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The future holds exciting opportunities for advanced practice nurses, not the least of which is participation during surgery as a First Assistant. RNFA is a Registered Nurse, RN, specializing in the Operating Room environment.

Early in the history of operating room nursing, there were numerous instances of nurses assisting in surgery. These nurses were highly skilled and valued for their contributions to successful outcomes of military surgeries. The nursing profession matured and developed curricula that educated nurses rather than “trained’ them.

RNFA Function is to provide direct patient care by acting as first assistant to the surgeon during operative procedures. First assisting will be performed under the direct supervision of the primary surgeon. RNFA will pay a hands-on role in surgical procedures. Controlling bleeding, suturing incisions and wounds and intervening if complications arise are all duties of the RNFA. If a patient’s heart stops, RNFA may perform CPR, if blood pressure drops RNFA may administer stabilizing drugs as well as monitoring the patient’s vital signs and alerting the surgeon if the patient begins to struggle.

This job requires working in a high-stress environment where you must think quickly and stay calm under pressure. Excellent communication skills and the ability to follow the surgeon’s instructions are vital as well as the ability to communicate clearly to other members of the team. Strict safety protocols must be followed to protect patients and the surgical team. Some surgeries may last for several hours which means a lot of time on your feet.

Another part of the RNFA job is the care for patients before and after their surgery. Before the procedure the RNFA may meet with patients and family members to answer any questions and assess the patient’s physical condition to identify any problems that could make surgery too risky. After the surgery the RNFA would evaluate the patient’s condition to determine if they are ready for transport by checking vital signs and ensuring everything is sutured and there is no bleeding or other complications.

Preoperative, intraoperative and postoperative duties of RNFA may include:

Patient history and assessment

Working with the surgeon and other professionals to assure an optimal outcome of the surgery involved. This could involve intra-operative retraction, homeostasis, tissue manipulation and wound closure.

Assisting with patient positioning, skin preparation, draping, handling tissue, controlling blood loss, suturing tissue.

Ability to calculate figures and amounts, such as proportions, percentages, area, circumference and volume.

Performing follow-up care

A Nurse RN must have a least two years of professional nursing experience within the operating room environment and have achieved CNOR (Certified Perioperative Nurse) or possess an Advanced Practice degree in order to quality as an RNFA.

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