1. (a) Qualifications for registered nurse first assistants (RNFAs):

   1. (1) A registered nurse who wishes to function as a first assistant (RNFA) in surgery shall submit an application and all applicable fees to the Board and shall submit evidence including, but not limited to, the following:

      1. (A) Current licensure as a registered nurse in the State of Texas or reside in any party state and hold a current, valid registered nurse license in that state;
      2. (B) Current national certification (CNOR) in perioperative nursing; and
      3. (C) Completion of a nurse first assistant educational program approved by an organization recognized by the Board; or
      4. (D) Current certification as a registered nurse first assistant (CRNFA) by a national certifying body recognized by the Board.
   2. (2) After review by the Board, notification of registration shall be mailed to the RNFA informing him/her that the registration process has been completed.
   3. (3) The registered nurse whose functions include acting as a first assistant in surgery shall know and conform to the Texas Nursing Practice Act; current Board rules, regulations, and standards of professional nursing; and all federal, state and local laws, rules, and regulations affecting the RNFA specialty area. When collaborating with other health care providers, the RNFA shall be accountable for knowledge of the statutes and rules relating to RNFAs and function within the scope of the registered nurse.
   4. (4) A registered nurse functioning as a first assistant in surgery shall comply with the standards set forth by the AORN.

2. (b) A registered nurse not qualifying under subsection (a) of this section may first assist until January 1, 2005 if he/she:

   1. (1) Has current licensure as a registered nurse in the State of Texas or resides in any party state and holds a current, valid registered nurse license in that state;
   2. (2) Was actively engaged in first assisting as of March 1, 2002;
   3. (3) Does not use any titles to imply that the person is a nurse first assistant or otherwise hold him/herself out as a nurse first assistant;

   4. (4) Has operating room experience that meets the following criteria:

      1. (A) CNOR eligible (meets qualifications to apply and sit for the national certification examination in perioperative nursing (CNOR) as defined by the Certification Board Perioperative Nursing) and
      2. (B) 500 hours of experience first assisting as of March 1, 2002; and
   5. (5) Complies with BNE Standards of Professional Nursing Practice Rule 217.11(12) requiring RNs to accept only assignments that take into consideration patient safety and that are commensurate with the RN's educational preparation, experience, knowledge and physical and emotional ability;
3. (c) Effective January 1, 2005, the exceptions outlined in subsection (b) of this section no longer apply, and any registered nurse first assisting must meet the requirements outlined in subsection (a).

Source Note:The provisions of this §217.18 adopted to be effective March 13, 2002, 27 TexReg 1735; amended to be effective February 20, 2003, 28 TexReg 1381.