Registered Nurse - First Assist

The Registered Nurse – First Assist (RNFA) is a credentialed perioperative nurse who primarily functions as the circulating RN, while also providing First Assist duties during surgical procedures within the scope of RNFA training, certification, and competency. The RNFA supports the surgeon by performing advanced technical skills—including retraction, suturing, hemostasis, and tissue handling—under the supervision of and in collaboration with the operating surgeon, who remains immediately available within the facility. The RNFA provides comprehensive perioperative nursing care using the nursing process and ensures compliance with clinical, safety, and regulatory standards. The role promotes teamwork, contributes to case readiness, and manages equipment and supplies to ensure safe, efficient operative care.

• Performs the circulating RN role by assessing, planning, coordinating, and implementing care throughout all phases of the perioperative experience.
• Assesses and diagnoses patient/family needs to develop and communicate individualized care plans in collaboration with the surgical and anesthesia teams.
• Implements nursing and medical interventions needed to support the patient during surgery, including patient positioning, prepping assistance, and safety verification processes.
• Performs RN First Assist functions as trained and credentialed, including: retraction, tissue handling, hemostasis, exposure, suturing, closure, insertion of drains, and assisting with operative instrumentation and techniques.
• Maintains a surgically safe and sterile environment, practicing aseptic technique and monitoring the sterile field to reduce risk of infection.
• Anticipates surgeon and OR team needs, facilitates procedural flow, and coordinates support services during surgery.
• Evaluates patient response to interventions, reassesses the plan of care, and documents nursing interventions and surgical assistance in the electronic medical record.
• Ensures availability and functionality of supplies, equipment, and surgical instruments, identifying needs proactively to support safe operative workflow.
• Maintains current licensure, RNFA certification, and clinical competencies applicable to both circulating RN and RNFA duties.
• Supports regulatory compliance by following departmental, facility, CMS, ACHA, and infection‑prevention standards.
• Promotes teamwork and communication across perioperative services, anesthesia, surgeons, and support departments.
• May act as charge nurse during on‑call, holiday, or assigned shifts, supporting staffing coordination, safety oversight, and unit leadership needs.

Minimum Education

• Technical Diploma/Certificate Nursing Required or
• Associates Degree Nursing Required
• Bachelor's Degree Nursing Preferred

Minimum Work Experience

• 3 years Operating room experience Required

Licenses and Certifications

• Registered Nurse Licensed State of Florida or eligible compact state Upon Hire Required and
• BLS for Healthcare Providers (BLS) American Heart Association Upon Hire Required
• CNOR (CNOR) CCI Upon Hire Required
• Certified RN First Assistant (RNFA) RNFA certificate of completion from school training Upon Hire Required

Required Skills, Knowledge and Abilities

• Demonstrated proficiency in acute care nursing and perioperative clinical skills.
• Demonstrated proficiency in both scrub and circulating RN responsibilities.
• Ability to function safely and independently as an RN First Assist during assigned portions of surgery.
• Ability to stand for extended periods and maintain retraction or limb positioning.
• Strong critical‑thinking, clinical‑judgment, and communication skills.
• Must be able to return to the facility within 30 minutes during callback.
• Ability to anticipate surgeon and patient needs and respond effectively in rapidly changing environments.