e) For RNs: If the applicant is a graduate of a nontraditional program in nursing and:

(i) Was licensed as a practical/vocational nurse prior to licensure as a registered nurse, the applicant shall submit the requirements outlined in WAC 246-840-048.

(ii) Was not licensed as a practical/vocational nurse prior to licensure as a registered nurse, the applicant shall submit documentation of at least 1,000 hours of practice as a registered nurse without discipline of the registered nurse license by any other state or territory.)):

(i) Include the applicant's dates of enrollment, course names, earned credits, date of graduation, and the credential conferred, if applicable. If credits have been accepted from other programs, the transcript must identify those programs; and

(ii) Show that the applicant has graduated from a nursing education program or that the applicant has completed the prelicensure portion of an approved graduate-entry RN program. The nursing education program must substantially meet the requirements of board-approved nursing education in Washington state at the time of graduation as determined by the board.

(b) An education verification, course descriptions, or syllabi may be requested from the applicant's nursing education program and must include clinical hours in specific content areas of direct care and simulation.

(5) Submit a completed licensure application with the required fee as specified in WAC 246-840-990.

Registered nurse (RN) and licensed practical nurse (LPN) applicants educated outside United States (U.S.) jurisdictions and applying for licensure by interstate endorsement shall:

(1) Have graduated and hold a degree from a nursing education program outside U.S. jurisdictions preparing candidates for licensure as a nurse. The nursing education program must substantially meet requirements for nursing education approved in Washington state at the time of graduation, as determined by the board. The board retains authority to evaluate and determine the sufficiency of academic preparation for all applicants. The board may request a copy of official transcripts and a completed education verification from the applicant's nursing education program.

(2) Hold one of the following:

(a) A current active nursing license in another U.S. jurisdiction;

(b) An inactive or expired license in another U.S. jurisdiction and successfully complete a board-approved refresher course;

(i) An applicant whose license is inactive or expired in another U.S. jurisdiction may be issued a limited education authorization by the board to enroll in the clinical portion of the refresher course;

(ii) The limited education authorization is valid only while working under the direct supervision of a preceptor and is not valid for employment as a nurse; or

(c) An inactive or expired license in another U.S. jurisdiction, and an active license in a Canadian jurisdiction, where the applicant has been actively practicing within the last three years. The applicant must submit verification of an active license and active nursing practice in a Canadian jurisdiction within the last three years.

(3) Provide verification that the applicant was originally licensed to practice as a nurse in another U.S. jurisdiction after passing the relevant board-approved licensure examination as described in WAC 246-840-050.

(a) The transcript must:

(i) Be in English or accompanied by an official English translation;

(ii) Include the applicant's dates of enrollment, course names, earned credits, date of graduation, and the credential conferred, if applicable. If credits have been accepted from other programs, the transcript must identify those programs; and

(iii) Document that the applicant has graduated from a nursing education program or that the applicant has completed the prelicensure portion of an approved graduate-entry RN program. The nursing education program must substantially meet the requirements of board-approved nursing education in Washington state at the time of graduation as determined by the board.

(5) Provide verification to the board directly from the program indicating that the theory and clinical components were taught in English. If the theory and clinical components of the applicant's nursing education program were not taught in English, the applicant must demonstrate English proficiency by one of the following:

(a) Provide evidence of passing a board-approved English proficiency examination with the minimum scores established by the board;

(b) Provide evidence of earning a diploma or degree directly from an educational institution in a U.S. jurisdiction prior to board approval to take the board-approved licensure examination as described in WAC 246-840-050. The education acquired by the applicant must have been taught in English; or

(c) Provide evidence of completing 1,000 hours of employment as a licensed nurse in another country in which English is the primary language spoken. The 1,000 hours of employment must be in the same licensed role as the nurse is applying for licensure in Washington state.

(6) Complete and submit a licensure application with the required fee as specified in WAC 246-840-990.

The ((Washington state board of nursing ())board(())) conducts background checks on applicants to assure safe patient care. Completion of a fingerprint-based national background check may cause a delay in licensing.

(1) The board may issue a temporary practice permit to an applicant who ((holds an unrestricted, active license in another state which has substantially equivalent licensing standards to those in Washington))has met all requirements for licensure under this chapter, with the exception of the fingerprint-based national background check. The applicant must not be subject to denial of a license or issuance of a conditional or restricted license.

(2) A temporary practice permit serves as a license to practice nursing during the time period specified on the permit.

(3) A temporary practice permit expires when:

(a) A license is granted;

(b) A notice of decision on application is ((mailed))sent to the applicant, unless the notice of decision on application specifically extends the duration of the temporary practice permit; or

(d) If, at the expiration of the original temporary practice permit, the department ((of health (department))) has not received information from the fingerprint-based national background check, the board may renew the temporary practice permit for an additional 30 days.

(4) To receive a temporary practice permit, the applicant ((must))shall:

(a) Submit to the board an application and the necessary application fee(s) for the license.

(b) Meet all other requirements and qualifications for the license, except for the results from a fingerprint-based national background check, if required.

