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Pearls for practice — RCWs vs. WACs: What’s the difference?


This story was published in the Fall 2021 issue of The Washington Nurse magazine.


Rcw vs wac

A nurse’s scope of practice is defined by each state’s Nurse Practice Act. In Washington state, this is encom­passed in the Revised Code of Washington (RCW) and Washington Admin­is­tra­tive Code (WAC). Let’s unpack each of these and learn how they affect nursing practice in Washington state.

RCWs are collec­tions of statutes written by the Washington State Legis­la­ture. Each statute is written, amended and approved by the Legis­la­ture and signed into law by the governor. RCWs governing nursing practice are under RCW 18.79. These cover scope of practice, delega­tion, educa­tion, disci­pline, licensing and other matters pertaining to nursing practice of RNs, LPNs, ARNPs and nurse techs. They also outline the scope and purpose of the Nursing Care Quality Assur­ance Commis­sion (NCQAC).

The Uniform Disci­pli­nary Act is found in RCW 18.130 — this is the specific RCW that deter­mines the threshold for formal disci­pline (what is consid­ered a charge­able offense) for all health profes­sions in Washington state.

WACs are rules that provide inter­pre­tive support for those covered by RCWs. They carry the full force of the law. WACs pertaining to nurses are written and adopted by the secre­tary of health or NCQAC. WACs pertaining to nursing practice begin at WAC 246 – 840 and cover educa­tion, practice, contin­uing compe­tency, nursing educa­tion, pain manage­ment, nurse techs and other areas of practice.

It sounds compli­cated, but it’s hugely benefi­cial to struc­ture things this way. WACs can get much more specific about the details of nursing care. Those rules are made for nurses, by nurses — which is much better than trying to get lawmakers to under­stand the various nuances of what nurses do (there are very few nurses in the legis­la­ture). This also means that NCQAC can involve the public and nursing stake­holders through public comment, meetings and other ways of solic­iting feedback in a time frame that isn’t limited by the legisla­tive session. WACs are not permitted to contra­dict RCWs in terms of content or interpretation.

Changes to WACs are also known as rulemaking.” Rules are created through a process involving public meetings and hearings. NCQAC will post notices of these sessions on its website and its email alerts. RNs are invited to provide input to these changes either by attending or writing to the commission.

A complete list of rules in progress, workshops, hearings and direc­tions for providing comments is on the NCQAC website.