RN FIRST Assistant- Duke University Hospital

Certified Registered Nurse First Assistant

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.

Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States. The largest of the four Duke Health hospitals with 1062 patient beds, it features comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.

The Certified Registered Nurse First Assistant will support the continuity of care for Perioperative patients. The scope of practice includes preoperative patient care management, intraoperative surgical first assisting and postoperative patient care management. The role will help expedite surgical productivity, support the education of surgical residents, 2nd assist where needed, and first assist the Surgeons when surgical Residents are not available.

The RNFA will provide patient care for all ages and/or provide leadership and direction to the perioperative team where needed.

The Certified Registered Nurse First Assistant (RNFA) plays a critical role in supporting continuity of care for perioperative patients across the preoperative, intraoperative, and postoperative phases. As a key member of the surgical team, the RNFA helps optimize workflow, enhance patient safety, and elevate clinical outcomes.

This highly skilled role provides:

• Expert intraoperative first assistance
• Support and education for surgical residents
• Second assist coverage across multiple specialties
• Leadership and clinical guidance for perioperative staff
• Seamless coordination of care for patients of all ages

In this fast-paced academic environment, RNFAs at Duke participate in complex and innovative surgical procedures while contributing to an exceptional patient and team experience.

To provide preoperative patient management in collaboration with other health care providers, including, but not limited to: preoperative evaluations, communicate/collaborate regarding the patient plan of care, writing preoperative orders according to established protocols; intraoperative surgical first assisting, including, but not limited to using instruments/medical devices, providing exposure, handing and/or cutting tissues, providing hemostasis, and suturing; postoperative patient management in collaboration with other health care providers in the immediate postoperative period including, but limited to writing postoperative orders/operative notes according established protocols, participating in postoperative rounds, and assisting with discharge planning.

To provide a qualified CRNFA to the operating surgeon during the operative procedure and comprehensive nursing management of care during the Perioperative phase. The CRNFA does not concurrently function as the Scrub Nurse.

Preoperative Patient Management

• Conduct preoperative assessments and screenings
• Participate in planning and coordination of individualized care plans
• Collaborate and communicate with the surgical team
• Write preoperative orders according to established protocols

Intraoperative First Assisting Provide skilled and safe intraoperative assistance, including:

• Using surgical instruments and medical devices
• Providing optimal exposure of the surgical field
• Handling and/or cutting tissues
• Achieving hemostasis
• Suturing and closing incisions
• Anticipating surgical needs to support efficient workflow

Note:

The RNFA does not simultaneously function as the Scrub Nurse.

Postoperative Patient Management

• Write postoperative orders and operative notes based on protocol
• Participate in postoperative rounds and clinical evaluation
• Assist with discharge planning and transitions of care
• Collaborate with multidisciplinary teams to support positive outcomes

CRNFA must have sound clinical knowledge of technology and treatment applications; must also possess skills to educate/train staff, and complies with AORN education standards for the CRNFA;, and a demonstrated knowledge of the surgeries in which the CRNFA participates. Must have sound clinical OR skills (scrubbing and circulating) and have excellent interpersonal skills and organizational capability.

CRNFA must have sound clinical knowledge of technology and treatment applications; must also possess skills to educate/train staff, and complies with AORN education standards for the CRNFA;, and a demonstrated knowledge of the surgeries in which the CRNFA participates. Must have sound clinical OR skills (scrubbing and circulating) and have excellent interpersonal skills and organizational capability.

BSN required, MSN preferred. Must be a graduate of an accredited school of Nursing. Completion of a RNFA (or CSFA program, if hired prior to 2/1/26)…