Are nurses allowed to use the C-arm?
In short, no. Absolutely not. One of the seemingly larger issues in the O.R. is the fact that nurses and sometimes other staff such as surgical techs are operating the c-arm during surgery when an x-ray tech is not available. This raises concerns with many radiologic technologists, as it should. Here in Florida, the Florida Department of Health answers this very issue.
"Do I need a Florida certificate (license) to administer ionizing radiation to humans in Florida, or perform other radiologic technology procedures?
Yes, unless you qualify for an exemption listed under s. 468.302, Florida Statute (F.S.)Â Section 468.302(1), F.S., states that no person shall use ionizing radiation on a human unless that person is a licensed practitioner or a radiologic technology certificate holder in Florida. According to s. 468.301, F.S., "licensed practitioner" means a person who is licensed or otherwise authorized by law in Florida to practice medicine, podiatric medicine, chiropody, osteopathic medicine, naturopathy, or chiropractic medicine in this state. A radiologic technology certificate holder is a: Basic X-ray Machine Operator, Basic X-ray Machine Operator-Podiatric Medicine, General Radiographer, Nuclear Medicine Technologist, Radiation Therapy Technologist or Radiologist Assistant. Section 468.302(6), F.S. contains a list of persons who may be exempt under certain situations which includes medical students, radiologic technology students, federal employees, or persons performing certain cardiopulmonary services."
Furthermore, Florida statute 468.311 states that it is a second degree misdemeanor if caught "Practicing radiologic technology or performing the duties of a radiologist assistant without holding an active certificate to do so." According to Online Sunshine, Florida statute 456.065(1) states that it is a 3rd degree felony to "practice, attempt to practice, or offer to practice a healthcare profession without an active, valid Florida license to practice that profession." The paragraph goes on to say "The minimum penalty for violating this subparagraph shall be a fine of $1,000 and a minimum mandatory period of incarceration of 1 year." A list of exceptions can be found here, including physicians, PA's, NP's, residents, and radiologic technologist students that are exempt from this law.
Many people in the O.R. who see us perform our duties day to day, standing behind the c-arm just "pressing buttons" may get the impression that what we do takes little schooling and/or education, therefore, when pressured by the physician they may feel that it is of no consequence who presses the button on the c-arm to obtain the image during a surgical case. This, of course, could not be further from the truth and it is up to us as x-ray techs to politely but firmly assert that under no circumstance (depending on local and state laws) are they to administer ionizing radiation to a patient without a license/certificate.
Remember, we are all ambassadors of our chosen career field and we must do what is best for the patient and staff in the room. Educate yourselves on your local and state laws and do your best to educate the staff and physicians on exactly who can and cannot use the c-arm if there is not an x-ray tech available for the room. If all else fails, sending an email to the appropriate supervisor regarding the current state statutes and penalties with respect to the administering of ionizing radiation without a license/certification along with a few names of the guilty parties will always constrict a few sphincters.