Registered Nurse First Assistants (RNFAs) are assigned to the Operating Room Service under the Operative Care Division and are directly accountable to the Operating Room Manager. RNFAs are functioning in an expanded perioperative nursing role. The RNFA must have acquired the necessary knowledge, judgement, and skills specific to the expanded role of RNFA clinical practice. Registered Nurse First Assistants (RNFAs) intra-operatively practice at the direction of the attending surgeon. The RNFA has the duty to verify the standardized procedures in effect before performing the functions of a surgical first assistant. Specific practice settings includes the perioperative arena. The practice of each RNFA is based on knowledge, experience, and research and has a direct impact on patient outcomes in the assigned area and for the facility. When not performing in the First Assistant role, the RNFA may provide care in the Operating Room Registered Nurse (OR RN) role. The OR RN provides professional nursing care to assigned operating room patients throughout the perioperative period and collaborates with the interdisciplinary team to strategize, implement and evaluate an individualized plan of care for each patient. Patient populations include, but are not limited to: ENT, General Surgery, Cardiothoracic Surgery, Liver Transplantation, GU, GI, Neurological, Vascular and Orthopedic procedures. Other duties and responsibilities of the RNFA include but are not limited to the following: Positioning the patient, preparing and draping the surgical site. Administering local anesthetic(s). Providing exposure and retraction. Providing hemostasis utilizing electrosurgical cautery (ESU), suture ligation, hemostatic agents and argon beam. Using and handling of surgical instrumentation. Tissue handling, dissection, suturing, and stapling. Making the skin incision or stab wound for laparoscopic surgery or drains and placement of trocar (based on State Board of Nursing) for laparoscopic access. Inserting, re-positioning and removal of Robotic instrumentation. Securing drains. Closing wounds and changing dressing, including wound vac therapy. Applying and removing casts and splints. Harvesting vein and arteries for bypass conduit. Cleansing surgical area, including superficial, subcutaneous, muscle and fascia, bone and abdominal and pelvic cavities. Removing surgical drains under the direction of the attending surgeon. Performing focused preoperative nursing assessments. Communicating and collaborating with other health care providers regarding the patient plan of care. Participating in postoperative rounds. Assisting with patient discharge planning and identifying appropriate community resources. Work Schedule: Monday-Friday, 7:00 am to 5:30 pm (8 or 10 hours shifts available); variable per Service needs; position will take call. Financial Disclosure Report: Not required
Providing Health Care for Veterans: The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.