RN First Assist

Title and Definition Essential Responsibilities

• Responsible to the patient and the surgical team to assist, educate and otherwise facilitate an optimal outcome for the patient
• Participate in preoperative assessment and planning for surgical patients specific to RNFA activities (eg, anatomical exposure, wound closure) in collaboration with perioperative team members.
• Develop an individualized perioperative patient plan of care.
• Implement the plan of care by:
• Assist with positioning, prepping and draping of the patient or perform there independently, if so directed by the surgeon.
• Protecting the patient from injury caused by extraneous objects and chemical, electrical, laser, mechanical, and thermal sources;
• Participating in accounting procedures to protect the patient from unintended retained surgical items;
• Performing interventions necessary to ensure that the patient’s procedure is performed on the correct site, side, and level;
• Delays surgical procedure if any discrepancy among parties, patient history and physical, consents, or scheduled procedure occurs.
• Assisting with management of the patient’s specimens as necessary;
• Communicating the patient’s current status to relevant parties throughout the continuum of care;
• Administering medications safely and correctly;
• Performing interventions to maintain the patient’s wound and tissue perfusion at or above baseline levels;
• Performing interventions to maintain the status of the patient’s genitourinary, gastrointestinal, musculoskeletal, endocrine, respiratory, cardiovascular, and neurological systems and fluid, electrolyte, and acid-base balances at or above baseline levels;
• Performing interventions to ensure the patient is at or returned to normothermia at the conclusion of the immediate postoperative period;
• Performing interventions to protect the patient from surgical site infection;
• Assessing the knowledge level of the patient or designated support person;
• Demonstrates the ability to operate specialized equipment intra-operatively; i. e. stapling instrumentation, laparoscopic tools and equipment, orthopedic drills, and instrumentation, lasers, etc. per established procedures.
• Providing education regarding the expected psychosocial response, nutritional management, medication management, pain management, wound management, and expected responses to the operative or invasive procedure;
• Acts as a resource person for the operating room staff.

• Acts as a resource person for the operating room staff.
• Involve the patient or designated support person actively in decisions affecting his or her perioperative care and the rehabilitation process;
• Protecting the patients’ rights, dignity, and privacy;
• Providing age-specific, culturally competent, ethical care within legal standards of practice; and
• Providing consistent and comparable care regardless of the setting.
• Function as an RN first assistant during operative and other invasive procedures by:
• Providing exposure through correct use of instruments, retractors, suction, and sponging techniques;
• Placing and holding surgical retractors and demonstrating stamina for sustained retraction
• Retaining manually controlled retractors in the position set by the surgeon with regard to surrounding tissue.
• Anticipating retraction needs with knowledge of the surgeon’s preferences and anatomic structures
• Packing sponges or laparotomy pads into body cavities to hold tissues and organs out of the operative field
• Managing all instruments in the operative field to prevent obstruction of the surgeon’s view.
• Considers anatomical and physiological implications when selecting, placing, and moving retractors to provide surgical site exposure and reduce tissue injury.
• Suctions surgical site as necessary to remove smoke, blood, and fluids from the site to improve visualization and decrease biohazard exposure.