RN, First Assist Lead

Kaiser Permanente; Northern (KY); Hybrid; USD 120,000 - 180,000; Full time

Job summary

Kaiser Permanente in the Northwest region seeks an RN First Assistant to lead the Specialty Service within a Hospital or Ambulatory Surgery Center. You will collaborate with the surgeon, anesthesia, and OR team to plan and perform procedures, ensuring staffing, instruments, and implants are ready for high-quality care.

The role spans pre-operative assessment, intra-operative assistance, and post-operative care, with emphasis on instrument handling, hemostasis, and patient safety.

Qualifications

• Two (2) years of intra-operative scrubbing and circulating experience within Specialty.
• 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.

Responsibilities

• Pre-operative: Performs assessment and planning with the surgical team and coordinates equipment and implant needs.
• Intra-operative: Provides knowledge-based technical assistance, instrument handling, hemostasis and tissue management.
• Post-Operative: Applies post-op splints and assists with transfer and turnover.
• Supports staffing, education, and quality improvement within the surgical specialty.

Job description

Job Summary: Position functions as the leader of a Specialty Service within a Hospital or Ambulatory Surgery Center. Provides assistance to the surgical team during the intra-operative phase of surgical care for the Northwest Regional Hospitals or Ambulatory Surgery Centers. Works in collaboration with the surgeon, anesthesia, health care team, materials, purchasing and outside vendors in the planning and performance of surgical procedures. This would include; assessment, planning, directing, providing advanced nursing care as well as working with above departments to ensure all equipment, instrumentation and adequate staffing are available to facilitate a high quality surgical experience for our members.

Essential Responsibilities

• Representative Functions or Duties: Pre-operative: Performs pre-operative assessment and evaluation if required. Collaborates with the surgical team on plan of care. Coordinate and communicate with circulator regarding equipment and implant needs for case, assist in obtaining. Plan for upcoming surgical cases in OR specialty. View upcoming schedules for instrument, equipment, staffing, implant, tissue and/or vendor needs. Responsible for organizing and communicating case needs to appropriate person or department. Reviews and updates surgical preference cards for specialty. This may be delegated to other team members.
• Representative Functions or Duties: 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. Acts as a clinical resource for the specialty. Helps facilitate issues during surgical cases. Responds to urgent/emergent needs of the department.
• Representative Functions or Duties:Post-Operative: Apply post-op splints and/or braces. During Anesthesia emergence, bring stretcher into room. Help transfer patient to stretcher. Remain in room for turnover unless specific instructions for Post-op care required in PACU.
• Practice standards of performance: Communicates information so that continuity of care is maintained. Communicates with patient, family and other staff in a professional and courteous manner. Obtains and demonstrates the skills and knowledge needed to provide appropriate population based and culturally sensitive care to patients and families 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. Function 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 the State of Oregon, institutional policies and procedures of Kaiser Permanente and the AORN Position Statement on RN First Assistants. Practice within limitations of preparation and experience. Demonstrate RNFA specific clinical skills. Review and update skills checklist on an ongoing basis as specified by policies of Kaiser Permanente. Assists with room preparation and opening of supplies in collaboration with the circulating nurse and scrub person. Have available patient X-rays/MRIs. Check image capture machine and films NOTE: Notify Team Lead or designee if films/MRIs etc. 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, i.e., 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 turn over in collaboration with the circulating nurse and scrub person. Assist in maintaining a safe environment and promoting efficiency in surgical procedures. Available for breaks and lunch relief, local monitor, scrub and circulate as needed. Provides input to Manager on team members performance and learning needs. Involved in team member selection, work with education and OR staff in the orientation of new staff. Collaborates on staffing assignments with the OR desk Charge Nurse, plans for breaks, lunch, hand off in care. Participates in quality improvement activities for the specialty.

Basic Qualifications

Experience

• Two (2) years of intra-operative scrubbing and circulating experience within Specialty.
• 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.

Education

• N/A

License, Certification, Registration

• Registered Nurse License (Oregon)

• Registered Nurse First Assistant Certificate

• Advanced Cardiac Life Support

• Nurse Operating Room Certificate

• Basic Life Support

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.