Nursing

The law keeps the nursing regulator operating through 2030 and changes how nurses and nursing programs are supervised, trained, and licensed. It also recognizes certain out-of-state nurse practitioner experience and broadens medication-administration authority.

What the law does ​

• Extends the Board of Registered Nursing and its executive-officer provisions until January 1, 2031, and requires quarterly meetings in geographically diverse locations when practicable.
• Requires the board to post approved nursing schools online, use national nursing-education approval guidelines for inspections, and set simulation training standards.
• Allows nursing programs facing unavailable clinical placements to seek a temporary reduction to 200 direct patient-care medical-surgical hours, subject to specified safeguards.
• Permits nurses to administer medications ordered by nurse practitioners or certified nurse-midwives, and medications directed by advanced practice registered nurses within their scopes of practice.
• Requires, beginning January 1, 2029, nurses to submit continuing-education completion documentation when renewing licenses.
• Lets the board recognize qualifying transition-to-practice experience completed in designated other states for nurse practitioners practicing without standardized procedures.
• Allows furnishing numbers for nurse practitioners and certified nurse-midwives to be issued with initial or renewal certification applications, eliminates late-renewal penalties for those numbers, and removes minimum fees for several advanced-nursing credentials.

Who it affects ​

• Registered nurses, including nurses in the board's intervention and discipline processes.
• Nurse practitioners, certified nurse-midwives, nurse anesthetists, and clinical nurse specialists.
• Approved nursing schools, nursing-program directors, faculty, students, and clinical-placement facilities.

Breakdown ​

Board Extension and Meeting Locations ​

This bill extends the Board of Registered Nursing and its executive officer appointment requirement through January 1, 2031. It also changes the board’s meeting-location rule: rather than requiring meetings in northern and southern California, the board must meet at least every three months in locations that are geographically diverse when practical.

Key takeaways

• The Board of Registered Nursing will continue operating through January 1, 2031.
• The board must continue appointing an executive officer through January 1, 2031.
• The board must still meet at least once every three months.
• Meetings no longer must be specifically held in both northern and southern California.
• The board must instead use geographically diverse meeting locations to the extent practicable.

Nursing Program Standards and Oversight ​

This part requires the nursing board to post its list of approved nursing schools online and to use national nursing-education guidelines when inspecting programs. It sets standards for simulation-based clinical training, makes a pathway for reducing certain direct patient-care hours available beyond the 2023–24 academic year, and changes approval and remediation rules for nursing faculty and program leaders.

Key takeaways

• The nursing board must publish its list of approved nursing schools on its website.
• The board’s inspection standards must be consistent with the National Council of State Boards of Nursing’s 2020 Nursing Education Approval Guidelines, or a successor guideline.
• Simulation-based clinical hours that do not have to involve direct patient care must follow identified best practices or equivalent board-approved standards.
• Approved nursing programs may request permission to reduce required direct patient-care hours to 200 hours in medical-surgical nursing when the required conditions are met.
• The bill removes the prior 2023–24 academic-year deadline for approving these requests and removes the automatic expiration of approved requests at the end of that year.
• Only individual faculty approvals, rather than approvals for directors or assistant directors, will be valid for five years and eligible for renewal under this provision.
• The board may approve an otherwise unqualified assistant director or director to serve for up to one year under a remediation plan and mentorship while completing the plan.

Medication Orders in Nursing Practice ​

This part expands the legal definition of nursing practice. Nurses may administer medications ordered by nurse practitioners and certified nurse midwives, and may administer medications as directed by other advanced practice registered nurses when that direction is within the advanced practice nurse’s authorized scope of practice.

Key takeaways

• Nursing practice will include administering medications ordered by a nurse practitioner.
• Nursing practice will include administering medications ordered by a certified nurse midwife.
• Nurses may administer medications as directed by an advanced practice registered nurse when the direction is allowed within that practitioner’s scope of practice.
• The change adds these advanced practice nursing professionals to the types of providers whose medication orders or directions nurses may carry out.

