(a) Nurse First Assistants.
  (1) A registered nurse who wishes to function as a first assistant (RNFA) in surgery shall meet the following requirements :
    (A) Current licensure as a registered nurse in the State of Texas or a current, valid registered nurse license with a multi-state privilege in a party state;
    (B) Completion of a nurse first assistant educational program approved or recognized by an organization recognized by the Board; and
    (C) Is either:
      (i) currently certified in perioperative nursing by an organization recognized by the board (CNOR certification in perioperative nursing); or
      (ii) currently recognized by the board as an advanced practice nurse and qualified by education, training, or experience to perform the tasks involved in perioperative nursing.
  (2) 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. Advanced practice nurses functioning as first assistants under the authority of (a)(1)(C)(ii) of this subsection shall function within the scope of the advanced role and specialty for which they hold authorization to practice from the board.
  (3) A registered nurse (including an advanced practice nurse) functioning as a first assistant in surgery shall comply with the standards set forth by the AORN.
(b) Assisting at Surgery by Other Nurses.
  (1) A nurse who is not a nurse first assistant as defined in subsection (a) of this section may assist a physician, podiatrist, or dentist in the performance of surgery if the nurse:
    (A) Has current licensure as a nurse in the State of Texas or a current, valid nursing license with a multi-state privilege in a party state;
    (B) Assists under the direct personal supervision and in the physical presence of the physician, podiatrist, or dentist;
    (C) Is in the same sterile field as the physician, podiatrist, or dentist;
    (D) Is employed by:
      (i) the physician, podiatrist, or dentist;
      (ii) a group to which the physician, podiatrist, or dentist belongs; or
      (iii) a hospital licensed or owned by the state; and
    (E) Is qualified by education, training, or experience to perform the tasks assigned to the nurse.
  (2) A nurse assisting in the performance of surgery under this subsection shall not use:
    (A) The title "nurse first assistant" or "registered nurse first assistant,"
    (B) The abbreviation "R.N.F.A.," or
    (C) Any other title or abbreviation that implies to the public that the person is qualified as a nurse first assistant under subsection (a) of this section.

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; amended to be effective February 19, 2006, 31 TexReg 850