animated banner
Public Employers Students Media More   en français

 Nursing Practice > You Asked Us Online 

Page modified November 03, 2006

RPNs as circulating nurses

Q

I am an RPN. Since 1986, I have worked as an operating-room scrub nurse, and part of my role is assisting the RN circulating nurse. After years of experience and related courses, I think I am able to work independently as a circulating nurse. Is this an appropriate role for an RPN?

A

The OR post-graduate 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 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 within their scope of practice. 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 Standards of Practice and Competencies for Perioperative Nursing Care for Licensed Practical Nurses/Registered Practical Nurses states that RPNs working in the circulating role need the immediate availability of a resource, such as an RN, in the event of an emergency. This is consistent with the College’s expectations. It is important for all nurses to realize that this resource is a critical factor. (An RN acting as a scrub nurse 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.)

At a minimum, it is suggested that an RPN working as a circulating nurse have strong clinical experience as a scrub nurse and successfully complete post-graduate 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.

[top]