From Laws to Nursing Regulations - How the System Works
- ANA California Staff
- Mar 5
- 5 min read
Updated: Mar 5
Part 1 of the Nursing Regulations Guide.
What You’ll Learn
The relationship between laws (statutes), regulations (rules), and policies that shape nursing practice in California.
How laws set broad frameworks while regulations define the details.
How this process determines what nurses can do, how they do it, and who oversees compliance.
When and where nurses can participate in shaping regulatory outcomes.
Why It Matters
A legal or regulatory decision shapes every part of your practice.
The number of hours you must complete to renew your license, how you document patient care, and what counts as independent practice all come from a combination of laws and regulations.
Many nurses are familiar with the Board of Registered Nursing (BRN), but few understand how deeply the regulatory system influences their professional lives.
Understanding how laws are created and translated into regulations helps nurses identify key advocacy points.
Knowing the system gives you power to influence it.
Understanding the Legal and Regulatory Landscape
In California, laws begin as bills passed by the State Legislature and signed by the Governor.
These laws, called statutes, establish the foundation for how the state governs issues such as healthcare, education, and professional licensing. However, most statutes do not include the detailed instructions needed for implementation.
They rely on state agencies to interpret, clarify, and operationalize their intent.
This is where regulations come in.
Laws (Statutes) | Regulations (Rules) |
Enacted by the California Legislature and signed by the Governor. | Created by a state agency such as the BRN. |
Define what must be done and why. | Define how it will be done and by whom. |
Found in the California Codes (for nursing, this is primarily the Business and Professions Code). | Found in the California Code of Regulations (CCR), often Title 16, Division 14 for nursing. |
Cannot be changed without new legislation. | Can be modified by the agency through the rulemaking process. |
Example:
The Nursing Practice Act (B&P Code § 2700) gives the BRN the authority to regulate nursing practice.
The BRN then develops regulations in the California Code of Regulations (CCR) that describe licensing, renewal, continuing education, and discipline procedures.
How a Law Becomes a Regulation
When a bill becomes law, it often directs a specific agency to implement or enforce it.
The agency must then develop regulations that outline exactly how the law will be carried out.
This process, called rulemaking, is governed by the Administrative Procedure Act (APA), which ensures transparency and public participation.
For example, if a new law requires nurses to complete additional continuing education, the BRN would determine:
How many hours are required
Which courses qualify
How compliance will be tracked
What happens if a nurse does not comply
The agency drafts these rules, releases them for public comment, revises them based on feedback, and finalizes them through approval by the Office of Administrative Law (OAL).
Only after OAL approval do they become enforceable regulations published in the CCR.
Visualizing the System
Imagine the process as a pyramid:
Statutes (Laws) – Broad policy goals and authorities (e.g., “The BRN shall regulate the practice of nursing.”)
Regulations (Rules) – Detailed requirements developed by agencies (e.g., “All licensees must complete 30 CE hours every two years.”)
Policies and Procedures – Internal rules developed by organizations to comply with regulations (e.g., “Our hospital tracks CE completion through an internal database.”)
At each level, there are points of influence where nurses can engage:
Supporting or opposing bills during legislative hearings.
Commenting on draft regulations before they are finalized.
Advising healthcare organizations on how to implement new rules.
Running Example: Expanding Continuing Education Requirements
Let’s trace one issue through the full system.
Legislative Stage
The Legislature passes a bill requiring nurses to complete additional CE hours to maintain licensure.
The statute states the intent but does not specify the details.
Regulatory Stage
The BRN, under the Department of Consumer Affairs, drafts regulations describing:
Which CE courses count.
How providers are approved.
How compliance will be reported.
The proposed regulation is published for public comment.
Nurses, nursing organizations, and schools have the opportunity to respond.
Agency Review and Finalization
The BRN reviews all submitted comments and may revise the regulation accordingly.
The rule is approved by the OAL and codified in the CCR.
Institutional Stage
Employers update their internal CE tracking systems.
Nurse leaders communicate compliance expectations to staff.
Each stage contains opportunities for advocacy and influence.
How Regulations Affect Nursing Practice
The effect of regulations extends beyond individual licensure. They determine:
The scope of practice for registered nurses and advanced practice nurses.
Standards for education and training programs.
Processes for discipline and enforcement.
The minimum requirements for safe, competent care.
These rules also shape how hospitals, schools, and clinics structure their policies.
If a regulation changes, internal procedures often change with it.
Why Nurses Should Pay Attention
Regulations are often where the most significant practice changes occur.
While legislative advocacy gets more public attention, many impactful changes happen quietly within agencies.
For example:
A rule defining “supervision” for nurse practitioners may expand or restrict clinical independence.
A change in continuing education requirements may open or limit access to professional development.
Updates to infection control standards may directly alter bedside procedures.
By understanding how rules are written, nurses can anticipate change instead of reacting to it.
Advocacy in Action
Advocating within the regulatory process can include:
Monitoring proposed regulations on agency websites.
Submitting written public comments based on evidence or nursing experience.
Joining advisory councils or committees.
Partnering with ANA\California to provide unified, evidence-based recommendations.
Example: During the BRN’s review of telehealth practice standards, nurses submitted comments describing how new rules might affect rural patient access.
Their collective input led to broader flexibility and improved access to care.
Think About It
What rules currently shape your daily nursing practice?
Who decided how those rules were written?
How might your experience help improve future regulations?
Identifying where your expertise fits is the first step toward meaningful participation.
Bookmark This
Key Terms:
Statute: A law passed by the Legislature and signed by the Governor.
Regulation: A rule issued by an agency that explains how to comply with a statute.
Administrative Procedure Act (APA): The California law governing how agencies adopt, amend, or repeal regulations.
Office of Administrative Law (OAL): The state office that reviews and approves all proposed regulations.
California Code of Regulations (CCR): The official publication of all approved state regulations.
Next Up
Part 2: Who Holds the Pen — The Agencies That Regulate Nursing
We’ll explore the agencies that create, enforce, and interpret nursing regulations in California, and how you can connect with their work.