Registered Nurse First Assistant; RNFA

Job Title

Registered Nurse First Assistant (RNFA)

SS1703

Full-time;
Non-Exempt;
No supervisory positions.

$15,000 sign-on bonus for eligible candidates.

The Registered Nurse First Assistant (RNFA) is a perioperative registered nurse who functions in an expanded role to work collaboratively with the surgeon and the surgical team. The RNFA provides first‑assist services during surgical procedures, performs perioperative nursing responsibilities, and ensures high‑quality patient care throughout the surgical experience. The RNFA practices under the RN scope of practice, Virginia Board of Nursing regulations, and facility policies, with documented RNFA training, competency, and surgeon delegation.

This role integrates both circulating/scrub nursing responsibilities and technical first‑assist duties.

• Provides first‑assist duties including exposure, tissue handling, retraction, hemostasis, suturing, and wound management
• Applies knowledge of instrumentation, anatomy, and sterile/aseptic technique
• Independently scrubs and assists across specialties including, but not limited to Orthopedics, General, Robotics, Vascular, Gynecology, and Spine
• Anticipates surgeon needs and ensures safe, efficient operative flow
• Participates in preoperative planning with surgeons and the surgical team
• Demonstrates knowledge and skills appropriate to the age and needs of the patient

• Performs circulating nurse duties according to Operating Room standards and policies
• Prepares the operating room with supplies, instruments, and equipment needed for the scheduled procedure
• Supports anesthesia providers and ensures safe patient positioning
• Monitors compliance with aseptic technique and safety protocols
• Engages in preadmission, preoperative, and postoperative RN duties as applicable to Outpatient Surgery (Outpatient Surgery Center, Preadmission, Post-Anesthesia Care Unit)
• Provides patient and family education regarding the perioperative process
• Conducts nursing assessments and documents care in accordance with policy

• Utilizes SBARQ and other structured communication tools
• Coordinates patient care activities with physicians, anesthesia, surgical technologists, and perioperative staff
• Maintains timely and accurate documentation
• Communicates updates or issues to the leadership team and intra‑operative staff

• Acts as an advocate for patient rights, privacy, and dignity
• Provides emotional support and individualized patient education
• Develops and implements nursing plans of care tailored to patient needs
• Ensures continuity of care across all perioperative phases

• Follows departmental and organizational policies and guidelines.
• Maintains, operates, and monitors equipment according to manufacturer and hospital standards.
• Completes department‑specific competency validation and ongoing training.
• Participates in on‑call rotation as assigned.

• Graduate of an accredited School of Nursing required
• Bachelor’s Degree in Nursing required
• Completion of an accredited RNFA program required

• Minimum two years of perioperative RN experience required
• Experience as an RNFA preferred

• Current RN license in the Commonwealth of Virginia
• Certified Nurse Operating Room (CNOR) certification required
• RNFA certification or documented completion of RNFA program required
• Refer to the Life Support Training policy for additional details

• Ability to independently scrub and first‑assist across multiple specialties
• Strong critical thinking, assessment, and decision‑making abilities
• Excellent communication, teamwork, and patient education skills
• Ability to multitask, prioritize, and respond effectively in emergencies

• Constant standing, frequent walking, bending/stooping
• Ability to lift/push/pull up to 100 lbs. with assistance (Safe Handling Equipment required >35 lbs.)
• Requires strong visual, auditory, and verbal communication abilities
• Frequent repetitive motions and ability to maintain attention to detail

• May require the use of safety equipment, such as HEPA mask, for infection prevention:
  Yes
• On call responsibilities as directed:
  Yes
• Ability to travel between campus buildings, remote facilities, and out of town as needed:
  Yes