Registered Nurse First Assistant - Duke Health Cary

Duke Health; Cary (NC); On-site; USD 110,000 - 140,000; Full time

Job summary

Duke Health Cary Surgery Center, opening 2027, seeks an experienced Registered Nurse First Assistant (RNFA) to join the founding clinical team. This role supports preoperative, intraoperative, and postoperative care in a new ambulatory surgery environment with advanced robotic capabilities.

You will help shape culture, workflows, and patient experience in a six-room facility. Minimum qualifications include a BSN, NC RN licensure, CNOR, and RNFA certification (or ability to obtain within two

Qualifications

• BSN required and RN license in North Carolina or compact state
• MSN preferred and RNFA certification or ability to obtain within 2 years
• CNOR certification is required
• Minimum 3 years perioperative nursing experience

Responsibilities

• Provide preoperative assessments and care plans
• Serve as first assistant intraoperatively with surgeons
• Assist in postoperative care and discharge planning
• Support patient safety, documentation, and workflow efficiency

Skills

Perioperative care

Ambulatory surgery

Team collaboration

Education

BSN required

MSN preferred

RNFA program completion

CNOR certification

Tools

Robotic-assisted surgery

Da Vinci systems

Job description

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

Duke Health Cary

Opening in Spring 2027, the next phase of this 85-acre, mixed use walkable Duke Health Cary campus will add emergency services, inpatient care, surgical services, imaging, specialty care, and infusion services, creating more than 230 career opportunities. Joining Duke Health Cary offers the opportunity to build something new, grow your career, and support our mission of advancing health across the communities we serve.

RN First Assistant (RNFA)

Duke Health Cary Surgery Center | Cary, NC

Help Build the Future of Ambulatory Surgery

Duke Health is seeking an experienced Registered Nurse First Assistant (RNFA) to join the founding clinical team of the new Duke Health Cary Surgery Center, a state-of-the-art ambulatory surgery center scheduled to open in 2027.

This is a rare opportunity to be part of a new surgical facility from the beginning, helping shape the culture, workflows, and patient experience while delivering exceptional surgical care in a highly collaborative environment.

The Duke Health Cary Surgery Center Will Feature Six Operating And Procedure Rooms, Including Advanced Robotic Surgery Capabilities With Two Da Vinci Surgical Systems. The Center Will Provide Outpatient Surgical Services Across Multiple Specialties, Including

• Urology
• Plastic Surgery
• Breast Oncology
• General Surgery
• Gynecology
• ENT
• Pediatric Urology
• Pediatric ENT
• Orthopedic Surgery

Why Join the Founding Team?

• Help establish a culture of excellence, innovation, and teamwork
• Work with cutting-edge surgical technology, including robotic-assisted procedures
• Contribute to process design and continuous improvement initiatives
• Collaborate with highly skilled surgeons and perioperative professionals
• Deliver exceptional patient-centered care in a modern outpatient environment
• Play a key role in launching one of the region's most advanced ambulatory surgery centers

Position Summary

The Registered Nurse First Assistant (RNFA) provides comprehensive perioperative patient care through the preoperative, intraoperative, and postoperative phases of surgery. Working collaboratively with surgeons and the perioperative team, the RNFA serves as the qualified first assistant during surgical procedures, helping optimize patient outcomes, surgical efficiency, and workflow effectiveness.

This role supports surgical services across multiple specialties and serves patients of all ages while promoting quality, safety, and excellence in surgical care.

Key Responsibilities

Preoperative Care

• Conduct patient assessments and evaluations
• Collaborate with surgeons and care teams to develop plans of care
• Prepare and document preoperative orders in accordance with established protocols
• Coordinate care and communicate with multidisciplinary team members

Intraoperative First Assisting

• Serve as the qualified first assistant to the operating surgeon
• Provide surgical exposure, hemostasis, tissue handling, and wound closure
• Utilize surgical instruments, equipment, and technology safely and effectively
• Support procedural efficiency and patient safety throughout the surgical procedure

Postoperative Care

• Collaborate with providers during the immediate postoperative period
• Assist with postoperative documentation and orders following established protocols
• Participate in patient rounds and discharge planning activities
• Support continuity of care and positive patient outcomes

The RNFA functions as the surgical first assistant and does not concurrently perform the role of scrub nurse during procedures.

What We're Looking For

• Have at least two years of ambulatory, outpatient, or perioperative surgical experience
• Thrive in a fast-paced, highly collaborative surgical environment
• Demonstrate accountability, professionalism, and reliability
• Embrace flexibility and cross-functional teamwork
• Support innovation, continuous improvement, and operational excellence
• Enjoy building new programs and contributing to organizational growth
• Be passionate about delivering exceptional patient care

Our Culture

• Puts patients first in every decision
• Works collaboratively across the perioperative continuum
• Embraces innovation and advanced technology
• Supports flexibility and operational excellence
• Values continuous learning and professional growth
• Promotes respect, inclusion, accountability, and psychological safety
• Takes ownership of quality, safety, and patient experience outcomes

Minimum Qualifications

Education

• Bachelor of Science in Nursing (BSN) required
• Master of Science in Nursing (MSN) preferred
• Graduate of an accredited school of nursing
• Completion of an accredited RNFA program that includes both didactic and supervised clinical practice and is based on the AORN Core Curriculum for the RNFA

Experience

• Minimum of three years of perioperative nursing experience required
• Previous operating room experience with both circulating and scrub responsibilities strongly preferred

Licensure & Certifications

• Current RN license in North Carolina or compact state licensure
• Basic Life Support (BLS) certification required
• CNOR certification required
• Current RNFA certification, or ability to obtain within two years of employment

Planned Start Dates

• February 8, 2027
• February 22, 2027

First patient procedures anticipated in April 2027.

Essential Physical Job Functions

Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.

Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.