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RN First Assist Surgery

Good Shepherd Health Care System • Full-time • Hermiston, Oregon, United States • 1w ago

Overview

Schedule: Monday-Friday 8:30a.m.-5:00p.m.

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. Primarily 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, but when no first assist is needed, may be assigned to secondary roles of scrub or circulator as needed.

Responsibilities

Promote the mission, vision, and values of the organization.
Assess patients at intervals in accordance with facility or health care organization policies and procedures.
Participate in preoperative assessment and planning for surgical patients specific to RNFA activities (eg, anatomical exposure, wound closure) in collaboration with perioperative team members.
Develop an individualized perioperative patient plan of care.
Implement the plan of care by
1. protecting the patient from injury caused by extraneous objects and chemical, electrical, laser, mechanical, and thermal sources;
2. participating in accounting procedures to protect the patient from unintended retained surgical items;
3. performing interventions necessary to ensure that the patient’s procedure is performed on the correct site, side, and level;
4. assisting with management of the patient’s specimens as necessary;
5. communicating the patient’s current status to relevant parties throughout the continuum of care;
6. administering medications safely and correctly;
7. performing interventions to maintain the patient’s wound and tissue perfusion at or above baseline levels;
8. 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;
9. performing interventions to ensure the patient is at or returned to normothermia at the conclusion of the immediate postoperative period;
10. performing interventions to protect the patient from surgical site infection;
11. assessing the knowledge level of the patient or designated support person;
12. providing education regarding the expected psychosocial response, nutritional management, medication management, pain management, wound management, and expected responses to the operative or invasive procedure;
13. involving the patient or designated support person actively in decisions affecting his or her perioperative care and the rehabilitation process;
14. protecting the patients’ rights, dignity, and privacy;
15. providing age-specific, culturally competent, ethical care within legal standards of practice; and
16. providing consistent and comparable care regardless of the setting.
Function as an RN first assistant during operative and other invasive procedures by
1. providing exposure through correct use of instruments, retractors, suction, and sponging techniques;
handling and dissecting tissues in collaboration with the surgeon;
clamping blood vessels, coagulating bleeding points, and ligating vessels in collaboration with the surgeon;
placing drains as directed by the surgeon; and
suturing muscle, fascia, subcutaneous, and skin in collaboration with the surgeon.
Follow selected surgical patients postoperatively specific to RNFA activities (eg, postoperative rounding, dressing changes) in collaboration with the interdisciplinary team.
Evaluate the patient’s progress toward attaining outcomes.
Transfer care as applicable.
Delegate tasks according to the state Nurse Practice Act and job descriptions.
Document nursing care accurately, completely, and legibly.
Collaborate effectively with other disciplines as applicable.
Participate in quality review and performance improvement projects.
Participate in the performance appraisal process.
Use problem-solving and conflict resolution skills to foster effective work relationships with team members.
Serve as an educator, mentor, consultant, and resource to peers, colleagues, and others in relation to RNFA activities.
Maintain regulatory, credentialing, and privileging requirements required for practice as an RNFA.
Participate in ongoing educational and competency verification activities applicable to RN and RNFA activities.
Act as a patient advocate and maintain privacy and confidentiality of individuals and health information.

Secondary Responsibilities as Scrub and/or OR Circulation (assigned and performed when on duty and no first assistant is required):

Scrub Duties:

Promote the mission, vision, and values of the organization.
Function as a scrub person during operative and other invasive procedures by
1. assembling supplies and equipment required for the procedure;
preparing and organizing sterile supplies and instruments for the procedure;
performing accounting procedures in concert with the RN circulator;
assisting with placement of sterile drapes;
providing instruments and supplies to the surgical team during the procedure;
maintaining an organized sterile field;
ensuring sterility of the field and taking corrective actions as needed; and
preparing sterile dressings.
Clean and prepare surgical instruments for processing and transport them to the decontamination areas.
Assist with post-procedure cleaning of the operative or other invasive procedure room and preparation of room for subsequent patients.
Participate in ongoing educational and competency verification activities applicable to scrub person activities.
Maintain privacy and confidentiality of individuals and health information.

Circulator Duties:

Promote the mission, vision, and values of the organization.
Assess patients at intervals as stated in policies and procedures.
Develop an individualized perioperative patient plan of care.
Implement the plan of care by:
1. protecting the patient from injury caused by extraneous objects and chemical, electrical, laser, mechanical, and thermal sources;
2. performing accounting procedures to protect the patient from unintended retained surgical items;
3. performing interventions necessary to ensure that the patient’s procedure is performed on the correct site, side, and level;
4. managing the patient’s specimens according to organizational policy and procedures;
5. communicating the patient’s current status to relevant parties throughout the continuum of care;
6. administering medications safely and correctly;
7. performing interventions to maintain the patient’s wound and tissue perfusion at or above baseline levels;
8. 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;
9. performing interventions to ensure the patient is at or returned to normothermia at the conclusion of the immediate postoperative period;
10. performing interventions to protect the patient from surgical site infection;
11. assessing the knowledge level of the patient or designated support person;
12. providing education regarding the expected psychosocial response, nutritional management, medication management, pain management, wound management, and expected responses to the operative or invasive procedure;
13. involving the patient or designated support person actively in decisions affecting his or her perioperative plan of care and the rehabilitation process;
14. protecting the patient’s rights, dignity, and privacy;
15. providing age-specific, culturally competent, ethical care within legal standards of practice; and
16. providing consistent and comparable care regardless of the setting.
Evaluate the patient’s progress toward attaining outcomes.
Transfer care as applicable.
Delegate tasks according to the state Nurse Practice Act and job descriptions.
Document nursing care accurately, completely, and legibly.
Collaborate effectively with other disciplines as applicable.
Participate in quality review and performance improvement projects.
Participate in the performance appraisal process.
Use problem-solving and conflict resolution skills to foster effective work relationships with team members.
Maintain required competencies.
Pursue professional growth and participates in a professional organization.
Act as a patient advocate and maintain privacy and confidentiality of individuals and health information.

Qualifications

Education:
- Bachelor’s degree in nursing
- Graduate from an accredited school of nursing

- Current registered nurse licensure in state of employment
- Certified Nurse, Operating Room (CNOR) certification
- Basic Life Support (BLS) certification
- RN First Assistant certification (CRNFA)
- Advanced Cardiac life Support (ACLS) certification

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

Experience:

- Two years perioperative RN or RNFA experience

Completion of the organization’s credentialing process

40 Hours USD $40.78/Hr. USD $69.38/Hr. 01-3210 Surgery - Hospital Day

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