(((c) Provide to the board verification of holding an unrestricted nursing license from another state that has substantially equivalent licensing standards to those in Washington.))

(5) The applicant shall initiate the fingerprint-based national background check process with the department within 30 days of applying to the board, or the permanent license application may be closed as incomplete. The temporary practice permit shall not be extended in accordance with subsection (3)(c) of this section unless the applicant's fingerprints have been received by the department and a fingerprint-based national background check is in process.

A registered nurse (RN) or licensed practical nurse (LPN) licensed under this chapter with an expired license as defined in WAC 246-12-010 may return their license to an active status. During the time the license is expired, the nurse cannot practice in Washington state.

(1) If the license has been expired for three years or less, ((the practitioner must))the nurse shall meet the requirements in WAC ((246-12-020 through 246-12-051))246-12-040 to return to active status.

(2) If the license has been expired for more than three years and the ((practitioner))nurse has been in active practice in another United States (U.S.) or Canadian jurisdiction, the ((practitioner must))nurse shall:

(a) Submit verification of active practice from any other ((United States))U.S. or Canadian jurisdiction; and

(b) Meet the requirements in WAC ((246-12-020 through 246-12-051))246-12-040.

(3) If the license has been expired for more than three years and the ((practitioner))nurse has not been in active practice in another ((United States))U.S. or Canadian jurisdiction, the ((practitioner must))nurse shall:

(a) Successfully complete a ((commission))board-approved refresher course. The ((practitioner will))nurse may be issued a limited educational ((license))authorization to enroll in the refresher course. The limited educational ((license))authorization is valid only while working under the direct supervision of a preceptor and is not valid for employment as a ((licensed practical or registered)) nurse;

(b) Meet the requirements in WAC ((246-12-020 through 246-12-051))246-12-040.

(4) Fees are specified in WAC 246-840-990.

A registered nurse (RN) or licensed practical nurse (LPN) licensed under this chapter may place their license in an "inactive status" as defined in WAC 246-12-010.

(1) ((A practitioner may obtain an inactive credential. Refer to the requirements in WAC 246-12-090 through 246-12-110.

(2) Practitioners with an inactive credential))To place a license in inactive status, the nurse shall comply with the requirements in WAC 246-12-090.

(2) An inactive license must be renewed on or before the nurse's birthday. To renew an inactive license, the nurse shall comply with the requirements in WAC 246-12-100.

(3) To return to active status:

(a) If the license is inactive for three years or less ((who wish to return to active status must)), the nurse shall meet the requirements in WAC 246-12-090 through 246-12-110.

(((3) Practitioners with an inactive credential))(b) If the license is inactive for more than three years((, who have))and the nurse has been in active practice in another United States (U.S.) or Canadian jurisdiction, ((and wish to return to active status must))the nurse shall:

(((a)))(i) Submit verification of active practice from any other ((United States))U.S. or Canadian jurisdiction;

(((b)))(ii) Meet the requirements in WAC 246-12-090 through 246-12-110.

(((4) Practitioners with an inactive credential))(c) If the license is inactive for more than three years((, who have))and the nurse has not been in active practice in another ((United States))U.S. or Canadian jurisdiction, ((and wish to return to active status must))the nurse shall:

(((a)))(i) Successfully complete a ((commission))board-approved refresher course. The ((practitioner))nurse will be issued a limited educational ((license))authorization to enroll in the refresher course. The limited educational ((license))authorization is valid only while working under the direct supervision of a preceptor and is not valid for employment as a ((licensed practical or registered)) nurse; and

(((b)))(ii) Meet the requirements in WAC 246-12-090 through 246-12-110.

(4) Fees are specified in WAC 246-840-990.

(1) A registered nurse (RN) or licensed practical nurse (LPN) may place their ((credential))license in "retired active" status as defined in WAC 246-12-010 by meeting the requirements of this section.

(2) (((A registered or licensed practical nurse))An RN or LPN who holds a retired active ((credential))license may only practice in intermittent or emergent circumstances.

(a) Intermittent means the ((registered or licensed practical nurse))RN or LPN will practice no more than ((ninety))90 days a year.

(b) Emergent means the ((registered or licensed practical nurse))RN or LPN will practice only in emergency circumstances such as earthquakes, floods, times of declared war, or other states of emergency.

(3) To obtain a retired active ((credential a registered or a licensed practical nurse must))license, an RN or LPN shall:

(a) Meet the requirements in WAC 246-12-120.

(b) Pay the appropriate fee as specified in WAC 246-840-990.

(4) To renew a retired active ((credential the registered nurse or licensed practical nurse must))license, the RN or LPN shall:

(a) Meet the requirements in WAC 246-12-130. The retired active ((credential))license fee is specified in WAC 246-840-990.

(b) Have completed eight hours of continuing nursing education within a ((twelve))12-month period prior to the renewal of licensure in compliance with WAC 246-840-220 (2)(b). Education may include CPR and first aid.

(c) Demonstrate they have practiced at least ((twenty-four))24 hours within a ((twelve))12-month period prior to the renewal of licensure. Practice may be paid or unpaid as a volunteer, but must require nursing knowledge or a nursing license.

