As a nurse working in an OR, can my employer ask me to place or exchange an instrument for a robot during a procedure, when the surgeon is operating remotely?

Placing or exchanging of an instrument being used by a robot in a procedure or surgery is not captured under any of the controlled acts authorized to a nurse. However, the Nursing Act, 1991, is broad enough that changing an instrument used by a robot would be considered “the provision of treatment of health conditions by therapeutic means."

As such, a nurse would not need an order or delegation to complete this activity. Placing or exchanging of an instrument can be done in collaboration with the surgeon, provided the nurse has the knowledge, skill and judgment to perform the activity safely and competently. Additionally, when determining whether it is appropriate for a nurse to perform any type of care, other factors that must also be considered include the individual nurse’s authority, context and competence in their specific practice setting, as outlined in the Scope of Practice standard.

What are my accountabilities if the wrong instrument is removed or exchanged with a robot?

A nurse’s accountability related to removing or exchanging instruments with a robot would not differ from if a nurse improperly performed any aspect of nursing care that is not a controlled act, such as taking vital signs. As with any activity, it is the nurse’s accountability to ensure they have the knowledge, skill and judgment to perform the task safely and competently, and if needed identify and advocate for appropriate training when necessary.

Accountabilities of a nurse working with robotics would be employer directed with clear policies and procedures outlining nursing roles and responsibilities within the interdisciplinary team, including if certain qualifications, experience or training is required, to ensure a workplace setting that supports safe nursing practice and safe and effective client care.

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