RN, First Assist-Ambulatory Surgery

About the role

Provides assistance to the surgical team during the intra-operative phase of surgical care for the Northwest Region Ambulatory Surgery Centers. Works in collaboration with the surgeon and health care team in the performance of surgical procedures, including assessment, planning, directing, providing and evaluating advanced nursing care.

Responsibilities

• Pre-operative: Performs pre-operative assessment and evaluation if required; collaborates with the surgical team on plan of care; coordinates and communicates with circulator regarding equipment and implant needs for case, assists in obtaining.
• Intra-operative: Provides knowledge based technical assistance to the surgeon and operating room team during the operative procedure according to AORN standards, licensure, state regulation and facility/practice protocols, including: use of instruments and medical devices; providing surgical exposure; handling and/or cutting tissue; providing hemostatis, clamp, cut, and ligate tissue as directed by the surgeon; suturing as directed by the surgeon.
• Post‑Operative: Applies post‑op splints and/or braces; during anesthesia emergence brings stretcher into room; helps transfer patient to stretcher; remains in room for turnover unless specific post‑op care required in PACU.
• Assessment & Planning: Communicates information to maintain continuity of care; communicates with patient, family and other staff professionally and courteously; obtains and demonstrates skills and knowledge needed to provide appropriate population‑based and culturally sensitive care through education, training and experience; provides continuous reassessment through the intra‑operative period; utilizes knowledge of type of procedure to plan for appropriate set up.
• Functions as an assistant in all surgical specialties at the direction of the attending surgeon; performs RNFA responsibilities in accordance with the Nurse Practice Act of Oregon, institutional policies and procedures of Kaiser Permanente and the AORN Position Statement on RN First Assistants; practices within limitations of preparation and experience; demonstrates RNFA specific clinical skills; reviews and updates skills checklist on an ongoing basis as specified by Kaiser Permanente policies.
• Assists with room preparation and opening of supplies in collaboration with the circulating nurse and scrub person; has available patient X‑rays/MRIs; checks image capture machine and films; notifies Team Lead or designee if films/MRIs are not available.
• Assists in patient transport to the operating room and transfer to the operating room table; assists in patient positioning; assists in patient preparation (prepping, catheterization, clipping) as necessary.
• Participates in briefing/time out and debriefing; assists in patient draping; sets up ESU, lights, suction for the sterile field; monitors free counted items on the sterile field; observes for breaks in sterile technique and takes appropriate action as necessary.
• Assists with instrumentation and equipment as requested; applies dressings and secures drainage tubes.
• Assists with patient transfer and positioning post‑operatively; assists with room tear down and turnover in collaboration with the circulating nurse and scrub person.
• Assists in maintaining a safe environment and promoting efficiency in surgical procedures; available for breaks and lunch relief, local monitor, scrub and circulate as needed.

Basic Qualifications

• Experience: Two (2) years of intra‑operative scrubbing and circulating experience.
• Experience: One (1) year of recent experience, within the last two (2) years, as an RNFA or successful completion of a CCI recognized RNFA course and agreement from ASC.
• License, Certification, Registration: Registered Nurse License (Oregon); Advanced Cardiac Life Support; Basic Life Support; Nurse Operating Room Certificate.

Additional Requirements

• Meets all qualifications of an RNFA as outlined in AORN Position Statement.

Preferred Qualifications

• Two (2) to five (5) years of practice as an RNFA.
• CRNFA Certification preferred.
• Ability to assist on all cases performed within Surgical Services.