While physicians perform important work in the diagnosis, prescription, and treatment of patients, nurses play an important role in the patients' rehabilitation. Furthermore, nurses aid in administration, tailored care, and even tiny details such as bedside manner, all of which assist patients recover completely. It is correct to state that without nurses to augment their efforts, physicians cannot do anything substantial; this also applies to circumstances when nurses act as surgical assistants. For the best nursing care for all the people living in the state of Virginia, a liaison of the state and federal government materialized a set of rules that were meant to enhance the practice of residents in surgery rooms. The Virginia State Nurse Practice Act and the Medical Practice Act, when it comes to matters revolving around nursing, resonate with the Joint Commision on Health Care’s provisions on the regulation of surgical assistants and surgical technologists (this was a Senate Bill 313 that was proposed by Senator Blevins). This paper will give invaluable insights regarding the provisions of the Virginia State Nurse Practice Act and Medical Practice Act, as well as any guidelines, position statements (has either Board adopted AORN’s Official Statement on the RN First Assistant?), informed opinions, qualifications or restrictions issued by the Virginia State Board of Nursing [BON] related to functioning as an assistant-at-surgery.
BON’s Definition of an Assistant-At-Surgery’s Roles
An “assistant-at-surgery” plays the role of a “co-pilot” or a ‘second set of hands’ for the surgeon. The assistant is crucial to the main surgeon and the two complement each other in their line of work. It should be clear that an “assistant-at-surgery” does not carry out surgical procedures on patients, but rather performs complex surgical tasks such as looking for veins for procedures such as bypass grafts, removing unnecessary tissue, dissecting tissue, alteration of tissue, cauterizing and clamping vessels, suctioning, subcutaneous sutures, irrigating, implanting and sponging devices. In as much as the role of assistant-at-surgery is many a time performed by a surgeon, physician assistant, physician, resident, and non –physician practitioners , it is the preference of the state that all these groups of healthcare professionals be trained (Zhang, Unruh & Wan, 2013).
Qualifications of Resident Nurses
The Virginia Board of Nursing, in bid to realize patient safety, prefers to align to the requirements of the Board of Medicine that all surgical assistants are licensed and surgical technologists are certified. The exceptions that are considered revolve around cases where a nursing student in a certified education program may be allowed to practice under immediate supervision; cases where the completion of approved training within the uniformed services may be accepted by the BON as an alternative for certification or licensure; and any resident nurse practicing as a surgical technologist would be required to get a license and not be allowed in a surgery room minus certification because it may lead to prosecution (Godin, Keefe, Kelloway & Hirdes, 2015).
Virginia BON’s Recommendations on Composition of Surgical Teams
The board is aware that time and again, the resident nurses involved in surgical teams have roles that are specified but overlapping; these roles have for the longest time been carried out by a number of licensed and unlicensed personnel. Lately the board commends that this does not happen again because it is a direct jeopardization of the health of patients. The state however, allows the surgery practitioners that are licensed to give directions to students. The delegation of minor tasks to resident students is allowed by the state. In the event that a practitioner does things contrary to the BON’s requirements they are bound to be indicted on the grounds of Board of Medication provisions which prohibit all practitioners from deliberately allowing “subordinates to risk the safety of patients or accord care out of the “scope of practice.” It is also worth mentioning that the Board of Nursing rules make sure to cover tasks that may not be delegated. What’s more, within the operating and/or surgery rooms, the regulations set by the State of Virginia and Medicare only have licensure needs for the circulating resident nurse (who within the State of Virginia ought to be a registered nurse).
General Roles
The State of Virginia Board of Nursing has no issue in the event that an experienced surgical technologist makes a choice to act as an assistant. In such an instance the surgical technologists will basically carry out a scrub role. These have to do with prior-to surgery activities such as preparing patients for all the surgery procedures that they will undergo and making a thorough observation of their vital signs to find out if they are fit for surgery.
Another set of activities are known as during-surgery activities and they revolve around the preparation and maintenance of the sterile field. What’s more, it involves the passing of fluids, instruments, and supplies to the surgeons. In essence, in as much as they are not the ones really doing the surgery, they take care of important things such as lasers, sterilizers, robots, lights, apparatus, suction, and diagnostic equipment. All the same it is worth mentioning that experienced surgical technologists at times carry out some secondary responsibilities linked to an assistant-at-surgery (Banaszak-Holl, Castle, Lin & Spreitzer, 2013).
Delegated Medical Acts
When it comes to matters revolving around the delegation of medical acts to resident nurses who are typically not physicians may be befitting in a number of restricted circumstances in the interests of appropriate patient care and the right use of resources in health care. The guidelines of the State of Virginia for the delegation of a medical act to an individual that is not a physician. It is worth mentioning that the delegation does not in any way absolve the surgeon of the role for the specialized care of the patient being operated on; it only makes wide the circle of responsibility for the safe conduction of the medical procedure.
State Regulation of Health Care Providers
Licensure
All resident nurses looking to work as surgery assistants in the State of Virginia are required to make an application and pass a professional education program and exam that is approved by the State of Virginia Board of Nursing. After the said resident passes the exam, there is issuance of a board –issued licensure; granted so as to enable practice (with possible exception of students and providers that are “grandfathered”.
Certification
All resident nursing applicants looking to work in Virginia may be needed to do well in a Board-approved specialized education test and program or to satisfy the needs of a certifying board (and the Board may insist on the certifying bodies or body that is approved. Unless official recognition to practice is a must, providers may be permitted to practice minus having any certification (Cowles, 2014).
Registration
All resident nursing applicants in the State of Virginia are required to give a provision their names and practice locations alone. In the event that an applicant defaults either by failing to provide such information or providing false information, it may lead to ultimate disqualification.
Opinion on the State on Lack of Regulation of Residents
At some point in the State of Virginia, the Board of Nursing came to a realization that there were no well placed rules on resident nurses who worked in operating rooms as surgical assistants or surgical technologists. Today, the state has made sure that there is no absence of regulatory requirements in Virginia and requires that all resident nurses doing their job in the name of surgical assistants and surgical technologists to look for formal voluntary certification.
Summary and conclusion
The State of Virginia is responsible for all its citizens’ health and wellness; more so now that the government of the United States is seeking inclusion and quality care for all Americans. The policies on professional qualifications are justified because if the healthcare system in Virgina were to be taken as conglomerate, it is the duty of a business to serve its customers in the best way possible. Patients commit their funds to medical care and this indirectly benefits the state by means of revenue; in turn, it is only appropriate that the state braces itself and matches the effort of the citizens.
References
Banaszak-Holl, J., Castle, N. G., Lin, M., & Spreitzer, G. (2013). An assessment of cultural values and resident-centered culture change in US nursing facilities. Health care management review, 38(4), 295.
Campbell, S. H., & Daley, K. (2012). Simulation scenarios for nursing educators: Making it real. Springer Publishing Company.
Cowles, C. M. (2014). Nursing home statistical yearbook, 2013.
Godin, J., Keefe, J., Kelloway, E. K., & Hirdes, J. P. (2015). Nursing home resident quality of life: testing for measurement equivalence across resident, family, and staff perspectives. Quality of life research, 24(10), 2365-2374.
Zhang, N. J., Unruh, L., & Wan, T. T. (2013). Gaps in nurse staffing and nursing home resident needs. Nursing Economics, 31(6), 289.
