Scope of practice: Can OR RNs run the C-arm?

Dear Nurse Beth Advice Column - The following letter submitted anonymously in search for answers. Join the conversation!

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I've been an RN since 1992. For the past 15yrs, I've been in the OR at an ambulatory surgical center. Our center needs clarification of the RN's scope of practice concerning the c-arm. I know we are not allowed to hit the pedal to X-ray the patient. The confusion comes when the surgeon says, "they will run the c-arm". We have been told that we can bring the c-arm into the room but as soon as the patient come into the OR suite that's where our assistance ends. This practice causes a lot of problems with the doctors as you might realize. I work in NJ and would like to have some written policy to be able to show our surgeons. Thank you.

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Specializes in Tele, ICU, Staff Development.

In New Jersey, all X-ray procedures must be performed by  licensed physicians or individuals licensed by the New Jersey Radiologic Technology Board of Examiners. In some states, APRNs can operate C-arms.

It seems like you're referring to a situation where doctors may want registered nurses (RNs) to operate the C-arm. In my experience, doctors often don't fully respect RNs' scope of practice and may pressure them to work in areas that are not clearly defined. This can put the RNs' professional license at risk.

In one ca se, in Illinois, two OR RNs were fined for operating a C-arm.

  • Here's an example of a hospital policy: Mini C-arm
  • Check your professional organization. If you have an AORN membership, you should be able to find recent journal articles, guidelines, and position statements.
  • Check with your organization's Risk Department.
  • Contact the vendor for your C-arm equipment and ask about best practices at other facilities and for model policies.

Best wishes,

Nurse Beth

Resources

AORN

New Jersey Technologist Education and Licensing Section of the Bureau of X-Ray Compliance 

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