First Assist

About the role

The Surgical First Assistant leads as a member of the perioperative team under the surgeon’s direction, performing both Surgical Technologist and Surgical First Assistant responsibilities based on department needs. The role practices within the job description’s scope, performing clinical and technical skills under surgeon supervision to assist with safe operations and optimal patient outcomes in collaboration with the circulating RN and perioperative/OB team members. The Surgical First Assistant provides leadership to support and guide other first assistants and scrub technicians, including daily mentoring and promoting optimum patient care and teamwork.

Responsibilities

• Functions as a surgical first assistant under the attending surgeon’s direct supervision, practicing within preparation, experience, and hospital scope limits.
• Provides visualization of the operative site via retractor placement and securing, digital manipulation, suctioning, irrigation, and sponge use.
• Assists with hemostasis using permanent (clamping, cauterizing, tying, ligating, clips, agents) and temporary (tourniquets, vessel loops, non-crushing clamps, digital pressure) techniques.
• Administers post-operative subcutaneous local anesthetic injection.
• Utilizes running or interrupted sutures for wound layers including muscle and fascia; assists with implant placement.
• For robotic procedures: inserts subsequent trocars with documented training and competency validated on at least 5 patients under direct supervision.
• For saphenous vein harvesting: performs endoscopic or open harvest with documented training and competency validated on at least 10 patients under direct supervision.
• Under direct or general perioperative supervision, closes body planes and applies wound dressings per attending physician’s method (sub-cuticular closure, skin closure with suture/staples/adhesives, securing drainage systems, immobilizing dressings).
• Assists with maintaining expected physiologic responses to surgery, including infection prevention (SCIP measures, disinfection, instrument processing, sterilization) and applies knowledge of preoperative deficits, intraoperative risks, and postoperative outcomes.
• Demonstrates safe patient positioning principles and uses positioning equipment to protect pressure points, nerves, and circulation.
• Communicates effectively and collaborates with the perioperative team, participates in Universal Protocol, and ensures timely and accurate sponge and sharp counts with corrective action as needed.
• Acts as a mentor and preceptor for surgical first assistants and technicians; coordinates or conducts inservices and participates in unit special projects.
• Functions as a Surgical Technologist as needed by the department, but does not concurrently serve as both surgical first assistant and surgical technologist.
• Wears proper surgical attire, opens sterile packs and supplies, scrubs, gowns, gloves, and drapes per aseptic technique; monitors and maintains sterile field integrity.
• Maintains knowledge of non-controlled medication storage areas (anesthesia boxes or carts) and ensures equipment is functional and used safely.
• Supports the Methodist Healthcare System mission and vision, demonstrates excellent customer service, and adheres to safety policies and reporting procedures.
• Complies with the MHS Code of Conduct and reports any activity that may violate laws, rules, regulations, or the Code of Conduct.

Requirements

• High School Diploma or GED.
• Graduate/completion of a CAAHEP-accredited first assistant training program.
• Meets one of the following:
  • Graduate/completion of a surgical technologist program, or
  • Practiced as a surgical technologist prior to 9/1/2009.
• New hires as of 11/1/2011: 2 years experience in the perioperative setting within the last 4 years as a surgical first assistant.

Certifications and Licenses

• Must have and maintain one of the following:
  • Surgical Technologist Certification:
    • CST – Certified Surgical Technologist through NBSTSA, or
    • TS-C – Tech in Surgery, Certified through NCCT.
  • Surgical First Assistant certification:
    • SA-C – Surgical Assistant, Certified through ABSA, or
    • CSA – Certified Surgical Assistant through NSAA, or
    • CSFA – Certified Surgical First Assistant through NBSTSA, or
    • LSA – Licensed Surgical Assistant through the Texas Medical Board.

Benefits

• Comprehensive medical coverage with many common services at no cost or low copay, including prescription drugs, behavioral health, free telemedicine, and free AirMed medical transportation.
• Dental and vision benefits; life and disability coverage; flexible spending accounts; supplemental health protection plans (accident, critical illness, hospital indemnity).
• Auto and home insurance; identity theft protection; legal counseling; long-term care coverage; moving assistance; pet insurance.
• Free counseling services for emotional, physical, and financial wellbeing.
• 401(k) Plan with 100% match on 3% to 9% of pay (based on years of service).
• Employee Stock Purchase Plan with 10% discount on HCA Healthcare stock.
• Family support through fertility and family building benefits with Progyny and adoption assistance; referral services for child, elder, and pet care, home and auto repair, event planning.
• Consumer discounts through Abenity and Consumer Discounts.
• Retirement readiness and rollover assistance services; preferred banking partnerships.
• Education assistance including tuition, student loan, certification support, and dependent scholarships.
• Colleague recognition program and Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage, leaves of absence).
• Employee Health Assistance Fund offering free employee-only coverage to full-time and part-time colleagues based on income.