News and Issues

First surgical assistant and nurse colposcopist role
At its meeting on 16 October 2008, the Nursing Council discussed a range of issues related to nurses working in roles which extend the registered nurse scope of nursing practice. The Council first considered this issue at its meeting in May 2008 in relation to the first surgical assistant role and as an interim measure required that nurses working in such roles would be required to undergo an authorisation process. In August a working group met and advised the Council that its preference was for employer credentialing to be the mechanism for ensuring competence to practice.

Following this consultation and further consideration of the issue as it relates to public safety and the scopes of practice, the Council advises that it confirms its decision that nurses working in the first surgical assistant role are working outside the current registered nurse scope of practice.

The Council has adapted the Australian College of Operative Nurses (ACORN) definition (2008) to describe the role:

The first surgical assistant is a perioperative nurse with additional education and skills, functioning in an extended role. The first surgical assistant during a surgical procedure carries out functions intended to assist the surgeon in performing a safe surgical procedure with optimal results for the patient. These may include incision of skin or tissue, tissue dissection, applying diathermy to body tissues, applying clamps or clips to vessels, suturing skin or any other tissue layers, preparation of transplant organs or tissues, and vein harvesting. The first surgical assistant practises perioperative nursing and has acquired the knowledge, skills and judgement necessary to assist the surgeon, through organised instruction and supervised practice. The first surgical assistant functions interdependently with the surgeon during the intraoperative phase of practice. The first surgical assistant does not concurrently function as an instrument nurse.

The Council considers that the registered nurse scope of practice statement does not clearly describe these activities as being within the scope and that the scope entry qualifications do not adequately prepare nurses for this extended practice role. The Council is not satisfied that appropriate measures are currently in place in all situations to ensure competence to practice in this extended role and thus assure the Council of safety to the public.

The Council advises nurses (and their employers) who are undertaking a first surgical assistant role to apply to the Council for an authorisation which would enable them to continue to practise.

For information on the process of applying for an authorisation for first surgical assistant click here (PDF 59KB) and the application form click here (PDF 14KB).

The Council has also determined that nurses performing colposcopies are also practising outside the scope of registered nurse practice. The Council requires these nurses to apply for an authorisation at the completion of a certification process as outlined in the New Zealand Nurses Organisation (NZNO) Women’s Health Section Standards for Nurse Colposcopists Training and Clinical Training Programme 2007.

http://www.nzno.org.nz/Site/Sections/Sections/Womens_Health/default.aspx

For information on the process of applying for an authorisation for nurse colposcopists click here (PDF 63KB) and the application form click here (PDF 15KB).

The Council wishes to reassure nurses currently working in these roles that they will be given time to apply for an authorisation. You are required to apply before 30 June 2009. There will be no fee for authorisations submitted prior to 30 June 2009.