A Registered Nurse (RN) is a licensed healthcare provider focused on assessment, treatment administration, and direct patient care across various medical settings. Whether an RN performs suturing is not a simple yes or no answer, as the ability to perform the procedure is heavily influenced by their specific training, facility policies, and geographic location. An RN’s scope of practice is fundamentally determined by a layered system of regulation that defines the legal boundaries of their professional activities.
Nursing Scope and State Practice Laws
For the majority of general bedside or inpatient Registered Nurses, the act of traditional suturing—laceration repair using a needle and thread—is outside of the standard professional scope of practice. The legal ability of an RN to perform any procedure is defined primarily by the State Nurse Practice Act (NPA), which is the law established by the state legislature that governs nursing licenses. These NPAs establish the legal limits of the RN license and often do not include complex procedural skills like suturing for the basic level of licensure.
Regulatory bodies in each state establish rules based on these laws. These rules typically require specific, advanced education and demonstrated competency for any deviation from routine care. When NPAs allow for expanded roles, they necessitate a formal, structured training program beyond the initial nursing degree, followed by a documented competency review. Without this specialized education, the procedure is considered a medical or advanced practice activity.
Facility policies act as a second, often more restrictive, layer of regulation. A hospital can prohibit a procedure even if the state law permits it. For example, a state NPA might allow an RN to perform a specific task with extra training, but the hospital’s internal policy may reserve that task for a physician or an Advanced Practice Registered Nurse. This system requires both legal authorization and institutional approval for procedural privileges.
In some contexts, such as emergency departments or specialized operating room teams, an RN may be trained to perform specific simple wound closures. This is a specialized role, not a universal expectation. Some state NPAs, such as those in Texas and California, permit RNs to perform suturing under strict conditions, including physician supervision and documented training. For the general RN working on a medical-surgical floor or in a typical clinic, laceration repair is delegated to other providers.
Wound Closure Alternatives Used by Registered Nurses
Since most RNs do not perform traditional suturing, they utilize several common wound closure methods within the standard nursing scope of practice. These alternatives are often applied independently or under a standing physician order for superficial wounds that do not require deep tissue repair. Sterile skin closure strips, commonly known as Steri-Strips, are frequently applied by RNs to hold the edges of small, low-tension lacerations together. They are a non-invasive method that supports the wound as it heals and reinforces the wound after sutures or staples have been removed.
Topical skin adhesives, often called medical glue, represent another method widely used by nurses for closing clean, simple lacerations rapidly and relatively painlessly. These adhesives, typically a formulation of cyanoacrylate, bond the superficial layers of the skin together, creating a microbial barrier. The RN applies the liquid adhesive after ensuring the wound edges are properly aligned and free of tension. This technique requires precision to avoid premature hardening or running into the wound itself.
Skin staples are a third alternative that RNs handle, particularly during the application and removal process for surgical incisions. Staples offer a fast, strong closure for wounds located on the scalp or the trunk, where speed and security are prioritized over cosmetic outcome. RNs are routinely trained in the proper sterile technique for both applying staples with a specialized device and removing them cleanly with a staple extractor once the wound has healed.
These non-suture methods are valuable components of the RN’s wound care duties, offering options for managing different types of superficial injuries. The choice of closure method depends on the wound’s depth, location, and the amount of tension across the edges. The RN plays a key role in the assessment and subsequent application or management of the chosen material, ensuring continuity of care and appropriate healing.
Roles of Advanced Practice Nurses and Surgical Assistants
Confusion often arises because the term “nurse” encompasses several distinct levels of licensure, including those with an expanded procedural scope, such as Advanced Practice Registered Nurses (APRNs). APRNs, like Nurse Practitioners (NPs) and Certified Registered Nurse Anesthetists (CRNAs), undergo extensive graduate-level education and specialized clinical training. This training grants them a wider scope of practice compared to the general RN. It is common for NPs to have privileges to perform minor surgical procedures, including the independent application of sutures for laceration repair and surgical incisions.
The authority for an APRN to suture is granted through a formal credentialing process at their facility. This process often requires documentation of training and a collaborative agreement with a physician. The ability to perform these procedures is based on their advanced education in areas like physical assessment, diagnosis, and procedural skills. For many patients, the NP is the provider who performs the necessary wound closure in urgent care clinics and emergency settings.
Another specialized role is the Registered Nurse First Assistant (RNFA), an RN who has completed additional training to function in the operating room. The RNFA works directly alongside the surgeon, performing first-assistant duties. These duties include handling tissue, providing hemostasis, and performing wound closure, such as suturing and stapling, under the surgeon’s direct supervision. This role focuses entirely on the intraoperative phase of surgical care and requires extensive practice hours and certification.