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Nevada Government Affairs

State Coordinator

Cheryl Lenhart
(775) 267-2039

Regional Coordinator

Ellen Bencken, RN,BSN,CNOR

(208) 908-1527

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» RN Circulator Laws and Language


NEVADA ADMINISTRATIVE CODE CHAPTER 449. MEDICAL AND OTHER RELATED FACILITIES HOSPITALS Policies and Procedures for Operation of Hospital 449.385 Surgical services. (NRS 449.037) 2. The operating rooms must be supervised by an experienced registered nurse or a doctor of medicine or osteopathy. 4. Circulating duties in an operating room must be performed by a qualified registered nurse, who shall not perform circulating duties in more than one operating room at a time.


NEVADA ADMINISTRATIVE CODE CHAPTER 449. MEDICAL AND OTHER RELATED FACILITIES SURGICAL CENTERS FOR AMBULATORY PATIENTS Medical Records, Services and Facilities 449.9935 Operating and recovery rooms; endoscopy suite. (NRS 449.037) 4. A registered nurse experienced in surgical procedures shall supervise the operating room. 5. Only a registered nurse may function as the circulating nurse in the operating room.

» Registered Nurse First Assistants (RNFAs)

Reimbursement: None

Definition: None

Scope: Nevada State Board of Nursing Practice Decision Scope of Practice of RNFA Preparing/harvesting saphenous vein for coronary artery bypass grafting Adopted by the Nevada State Board of Nursing March 16, 2005 If the RN is a Registered Nurse First Assistant, prepare/harvest a saphenous vein for coronary artery bypass grafting. This procedure is within the scope of nursing for a Registered Nurse First Assistant (RNFA) and/or a Certified Registered Nurse First Assistant (CRNFA) provided the following guidelines are followed (The nurse in the following text refers to either the RNFA or the CRNFA): 1. The nurse must have successfully completed an RN First Assistant program that meets the “AORN Education Standards for RN First Assistant Programs” and a clinical preceptorship devoted to the application of knowledge and clinical skills associated with the process of harvesting a coronary conduit/saphenous vein. The nurse must maintain documentation of competency and maintain current CNOR certification. 2. The nurse will use surgical instruments to perform dissection or manipulate tissue as directed by the surgeon to accomplish the preparation/harvest of saphenous vein. 3. As part of informed consent, the patient or responsible party is informed that a registered nurse will be practicing as a first assistant at surgery and performing the procedure. 4. The nurse is competent to perform the procedure and has the documented and demonstrated knowledge, skill and ability to perform the procedure pursuant to NAC 632.071, 632.224, and 632.225. 5. There are agency policies and procedures, a provision for privileging and required protocols in place for the nurse to perform the procedure. 6. The nurse maintains accountability and responsibility for nursing care related to post-operative follow up for the procedure and follows the accepted standard of care which would be provided by a reasonable and prudent nurse. 7. The procedure is performed interdependently by the surgeon and the nurse. The surgeon must be in attendance while the nurse performs this procedure.

Guidelines for Perioperative Practice


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