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To: New York State Licensed Health Care Professionals and Other Interested Parties

From: Richard M. Cook, Deputy Commissioner, NYS Department of Health, Office of Health Systems Management and Barbara Zittel, RN, PhD, Executive Secretary, State Board for Nursing

Re: Medical Assistants and Other Unlicensed Persons/ Recovery of Patients from an Invasive and/or Surgical Procedure Involving Anesthesia and/or Sedation in Clinical Settings and Private Medical Offices

Date: August 15, 2011

Questions continue to arise regarding appropriate utilization of medical assistants and other unlicensed persons in clinical settings and private medical offices. This memo supplements the April 2010 State Education Department (SED) memo regarding utilization of medical assistants posted on this site.

It is the opinion of the NYSDOH, SED and the State Board for Nursing (SBFN) that emergence from anesthesia/sedation requires extreme vigilance and constant, total care provided by physicians and/or registered nurses. Staffing in recovery areas should minimally include a physician or registered nurse competent in the care of patients recovering from anesthesia/sedation plus at least one other caregiver to provide assistance with delegated tasks and/or seek assistance if required. Access to anesthesia and surgical care should be available at all times.

Responsibilities assigned to medical assistants and other competent unlicensed personnel should be limited to activities not requiring licensure such as vital signs, provision of comfort measures, assistance with moving patients and getting them out of bed upon the direction of the registered nurse or physician, etc.

Patient readiness for discharge must be authorized by a physician or other licensed independent practitioner.

If you have any questions about this memo, feel free to call the State Education Department's Board for Nursing by phone at 518-474-3817, ext. 120 or email: or the Department of Health Patient Safety Center by phone at 518-408-1219 or email: