Definition:
Under the general direction of Kern Medical Center’s (KMC) Director of Surgical Services, Surgical Service’s Leadership, and the Chief Nursing Officer (CNO), the Registered Nurse First Assistant (RNFA) renders direct patient care in the operating room, as part of the perioperative team, by assisting the surgeon in the surgical treatment of the patient. The responsibility of functioning as first assistant must be based on documented knowledge, training, and skills acquired after specialized preparation, formal instruction, and supervised practice. The RNFA practices perioperative nursing and must have acquired the necessary specific knowledge, skills and judgment, for this role. While performing the duties of RNFA, the RN must adhere to standardized procedures.
Kern Medical has been a community cornerstone since its founding in 1867. Today, we are an acute care teaching center with 222 beds, offering the only advanced trauma care between Fresno and Los Angeles. Kern Medical offers a range of primary, specialty, and multi-specialty services including high-risk pregnancy care, inpatient psychiatric services integrated with county mental health programs, and a growing network of outpatient clinics providing personalized patient-centered wellness care. Kern Medical cares for 15,500 inpatients and 125,000 clinic patients a year.
Career Opportunities within Kern Medical include many benefits such as:
- New Hire Bonus: $6,000.00
- New Hire Premium: +6% of base rate of pay, matched up to 6% if contributed to Deferred Compensation Plan.
- Shift Differential Pay: P.M. shift (7:00 PM - 7:30 AM) = 10% of base pay.
- A Comprehensive Benefits Package: includes Holidays, Paid Time Off, Retirement, Medical, Dental, Vision and Life Insurance.
Position: Registered Nurse First Assist (RNFA)
Compensation
The estimated pay for this position is $72.6247 to $89.3193. The rates shown include a 6% premium pay (base= $-$ plus 6%). This reflects only a portion of the total compensation package for this position. Additional compensation may be available for this role through differentials, incentives, and bonuses. In addition, this position may be eligible for participation and company contributions into the Kern County Employees’ Retirement Plan.
Distinguishing Characteristics:
The RNFA is a registered nurse with a high degree of experience and training specific to perioperative patient care. The RNFA practices under the direct supervision of the surgeon during the intraoperative phase of the perioperative experience. The role of the RNFA to the surgeon requires the performance of a combination of nursing and medical function tasks.
Essential Functions:
- Creates and sustains an environment that supports compassionate caring through authentic presence with the patient and family, building trusting relationships, creates connections that embrace mind, body, spirit modalities to mobilize the patient’s strengths and abilities toward healing.
- Assists with the positioning, prepping and draping of the patient or perform these tasks independently, if so directed by the surgeon.
- Communicates with the patient’s physician (operating surgeon) immediately, when the patient’s condition changes or deteriorates, or abnormal lab or diagnostic testing results are available.
- Provides homeostasis by applying electrocautery tip to clamps or vessels in a safe and knowledgeable manner as directed by the surgeon; sponges and utilizes pressure as necessary; utilizes suction techniques; applies clamps on superficial vessels and the tying or electrocoagulation of them as directed by the surgeon.
- Handles tissues as directed by the surgeon.
- Assists the surgeon directly by controlling bleeding, suturing and other surgical needs.
- Provides exposure through appropriate use of instruments, retractors, suctioning, and sponging techniques. Manages all instruments in the operative field to prevent obstruction of the surgeon’s view. Retains manually controlled retractors in the position set by the surgeon with regard to surrounding tissue. Anticipates retraction needs with knowledge of the surgeon’s preferences and anatomical structures.
- Assists surgeon with wound closure of layers; sutures the peritoneum, fascia, subcutaneous tissue and skin.
- Assists surgeon at the completion of the surgical procedure by providing knot tying, affixes and stabilizes all drains, cleaning the wound and applying the dressings.
- Provides other advanced assistance, such as mobilization of tissue, patient positioning and directing other surgical team members with specific individual tasks.
- In extreme emergencies, assists on procedures that present an unusual hazard to life.
- Assists with applying casts or splints as needed.
- Collects and documents data for assigned patients according to prescribed methods.
- Assists with the perioperative patient assessment, teaching, management and planning for the perioperative experience.
- Provide patient care by circulating or scrubbing surgical procedures or cleaning operatories as needed when First Assist duties are not assigned.
- Uses education, experience and interpretation of assessment data to prioritize appropriate nursing actions;
- Establishes nursing diagnoses, uses appropriate resources to formulate a written plan of care; evaluates the effectiveness of nursing interventions and revises patient care plans, as necessary.
- Anticipates and effectively manages rapidly changing situations by rapid grasp of changes in patient status and problem situations. Prioritizing and responds quickly and appropriately to identify the need for and activation of emergency protocols and assistance.
- Performs and documents the nursing process consistent with scientific principle and hospital policy as required by patient assignment using critical thinking and nursing judgment.
- Contributes to team building through participation in unit programs and meetings; contributes to positive morale, using constructive and effective conflict resolution skills.
- Adheres to hospital-approved policies and procedures.
- Completes all competencies, mandatory classes and educational coursework as required by the Department of Nursing
- Demonstrates clinical knowledge and skill in the care of populations served by Kern Medical facilities.
Other Functions:
- Performs other job-related duties, as required
Employment Standards:
- Graduation from an accredited school of nursing; Masters or Bachelor’s degree in Nursing or Healthcare Administration preferred.
- Current unrestricted registered nurse licensure in the State of California
- Successful completion of didactics of structured course in first assisting
- Completion of 120 hours of proctored instruction in the OR with a qualified surgeon at hire if certified RNFA or successful completion of hours within 60 days of hire.
- Certificated Operating Room RN (CNOR) required.
- Certified RNFA preferred (CRNFA)
- Basic Life Support (BLS) certification;
- Advanced Cardiac Life Support (ACLS) certification;
- Pediatric Advanced Life Support (PALS) certification beneficial
Knowledge of:
- Modern principles, methods and practices of the surgical services department.
Ability to:
- Determine appropriate course of action in more complex situations;
- Communicate effectively, both orally and in writing;
- Handle difficult situations involving patients, physicians, or other in a professional manner;
- Demonstrate a calm demeanor under stress.
- Demonstrate flexibility with operating room and surgical procedure assignments.
- Work cohesively as part of the perioperative team.
- Function independently as a RN in the operating room as needed.
Skills:
- Strong organizational and interpersonal skills
Supplemental:
A background check may be required for this classification.
All KMC employees are designated “Disaster Service Workers”. In the event of a disaster or civil disorder, all Kern Medical employees are to remain at work or to report to work in a safe and practicable manner.
If position responsibilities require driving a personal vehicle, then possession of a current valid California Driver’s License and adherence to the Kern County Hospital Authority Vehicle Use and Driving Standard Policy (ENG-EC-119) is required.
If position responsibilities require driving a vehicle owned, leased or rented by Kern Medical, then possession of a current valid California Driver’s license, a signed authorization for Release of Drivers Record Information and adherence to the Kern County Hospital Authority Vehicle Use and Driving Standard Policy (ENG-EC-119) is required.
