apply ultrasound for diagnostic or imaging purposes, including application of ultrasound to a fetus;
apply electricity for the purposes of destroying tissue or affecting activity of the heart or nervous system;
apply laser for the purpose of destroying tissue
The Regulation indicates that, with a client-specific order from a listed health professional, registered nurses may apply ultrasound for diagnostic or imaging purposes. Section 6 permits registered nurses to apply ultrasound for limited purposes (such as blood flow monitoring) within their autonomous scope of practice. With a client-specific order from a listed health professional, registered nurses working in specialty areas may carry out additional related activities. For example, vascular access nurses working in hemodialysis may assess blood vessels pre and post access creation and provide this information to the physician.
The Regulation also states that, with an order, registered nurses may apply electricity that destroys tissue or affects heart or nervous system activity. This expands the application of electricity beyond what is permitted in Section 6 (i.e., defibrillation to provide emergency cardiac care). For example, with a client-specific order from a listed health professional, registered nurses may use electricity for transcutaneous pacing, cardioversion, adjusting pacemakers, and setting or adjusting implanted cardiac devices.
The Regulation permits registered nurses to apply laser, with an order from a listed health professional, for the purpose of destroying tissue. This includes the application of laser for removing hair; reducing hyperpigmentation, rosacea, acne scars and port wine stains; and minimizing the appearance of facial veins and surface spider leg veins. Registered nurses are not authorized to apply laser for the purpose of cutting tissue.
Registered nurses must successfully complete an RN First Assist Program before doing electrocautery under a physician’s order.
Registered nurses do not perform other types of electrocautery (e.g., to treat epistaxis).