Board opinions usually are issued in response to a specific inquiry from a nurse. States have different names for these opinions, including advisory statements, position statements, policy statements, and advisory rulings. Most states do not have laws or regulations pertaining to RNFAs, but a number of state boards of nursing have issued some type of opinion regarding RNFAs. Eventually, through education, communication, and influence, the practice of first assisting was recognized as being within the scope of nursing in all 50 states. Throughout the 1980s and into the early 1990s, AORN periodically surveyed state boards of nursing regarding their positions on RN first assisting. * What do individual states' laws, regulations, or board statements say about the use of unlicensed personnel as first assistants? * What do the medical practice acts and medical regulations say about physicians delegating medical tasks in the OR? * Are there individual state laws or regulations pertaining to RNs practicing as first assistants? * Has the state board of nursing issued any guidance statements regarding the RN first assistant (RNFA)? Additionally, this article poses questions that OR supervisors and circulating RNs should seek to answer, such as the following. Whereas the "health policy issues" column in the June 2004 issue of the AORN Journal describes in very general terms various groups providing first assisting services, this article sheds further light on the first assistant role and the legal environment that allows a number of different individuals to practice in this role.
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