(d) Renew their retired active ((credential))license every year on their birthday.

(5) To return to active status, the ((registered or licensed practical nurse must))RN or LPN shall meet the requirements in WAC 246-12-140. The active renewal fee is specified in WAC 246-840-990.

(6) (((A registered or licensed practical nurse))An RN or LPN who holds a retired active ((credential))license is subject to a continuing competency audit as outlined in WAC 246-840-220 and 246-840-230.

The definitions in this section apply throughout WAC 246-840-200 through 246-840-260 unless the context clearly requires otherwise.

(1) "Active nursing practice" means engagement in paid, unpaid, or volunteer activity performing acts requiring substantial nursing knowledge, judgment, and skills described under RCW 18.79.040, 18.79.050, and 18.79.060. Active nursing practice may include, but is not limited to, working in direct care roles or administrative rules such as an administrator, quality manager, policy officer, ((public health nurse, parish nurse, home health nurse,)) educator, consultant, or regulator((, and investigator or case manager)).

(2) (("Advanced nursing degree" means education preparation beyond one's initial education for nurse licensure.

(3))) "Attestation" means the affirmation by signature of the nurse indicating compliance with the standards and terms of the continuing competency requirements.

(((4)))(3) "Compliance audit" means a review of documents to determine whether the nurse has fulfilled the requirements in WAC 246-840-220 through 246-840-260.

(((5)))(4) "Continuing competency" is the ongoing ability of a nurse to maintain, update and demonstrate sufficient knowledge, skills, judgment, and qualifications necessary to practice safely and ethically in a designated role and setting in accordance with the scope of nursing practice. A nurse achieves continuing competency through active practice and continuing nursing education.

(((6)))(5) "Continuing nursing education" refers to systematic professional learning experiences obtained after initial licensure and designed to augment the knowledge, skills, and judgment of nurses and enrich nurses' contributions to quality health care and the pursuit of professional career goals, related to a nurse's area of professional practice, growth and development.

(((7)))(6) "Nurse" means a registered nurse ((and))or licensed practical nurse.

(((8)))(7) "Review period" is one full licensing renewal cycle. For purposes of a compliance audit, the review period will be the one year preceding the audit due date.

(((9) "Technical assistance" means guidance provided by commission staff to help the nurse comply with laws and rules.))

(1) Upon license renewal a nurse ((must))shall attest on a form provided by the department of health declaring completion of the required active nursing practice hours and continuing nursing education hours.

(2) A nurse ((must))shall complete within a 12-month period prior to the renewal of licensure:

(a) A minimum of 96 hours of active nursing practice; and

(b) A minimum of eight hours of continuing nursing education of which at least two hours must be on health equity training, as specified in WAC 246-840-222.

(3) ((Nurses must))A nurse shall complete a qualified suicide prevention training as follows:

(a) A registered nurse, except for registered nurses holding an active certified registered nurse anesthetist license, and licensed practical nurses must complete a one-time, six-hour training in suicide assessment, treatment, and management from a qualified suicide prevention training program. The training must be completed by the end of the first full year of ((practice))licensure.

(b) A qualified suicide training program must be on the department of health model list, required under RCW 43.70.442, to be accepted.

(c) The hours spent completing a qualified training program in suicide assessment, treatment, and management under this section counts toward continuing competency requirements in subsection (2)(b) of this section.

(4) ((Nurses who are))A nurse who is enrolled in, or ((have))has completed prerequisite classes for, an advanced nursing education program ((are))is exempt from the continuing competency requirements during their current review period.

(5) A nurse providing clinical services through telemedicine shall complete requirements under RCW 43.70.495.

(1) ((Licensed practical nurses and registered))Nurses must complete a minimum of two hours of health equity continuing education every year upon license renewal as described in WAC 246-12-800 through 246-12-830.

(2) ((This))The hours spent completing health equity continuing education under this section count toward meeting applicable continuing education requirements for nurse license renewal as described in WAC 246-840-220.

(3) Nurses shall complete a health equity continuing education training that must include:

(a) Implicit bias training to identify strategies to reduce bias during assessment and diagnosis. The training may include at least one other topic listed in RCW 43.70.613 (3)(c).

(b) Trainers with demonstrated knowledge and experience related to health equity. Research referenced in the training must be based on current empirical research and known best practices.

(c) Courses that assess the health care professional's ability to apply health equity concepts into practice in accordance with profession specific rules, which may include, but are not limited to:

(i) An assessment at the end of an in-person or virtual continuing education training to determine knowledge gained during that training; or

(ii) A document provided at the end of an in-person or virtual continuing education training that attests attendance at the training.

(4) The health equity continuing education training must be completed by ((the end of the second full continuing education reporting period after January 1, 2024, or)) the second full continuing education reporting period after initial licensure or 2026 renewal, whichever is later.

(((3)))(5) After the first required reporting period, this training must be completed within a 12-month period prior to license renewal. Additional hours cannot be rolled over to the following year.

(((4) The hours spent completing health equity continuing education under this section count toward meeting applicable continuing education requirements for nurse license renewal as described in WAC 246-840-220.))