Registered Nurse First Assist I - General Surgery

CHRISTUS Health; Longview (TX); On-site; USD 100,000 - 140,000; Full time

Job summary

CHRISTUS Health in Texas is seeking a Nurse First Assistant (RNFA) to collaborate with surgeons and the healthcare team for optimal patient outcomes. The RNFA practices intraoperatively under the surgeon’s direction, not as a scrub nurse, and operates within CHSB policy and safety guidelines.

The ideal candidate will have RNFA training, 5+ years of OR experience (scrub and circulate), and active CNOR certification, with BLS/ACLS credentials.

Qualifications

• RNFA program completion that meets AORN/CCI standards.
• At least 5 years of OR experience including scrubbing and circulating.
• Current RN license in state of employment or compact.
• BLS and ACLS certifications required.
• CNOR perioperative nursing certification

Responsibilities

• Demonstrates effective management of surgical patient care using the nursing process and plan of care.
• Maintains sterile field and aseptic technique; monitors team movement around sterile area.
• Ensures equipment readiness and safety; supports turnover and efficiency.
• Performs counts (sponge, sharps, instruments) and documents results.
• Maintains safety of patients and staff; supports anesthesia as needed.
• Administers and documents medications per policy.
• Demonstrates ethical practice and adaptability to nursing practice changes.
• Delegates tasks per laws and competency; supports teaching to patients and families.
• Assists in safe patient positioning considering physiological effects.
• Uses sterilization techniques and documents validation of sterilization parameters.
• Handles specimens per policy and procedure.
• Participates in Universal Protocol/Time-Out process.
• Keeps accurate inventory and uses supply/pharmacy pyxis correctly.
• Keeps schedule changes in mind to ensure proper instrumentation and supplies.
• Assists with high-risk equipment safety and monitoring during procedures.
• Fosters collaborative environment and recognizes each provider’s contribution.
• Provides first-assistant duties including using instruments, achieving exposure, tissue handling, hemostasis, and suturing.

Skills

OR nursing

First assistant duties

Education

RN license (state or compact)

BLS Certification

ACLS Certification

CNOR Perioperative Nursing Certificate

Job description

Summary

The RNFA is a perioperative RN who works in collaboration with the surgeon and health care team members to achieve optimal patient outcomes. The RNFA must have acquired the necessary knowledge, judgment, and skills specific to the expanded role of RNFA clinical practice. Intraoperatively, the RNFA practices at the direction of the surgeon and does not concurrently function as a scrub nurse.

Responsibilities

• Demonstrates effective management of surgical patient care delivery by utilizing the nursing process. Completes and documents patient assessments and reassessments according to policy and procedure. Initiates, updates, and communicates an appropriate multidisciplinary plan of care base on identified nursing diagnosis and patient needs. Evaluates patient response to care and documents appropriately.
• Creates and maintains a sterile field using principles of aseptic practice. Monitors movement of surgical team in and around the sterile field. Initiates appropriate corrective action when breaks in technique occur. Demonstrates knowledge of prepping and draping techniques for various procedures. Performs hand washing techniques according to established policies.
• Provides surgical equipment and supplies based on age appropriate patient needs. Demonstrates efficient use of time and maintains turnover to a minimum. Assures all equipment is functioning properly before use and operates equipment according to manufacturers’ guidelines and CSHS protocol. Participates in the annual skills fair.
• Performs sponge, sharps, and instrument counts according to policy. Initiates appropriate corrective action for incorrect counts. Communicates and documents results of counts. Insures all instrument count sheets are completed and returned to the SPD.
• Monitors and controls the environment to maintain patient and associate safety by adhering to safety policies, maintaining traffic patterns, maintaining environmental controls for temperature and humidity, and assisting anesthesia as needed.
• Administers and documents medications according to CHSB policy.
• Demonstrates accountability by practicing within ethical and legal guidelines. Exercises safe judgment in decision-making. Demonstrates flexibility and adaptability to changes in nursing practice and remains up-to-date on such changes.
• Delegates tasks and functions according to applicable laws, regulations, and standards, taking into consideration the competency of the assignee.
• Participates in associate and patient/family teaching by identifying teaching needs and readiness to learn. Communicates needs, determines teaching effectiveness, and documents appropriately.
• Demonstrates ability to plan and implement safe patient positioning using knowledge of the physiological effects of various surgical positions.
• Demonstrates knowledge of sterilization techniques by determining the appropriate method of sterilization for instruments and supplies. Operates sterilization equipment safely and according to policy. Documents necessary patient information and verification of flash sterilization parameters according to policy.
• Competently handles specimens accurately and according to policy and procedure.
• Participates in and documents the Universal Protocol/Time-Out process according to policy.
• Demonstrates accurate inventory management through accurate documentation of supply usage on the preference sheet and accurate use of the supply and pharmacy pyxis machines.
• Remains updated to changes in the surgical schedule to ensure proper instrumentation and supplies are readily available for use as needed.
• Exercises safety precautions with high-risk equipment/supplies such as electrosurgical units, light sources, lasers, and other technology. Follows safety protocols to minimize risks to patients and associates. Keeps abreast of patient’s condition at all times during the procedure.
• Fosters a collaborative environment and recognizes the value of each provider’s contribution to the comprehensive care of the perioperative patient.
• Demonstrates competency to provide the duties and responsibilities as a first assistant including but not limited to using instruments/medical devices, providing exposure, handling and/or cutting tissue, providing hemostasis, and suturing. See RNFA/NP Job Description

Education/Skills

• Successful completion of an RNFA program that meets the “AORN standards for RN first assistant education programs” and is accepted by the Competency and Credentialing Institute (CCI).

Experience

• At least 5 years of OR experience required including both scrubbing and circulating.
• Previous OR experience required for members of the CV team.

Licenses, Registrations, or Certifications

• Current RN License in state of employment or compact
• BLS Certification required.
• ACLS Certification required.
• CNOR Perioperative Nursing Certificate

Work Schedule

4 Days - 10 Hours

Work Type

Full Time