RN Circulator Laws and Language
Hospital: CALIFORNIA CODE OF REGULATIONS
TITLE 22. SOCIAL SECURITY
DIVISION 5. LICENSING AND CERTIFICATION OF HEALTH FACILITIES, HOME HEALTH AGENCIES, CLINICS, AND REFERRAL AGENCIES
CHAPTER 1. GENERAL ACUTE CARE HOSPITALS
ARTICLE 3. BASIC SERVICES. Organization and Supervision
70217. Nursing Service Staff
(2) The surgical service operating room shall have at least one registered nurse assigned to the duties of the circulating nurse and a minimum of one additional person serving as scrub assistant for each patient-occupied operating room. The scrub assistant may be a licensed nurse, an operating room technician, or other person who has demonstrated current competence to the hospital as a scrub assistant, but shall not be a physician or other licensed health professional who is assisting in the performance of surgery.
70225. Surgical Service Staff
(d) There shall be sufficient nursing personnel so that one person is not serving as circulating assistant for more than one operating room.
Registered Nurse First Assistants (RNFAs)
State of California Department of Consumer Affairs, Board of Registered Nursing, NPR-B-18 6/16/2011: “The RN as First Assistant to the Surgeon”
The role of RN first assistant to the surgeon requires the performance of a combination of nursing and medical functions. The RN first assistant directly assists the surgeon by controlling bleeding, providing wound exposure, suturing and other surgical tasks. The RN first assistant may provide other advanced assistance, such as mobilization of tissue, patient positions and directing other surgical team members with specific individual tasks. The RN first assistant, practices perioperative nursing and must have acquired the necessary specific knowledge, skills and judgment. The RN first assistant practices under the supervision of the surgeon during the intraoperative phase of the perioperative experience. In order to perform those functions considered to be first assistant to the surgeon, the RN must adhere to standardized procedures. The RNFA may not perform the function of the scrub nurse while functioning as the RNFA.
* This Advisory Opinion links to AORN’s Standards for RN first assistant education programs.
Would require every general acute care hospital to establish and maintain a patient classification system for establishing staffing requirements by unit, patient and shift.
5/9/13: In Senate: Read 3rd time, failed to pass. Motion to reconsider granted.