Surgery Registered Nurse First Assistant- Full Time

Lines of Responsibility: Main Surgery Campus (MSC) Team Leader, MSC Manager, Director of Surgical Services, Vice President of Clinical Services, Chief Executive Officer

Job Summary: Responsible for the delivery of safe, effective, and quality patient-family centered care in the OR and other areas of perioperative services for all patient populations. Functions as an RN first assistant during operative and other invasive procedures and throughout the perioperative continuum in accordance with scope of practice credentials, privileges, experience, education, and competency verification. May also facilitate the operative or other invasive procedure by preparing and providing the required sterile instruments, supplies and equipment. Maintains the sterile field and anticipates and responds to the needs of the surgical team. Functions as a second assistant during operative and other invasive procedures in accordance with scope of practice, experience, education and competency verification. Responsible for meeting the needs of the OR whether it is in a secondary or primary assistant role.

Primary Responsibilities:

1. Promote the mission, vision, and values of the organization.

2. Assess patients at intervals in accordance with facility or health care organization policies and procedures.

3. Participate in preoperative assessment and planning for surgical patients specific to RNFA activities (eg, anatomical exposure, wound closure) in collaboration with perioperative team members.

4. Develop an individualized perioperative patient plan of care.

5. Implement the plan of care by

a. protecting the patient from injury caused by extraneous objects and chemical, electrical, laser, mechanical, and thermal sources;

b. participating in accounting procedures to protect the patient from unintended retained surgical items;

c. performing interventions necessary to ensure that the patient’s procedure is performed on the correct site, side, and level;

d. assisting with management of the patient’s specimens as necessary;

e. communicating the patient’s current status to relevant parties throughout the continuum of care;

f. administering medications safely and correctly;

g. performing interventions to maintain the patient’s wound and tissue perfusion at or above baseline levels;

h. performing interventions to maintain the status of the patient’s genitourinary, gastrointestinal, musculoskeletal, endocrine, respiratory, cardiovascular, and neurological systems and fluid, electrolyte, and acid-base balances at or above baseline levels;

i. performing interventions to ensure the patient is at or returned to normothermia at the conclusion of the immediate postoperative period;

j. performing interventions to protect the patient from surgical site infection;

k. assessing the knowledge level of the patient or designated support person;

l. providing education regarding the expected psychosocial response, nutritional management, medication management, pain management, wound management, and expected responses to the operative or invasive procedure;

m. involving the patient or designated support person actively in decisions affecting his or her perioperative care and the rehabilitation process;

n. protecting the patients’ rights, dignity, and privacy;

o. providing age-specific, culturally competent, ethical care within legal standards of practice; and

p. Providing consistent and comparable care regardless of the setting.

6. Function as an RN first assistant during operative and other invasive procedures by

a. providing exposure through correct use of instruments, retractors, suction, and sponging techniques;

b. handling and dissecting tissues in collaboration with the surgeon;

c. clamping blood vessels, coagulating bleeding points, and ligating vessels in collaboration with the surgeon;

d. placing drains as directed by the surgeon; and

e. Suturing muscle, fascia, subcutaneous, and skin in collaboration with the surgeon.

7. Follow selected surgical patients postoperatively specific to RNFA activities (eg, postoperative rounding, dressing changes) in collaboration with the interdisciplinary team.

8. Evaluate the patient’s progress toward attaining outcomes.

9. Transfer care as applicable.

10. Delegate tasks according to the state Nurse Practice Act and job descriptions.

11. Document nursing care accurately, completely, and legibly.

12. Collaborate effectively with other disciplines as applicable.

13. Participate in quality review and performance improvement projects.

14. Participate in the performance appraisal process.

15. Use problem-solving and conflict resolution skills to foster effective work relationships with team members.

16. Serve as an educator, mentor, consultant, and resource to peers, colleagues, and others in relation to RNFA activities.

17. Maintain regulatory, credentialing, and privileging requirements required for practice as an RNFA.

18. Participate in ongoing educational and competency verification activities applicable to RN and RNFA activities.

19. Act as a patient advocate and maintain privacy and confidentiality of individuals and health information.

Working Conditions/Physical Requirements:

• Physically demanding, high-stress environment

• Exposure to blood, sharps, body fluids and tissue, communicable diseases, chemicals, radiation, and repetitive motions

• Pushing and pulling heavy objects

• Full range of body motion including handling and lifting patients

• Manual and finger dexterity

• Hand and eye coordination

• Standing and walking for extensive periods of time

• Lifting and carrying items weighing up to 50 lbs

• Corrected vision and hearing to within normal range

• Working under stressful conditions

• Working irregular hours including call hours

Required Skills

Preferred:

• Bachelor’s degree in nursing preferred

• Certified Nurse, Operating Room (CNOR) certification

• RN First Assistant certification (CRNFA)

• Pediatric Advanced Life Support (PALS) certification, depending on patient population

• Basic computer skills (eg, Microsoft® Word)

Minimum Education

• Graduate from an accredited school of nursing

• Current registered nurse licensure in state of employment

• Basic Life Support (BLS) certification

• Advanced Cardiac life Support (ACLS) certification (Provided by hospital and required within 12 months of hire)

Required Experience

Qualifications –Required:

• Two years perioperative RN or RNFA experience

• Completion of the organization’s credentialing process