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Page modified February 02, 2010

RPNs as circulating nurses

Q

I am an RPN. Since 1986, 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, I feel that I am able to work independently as a circulating nurse. Is this an appropriate role for an RPN?

A

The OR postgraduate education program for RNs 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. This introduction to the role allows RPNs and RNs to work collaboratively; it is not intended to give RPNs the competencies to act independently in the circulating nurse role.

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, in less complex situations in which the client’s needs are stable and predictable and RN resources are immediately available to manage unexpected 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 an emergency. 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.]

The College believes that an RPN working as a circulating nurse should have, at a minimum, strong clinical experience as a scrub nurse and successfully completed postgraduate courses in physical assessment, pharmacology, basic life support and OR education.

There may be moderately complex 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 care needs of the perioperative client are highly complex, and client outcomes either vary or there is a high risk of a potentially negative outcome, 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.

Last Updated Feb. 2010

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