RPNs as circulating nurses
I am an RPN. Since 2000, I have worked as an operating room (OR) scrub nurse, and part of my role is assisting the RN circulating nurse. After years of experience and related courses, can I work as a circulating nurse? Is this an appropriate role for an RPN?
The OR postgraduate education program is designed for RNs and includes in-depth content to prepare the RN for the circulating role. The curriculum of the RPN program concentrates on the scrub nurse role and includes a basic introduction to the role of the circulating nurse.
Although RPNs may have developed an understanding of the competencies for the circulating role through extensive experience and relevant courses, the role is not appropriate for independent practice.
For RPNs who have developed the competencies for the circulating role by other means, such as extensive experience and relevant courses, there may be situations in which this role is appropriate. For example, when the client’s needs are less complex, predictable and RN resources are immediately available to manage outcomes, an RPN with circulating role competencies may take on this responsibility.
The College’s expectation is that RPNs working in the circulating role need the availability of an immediate resource, such as an RN, in the event of unexpected outcomes. It is important for all nurses to realize that this resource is a critical factor. A scrub nurse (RN) cannot be considered an immediately available resource because the nature of the scrub role does not permit the nurse to provide an immediate intervention to manage an emergency situation.
There may be situations in which RPNs can work collaboratively with RNs in a circulating role. For example, when two circulating nurses are required, one may be an RPN. When the perioperative clients are highly complex, unpredictable with high risk of negative outcomes, the RN is the most appropriate category of nurse to be assigned as the circulating nurse.
As with any role, once you accept responsibility for acting as a circulating nurse, you are accountable for your competence, actions and decisions.