Performance of Punch Biopsies and Small Skin Lesion Excisions by RNs

In December 2004, in response to an inquiry, the Board reviewed the following information: statutes governing registered nursing practice; Association of periOperative Registered Nurses (AORN) “Registered Nurse First Assistant Competencies,” and “AORN Statement on RN First Assistants” (revised March 2004).  Based upon this review, it was the advisory opinion of the Board that the performance of small skin lesion excision and punch biopsy are within the scope of registered nursing practice for the registered nurse who possesses substantial, specialized knowledge and current clinical competency in the performance of the procedures.  The procedures should be preformed under the supervision of a physician who is onsite and immediately available to the nurse.