Registered Nurse Licensing Updates ​

This part updates several rules for registered nurses. It removes the requirement that licensing exams be written and the related rules for oral or practical supplements. It also adds requirements for intervention programs, continuing-education proof at renewal beginning in 2029, and petitions after a default license revocation.

Key takeaways

• The bill removes the requirement that registered nurse licensing examinations be written.
• The bill also removes the provision allowing the board to supplement examinations with oral or practical tests in subjects it chooses.
• When creating a rehabilitation plan for an intervention-program participant, the evaluation committee must decide whether the participant must practice nursing before completing the program.
• Beginning January 1, 2029, nurses renewing their licenses must submit proof of required continuing education or equivalent professional development at the time of renewal.
• The renewal proof must include documentation showing completion of continuing-education requirements during the prior renewal period or prior two years.
• A nurse whose license was revoked by default for not submitting a notice of defense may seek reinstatement without waiting for a minimum time period.

Nurse-Midwife Furnishing Numbers ​

The bill allows the nursing board to issue a drug-and-device furnishing number when a certified nurse-midwife renews a nurse-midwifery certificate, not only when applying initially. It clarifies that the relevant initial and renewal applications are for the certificate to practice nurse-midwifery. The bill also eliminates the late penalty fee for failing to renew a furnishing number on time.

Key takeaways

• The board may issue a furnishing number to a qualified certified nurse-midwife during either an initial or renewal application for a nurse-midwifery certificate.
• The bill ties furnishing-number applications to the initial and renewal applications for a certificate to practice nurse-midwifery.
• The board may no longer charge a penalty fee for failing to renew a furnishing number within the required time.
• The existing authority to charge fees for initial and renewal applications remains subject to the stated fee limits.

Nurse Anesthetist Application Fees ​

The bill removes the $500 minimum application fee for nurse anesthetist certificates. The nursing board may still set the fee, but it is no longer required to charge at least $500.

Key takeaways

• The bill eliminates the $500 minimum fee for applying for a nurse anesthetist certificate.
• The nursing board continues to set the application fee for these certificates.
• The existing maximum application fee of $1,500 is not changed by this provision.

Nurse Practitioner Furnishing and Practice ​

The bill lets the nursing board issue or renew a nurse practitioner furnishing number through the nurse practitioner qualification or certification application process. It removes the late-renewal penalty for furnishing numbers. It also allows qualifying transition-to-practice experience completed in certain other states to count toward the experience required for nurse practitioners to practice without standardized procedures.

Key takeaways

• The board may issue a furnishing number when a nurse practitioner applies initially for qualification or certification or renews that qualification or certification.
• The bill clarifies that the relevant initial and renewal applications are applications for nurse practitioner qualification or certification.
• The bill removes the board's authority to charge a penalty for failing to renew a furnishing number on time.
• Nurse practitioners may use qualifying transition-to-practice experience completed in another state to meet the experience requirement for independent practice functions.
• By January 1, 2028, the board must identify other states whose practice experience requirements meet or exceed the applicable California requirements.

Clinical Nurse Specialist Fee Flexibility ​

The bill removes the minimum amounts set in law for several clinical nurse specialist fees. The nursing board may set these fees without being required to meet the former minimums, while the existing maximum limits remain in place.

Key takeaways

• The bill removes the $500 minimum application fee for a registered nurse seeking recognition as a clinical nurse specialist.
• The bill removes the $30 minimum fee for a temporary clinical nurse specialist certificate.
• The bill removes the $150 minimum biennial renewal fee for a clinical nurse specialist certificate.
• The bill removes the $75 minimum late-renewal penalty fee.
• The existing maximum fee limits are not changed by this provision.

Technical Nursing Updates ​

This part makes various nonsubstantive updates to nursing-related laws. These changes do not alter the underlying legal requirements or policies.

Key takeaways

• The bill makes technical, nonsubstantive changes to multiple nursing-related provisions.
• These updates do not change the substance of existing nursing laws.
• The digest does not identify the specific provisions affected by these changes.