RN First Assistant

Description

RESPONSIBILITIES

• Applies nursing knowledge as the basis for effective problem solving and decision making when providing perioperative patient care
• Reviews and uses history, physical assessment, and preoperative test results to establish a physiologic baseline.
• Implements patient safety standards as the patient, equipment, and environment are prepared.
• Accepts delegated medical functions as defined within the RNFA scope of practice.
• Demonstrates situational monitoring, attention to detail, thoroughness, and concentrated focus during the surgical procedure.
• Recognizes anatomical abnormalities that may affect the surgical intervention.
• Uses safe methods for exposure of the surgical site, including use of retractors and other instruments, retraction sutures, and packing materials as dictated by procedural need.
• Uses effective problem- solving techniques and decision making abilities when encountering unfamiliar situations.
• Maintains flexibility and adaptability when emergencies or unanticipated events occur.
• Implements conservative surgical techniques when hemoglobin (Hgb), hematocrit (HCT), and blood availability are compromised.
• Uses acquired knowledge to anticipate, prevent, and respond to circumstances that could compromise the patient’s well being.
• Verifies operative procedure, surgical site, and laterality.
• Follows health care organization policy for preoperatively identifying correct surgical site.
• Participates in the Universal Protocol (eg, preoperative verification, time out) for each operative or invasive procedure.
• Verifies that prophylactic antibiotic medication (if required) is administered at the correct time to maximize effectiveness.
• Delays surgical procedure if any discrepancy among parties, patient history and physical, consents, or scheduled procedure occurs.
• Participates in positioning the patient in collaboration with the surgeon, anesthesia professional, and other members of the perioperative team.
• Uses safe positioning principles during preparation, application and removal of positioning devices.
• Assists with transferring the patient safely (eg, locks transport vehicle wheels; secures IV lines, catheters, feeding tubes; protects patient’s extremities; uses transfer devices correctly).
• Functions as first assistant to the primary surgeon during operative or other invasive procedures and throughout the perioperative continuum in accordance with scope of practice, credentials, privileges, education, and experience.
• Demonstrates physical capacity, visual acuity, dexterity, and fine motor skills necessary to provide first-assisting behaviors to the surgeon.
• Uses surgical instruments safely and correctly.
• Applies safe tissue handling, dissection, or cutting techniques based on assessment of tissue location, type, and patient’s health status.
• Performs specialized tissue handling, dissection, or cutting techniques under the direction of the operating surgeon. (eg, trocar placement, preparation of allografts, saphenous vein harvesting).
• Considers anatomical and physiological implications when selecting, placing, and moving retractors to provide surgical site exposure and reduce tissue injury.
• Chooses suturing material and techniques (eg, knot tying, ligation of vessels, wound closure) based on physician preference, density of tissue, support for suture line, potential tissue necrosis, need to evert skin edges, and cosmetic effect.
• Demonstrates proficiency in knot-tying techniques with various suture materials.
• Demonstrates proficiency in skin stapling techniques by assessing blood supply of tissues to be stapled, inspection of staple line, and applying skin staples correctly.
• Suctions surgical site as necessary to remove smoke, blood, and fluids from the site to improve visualization and…