Current through Register Vol. 40, No. 6, March 31, 2022
The registered nurse may function as a
surgical first assistant according to standardized procedures, as defined in
The RNFA has the duty to verify that standardized procedures are in effect
before performing the functions of a surgical first assistant.
(2) Performing intra-operative functions as a
RNFA is limited to the direct supervision of the attending surgeon physically
present in the surgical suite where the case is being performed.
When directed by the attending surgeon,
the RNFA intra-operative functions include, but are not limited to:
(a) Positioning the patient, preparing and
draping the surgical site.
Providing exposure, retraction, and hemostasis.
(c) Use and handling of surgical
handling, dissection, suturing, and stapling.
(e) Making the skin nick or stab wound for
laparoscopic surgery or drains, excluding placement of primary trocar for
laparoscopic and robotic access. Secondary placement of trocars for
laparoscopic and robotic surgery if the RNFA is deemed competent to perform by
the attending surgeon who is within proximity of the sterile field.
(f) Securing drains.
(g) Closing of wounds external to the
(h) Harvesting extremity
veins and closure of the resulting wounds.
(4) Functions for the RNFA that are not
listed in these rules shall be defined in standardized procedures, which
require Board approval prior to implementation for all practice
procedures for the RNFA shall include a statement of clinical privileges for
additional technical functions that are permitted in a hospital.
(6) The RNFA shall not function as a scrub
nurse concurrently with responsibility as a surgical first assistant.
(7) Practice as a registered nurse first
assistant does not include the functions and privileges reserved for advanced
practice nurses elsewhere in these rules.
Ala. Admin. Code r.
New Rule: Filed February
4, 1997; effective March 11, 1997. Repealed: Filed October 29, 2001; effective
December 3, 2001. New Rule: Filed November 23, 2009; effective December 28,
2009. Amended: Filed April 15, 2010; effective May 20, 2010.
Administrative Monthly Volume XXXIV, Issue No. 10, July 29, 2016,
Administrative Monthly Volume XXXV, Issue No. 10, July 31, 2017,
Author: Alabama Board of Nursing
Code of Ala.