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HB 232

Collaborative agreements; removes registered nurses from list of practitioners, etc.

2026 Regular Session Introduced by Otto Wachsmann

HB 232 eliminates mandatory physician collaborative agreements for registered nurses in Virginia, expanding RN practice independence but raising patient safety and professional oversight questions.

Approved by Governor-Chapter 94 (effective 7/1/2026)
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Bill Summary · HB 232

Legislative bill overview

HB 232 removes registered nurses (RNs) from Virginia's list of healthcare practitioners required to operate under collaborative agreements with physicians. This change would allow RNs to practice with greater independence in certain clinical settings without the formal physician oversight structure currently mandated by state law.

Why is this important

This bill directly affects healthcare delivery scope and workforce autonomy in Virginia. The change could expand RN practice authority, potentially improve access to care in underserved areas, and alter the physician-nurse working relationship—but it also raises questions about patient safety oversight and professional regulation in clinical practice.

Potential points of contention

  • Patient safety concerns: Opponents may argue that collaborative agreements provide necessary physician oversight for complex clinical decisions, while supporters contend that RNs are adequately trained for independent practice in their scope
  • Professional turf disputes: Physician organizations may resist reduced collaborative requirements as a threat to their gatekeeping role, while nursing advocates view it as long-overdue recognition of RN competency
  • Implementation ambiguity: The bill's language ("removes from list") requires clarification on which specific practice settings or procedures remain physician-supervised versus fully independent

Compiled from official sources — confirm details with the bill’s official record.

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