RN First Assistant

ESSENTIAL JOB FUNCTIONS AND CORE RESPONSIBILITIES

• Responsible for RNFA duties specific to Cardiothoracic surgery
• Responsible for RNFA duties specific to robotic and thoracoscopic surgery
• Maintains familiarity with robotic instrumentation.
• Responsible for effective coordination and proper staffing of robotic cases
• Able and facile with assisting bedside robotic cases
• Preoperatively performs a focused nursing assessment in reference to planned procedure; reviews analyze and interprets information from the medical record; verifies consent is consistent with planned procedure, verifies allergies and /or sensitivities.
• Provides quality nursing care in accordance with the California Nurse Practice Act.
• Provides expertise regarding Cardiothoracic surgical equipment and instrumentation.
• Ensures patient safety in the operating room, by helping to coordinate and maintain a smoothly functioning operating room environment and team.
• Serves as First and second assistant in the operating room, including wound opening and closing.
• Serves as First and Second assistance on thoracic robotic cases.
• Performs endoscopic techniques for saphenectomy and radial artery harvest under the supervision of a cardiac surgeon.
• Directly assists the surgeon by controlling bleeding, providing wound exposure, suturing and other surgical tasks.
• The RNFA may provide other advanced assistance, such as mobilization of tissue, patient positioning and directing other surgical team members with specific individual tasks.
• Intraoperatively assesses patient, wound, and sterile field; assesses for proximity of nerves and adjacent critical structures when activating electrosurgical active electrode or other devices.
• Monitors and assesses patient's postoperative status to determine progress toward expected outcomes or signs and symptoms of postoperative complications.
• Formulates and modifies nursing diagnosis based on relevant patient data throughout the perioperative continuum.
• Documents nursing diagnosis and communicates any change in patient condition to members of the health care team.
• Identifies and communicates desired patient outcomes throughout the perioperative continuum.
• Develops and manages an individualized plan of care that directs the interventions of the RNFA.
• Implements, manages and coordinates the perioperative plan of care related to RNFA interventions.
• Applies nursing knowledge as the basis for effective problem solving and decision making when providing perioperative patient care.
• Verifies operative procedure, surgical site and laterality.
• Participates in positioning the patient in collaboration with the surgeon, anesthesia, and other members of the perioperative team.
• Functions as first assistant to the primary surgeon during operative or other invasive procedures throughout the perioperative continuum and in accordance with the scope of practice, credentials, privileges, education, experience, and standardized procedures.
• Minimizes the length of the operative or invasive procedure and maximizes the surgeon's efficiency of movement within the surgical wound.
• Implements and maintains sterile technique.
• Protects patient from thermal, electrical, chemical, or mechanical injury throughout the perioperative continuum.
• Implements hemostasis techniques.
• Implements measures to prevent injury related to retained surgical items.
• Make postoperative rounds in conjunction with or at the direction of the surgeon as determined by health care organization policy and guidelines of practice. May require advanced practice designation (e.g., NP or PA) with requisite privilege through MHSC Medical Staff Office.
• Provides individualized patients, designated support person, or health care education regarding identified needs related to RNFA interventions.
• Participates in quality monitoring and performance improvement activities to improve patient outcomes.
• Participates in professional activities directed toward improving patient care.
• Acquires and maintains specialized knowledge and skill in perioperative nursing practice.
• Evaluates personal practice in context of current professional practice standards, rules and regulations.
• Interacts with and contributes to the professional growth of peers, colleagues and others.
• Works with professional colleagues within the perioperative team and collaborates with the patient, designated support person, and other health care providers with making decisions regarding the plan of care.
• Practices in an ethical manner, always demonstrating the IRAISE values of the organization.
• Utilizes evidence-based practice to guide perioperative care management.
• Considers health care access, fiscal responsibility, efficacy, and quality when providing care.
• Advocates for innovative care practice improvement and technical advances when appropriate.
• Demonstrates key leadership traits: a) supervises peers, colleagues, allied health personnel and support team members in the delivery of perioperative patient care as assigned; b) participates in ongoing quality improvement; c) advocates for advances in perioperative nursing by participating in professional nursing organizations.

JOB REQUIREMENTS

Education

Minimum (Required)

BSN required

Preferred (Not required)

MSN preferred

Work Experience

Minimum (Required)

• Three years of RN work experience in peri-operative nursing
• Proficiency in preoperative nursing includes the ability to scrub on surgical cases and function in circulating roles.
• Demonstrated proficiency in aseptic and sterile technique.
• Previous work experience in cardiac surgery, thoracic surgery, and robotic surgery

Preferred (Not required)

Licenses and Certifications

Minimum (Required)

• A current RN licensure in the State of California is required.
• Must successfully complete and maintain BLS certification.
• Certified in peri-operative nursing (CNOR).
• Successful completion of certified RNFA program: Credentialed through Allied Health Professionals of the Medical Staff.

Preferred (Not required)

Pay Transparency

The hourly rate range for this position is $ $96.53. When extending an offer of employment, the University of Southern California Arcadia Hospital considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, key skills, internal peer equity, federal, State, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.

POSITION SUMMARY The Registered Nurse First Assistant (RNFA) is a perioperative registered nurse (RN) or an Advanced Practice Registered Nurse (APRN) who functions in an expanded role as a surgical first assistant for Cardiothoracic surgeries and for robotic surgery cases. The RNFA works in collaboration with the surgeon and other care team members to achieve optimal patient outcomes and utilizes the necessary knowledge, judgement, and skills specific to the expanded role of RNFA clinical practice, intraoperatively and at the direction of the surgeon. The RNFA practices perioperative nursing and must have the necessary specific knowledge, skills and judgment to demonstrate competency in the RNFA Cardiothoracic surgery duties. The RNFA practices under the supervision of the surgeon during the intraoperative phase of the perioperative experience. In order to perform in this role, the RNFA must adhere to the RNFA Standards of Practice (AORN) and function under specific hospital approved standardized procedures. The RNFA may not perform the function of the scrub nurse while functioning as the RNFA.

Job ID REQ Posted Date 11/14/2025

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