Overview

Within his or her scope of practice, the RN First Assist CVOR Specialty identifies the patient's surgical needs, prioritizes care based on continuous assessment, and executes therapeutic physician orders and therapeutic nursing interventions. He or she is accountable for outcomes of patient care delivered during the surgery. The Registered Nurse First Assistant collaborates with the surgeon in performing a safe operation with optimal outcomes for the patient and practices under the supervision and direction of the surgeon during all surgical procedures. The Registered Nurse First Assistant does not concurrently function as a scrub nurse.

Responsibilities

Core Responsibilites and Essential Functions

• Essential Functions: * Initiates assessment based on the patient's presenting problems or needs and the physician's medical diagnosis. * Completes on-going assessments during the surgical case. * Performs therapeutic and surgical interventions as ordered by the physician. * Demonstrates correct, appropriate use of related equipment; use, care and handling of instruments; and use, care and handling of sterile supplies. * Assures the operating room is ready for patient use for the appropriate procedure. * Applies and monitors the principles of aseptic technique. * Coordinates the activities of other health care professionals as necessary. * Provides complete, accurate documentation appropriate for the surgery performed. * Functions as RN circulator and/or scrub if appropriate competencies are maintained. Employee may not concurrently function as an RNFA, RN circulator or RN scrub. * Assists in maintaining correct sponge, needle and instrument count throughout the surgical procedure. May participate in counts. * Prepares the incision site according to established procedure. * Assists in identifying, labeling and/or dispatching specimens from the sterile field to the RN circulator or Laboratory. * Scrub, gown, and glove self and another team member as necessary. * Drapes patient per physician preference. * Anticipates surgeon’s needs and requests additional items from the RN circulator in time for surgical use. * Verifies solutions and medications prior to them being dispensed to the sterile field. Label all solutions and medications immediately after them begin dispensed to the sterile field * Applies surgical dressings per protocol and physician preference * Assists with room preparation and set up of sterile tables, cleaning of operating room post-surgery and containment of contaminated needles and sharps. * Assists in the orientation and training of new employees. * Demonstrates knowledge of surgical anatomy, physiology, and operative techniques appropriate to the surgical procedures to which providing assistance. * Provides exposure through appropriate use of instruments, retractors, suctioning and sponging techniques. * Although not an exhaustive list, under the direction of the surgeon, handles tissue; appropriately uses instruments and equipment; provides hemostasis by clamping, coagulating, and/or ligating vessels; performs wound closure; places and secures drains; and assists with cannulation. * Attends all required in-services and training. * Performs other duties as assigned, within the skill set and competency level of the individual.
• Exemplary Practice and Outcomes * Performs the Nursing Process (assessment; diagnosis; identification of outcomes; planning; implementation and evaluation) in the performance of clinical care using evidence base practice, uses analytical/critical thinking and ensuring that care is individualized; coordinating care through effective partnerships recognizing that caring is central to achieve optimal patient care outcomes * Provides relationship-based patient centered care that is consistent with population specific characteristics (e.g. age, gender, disease, etc) in a manner that adapts service delivery to reflect an understanding of cultural diversity * Always partners with the patient and significant others (as appropriate) using such appropriate method for setting and purpose (e.g., bedside shift report; interdisciplinary rounds; just in time and planned patient teaching; keeping the patient and significant others updated and making the patient’s goals the focus of the plan of care. * Practices using current clinical practice standards.
• Teamwork and Collaboration * Coordinates the delivery and documentation of safe quality patient care that promotes the professional care delivery model. This includes, but is not limited to diverse and inclusive interdisciplinary communication methods (interdisciplinary rounds, case review, etc); completion of timely documentation and promotion of a respectful, inclusive clinical environment * Demonstrates teamwork and collaboration by practicing in a manner that is fiscally responsible and promotes the recruitment and retention of all healthcare team members. * Participates and supports performance improvement inclusive of all stakeholders, research and research utilization to promote safe, quality patient care including initiating and/or leading such activities as well as, promoting an inter/intra-disciplinary process and actively supports/participates in shared governance at all levels in the system.
• Professional Development and Initiative * Completes all initial and ongoing professional competency assessment, required mandatory education, population specific education. * Serves as a preceptor and/or or mentor for other professional nurses (and staff or students for all disciplines) to ensure that there is a current and future qualified workforce; modeling the professional practice of nursing and creating a healthy work environment
• Evidence Based Practice and Research * Promotes Evidence based practice, nursing research and performance improvement in nursing. Participates in activities such as value analysis as part of the decision-making process in evaluating patient care products. * Upholds all health care system/organizational policies and procedures and clinical competencies put forth by this job description and professional association including legal, regulatory and accreditation requirements and standards ensuring by way of example, such goals as TJC Patient Safety Goals and WellStar Health Systems’ safety absolutes * Participates in data collection, poses relevant clinical questions to advanced evidence-based practice. Consults appropriate experts and uses appropriate resources and evidence to address practice questions
• Resources and Support * Proactively plans for the care of patients across the care continuum in the course of giving direct patient care. * Participates in the development of protocols and procedures when called upon or through self-initiation in collaboration with care managers and other members of the health care team to achieve best practice outcomes (i.e., decrease in re-admission rates; avoidable days; adverse events; etc). * Supports efficient and effective use of human and material resources

Required for All Jobs

• Performs other duties as assigned
• Complies with all WellStar Health System policies, standards of work, and code of conduct.

Qualifications

Required Minimum Education

• Graduate of an Accredited School of Nursing with Current Georgia Licensure. Required and
• Proof of successful completion of an organized program of study on RN First Assisting, including clinical practice that has been accepted by CBPN (Certification Board Perioperative Nursing). This course of study must follow the format of the “Core Curriculum for the RN First Assistant” published by AORN. Required

Required Minimum Experience

• Minimum 2 years scrubbing and circulating proficiency Required and
• Prior First Assist experience Preferred

Required Minimum Skills

• The Cardiovascular O.R. Nurse First Assist demonstrates a thorough knowledge of new trends and techniques in Cardiovascular surgery.
• Ability to multi-task using critical thinking skills anticipates surgeon’s needs.
• Capable of prioritizing appropriate patient care in emergency situations.
• Current CPR certification and participates in annual safety and infection control programs.
• Emergency call coverage is required for weekdays, weekends and holidays.
• Attendance and punctuality must be commendable.
• Must be able to effectively communicate and understand verbal and written English language.
• Must be able to communicate effectively in a clear, courteous, professional and tactful manner especially in stressful situations.
• Demonstrates excellent organizational skills.
• Basic keyboarding skills required.
• Flexible in hours and work shifts due to need of continued patient care.
• Must be available for call on weekdays, weekends and holidays

Required Minimum License(s) and Certification(s)

• CRNFA - Cert RN First Assistant 1.00 Required 1.00
• RNAS-C - Reg Nurse Asst Surg Cert 1.00 Required 1.00
• BLS - Basic Life Support 2.00 Required 2.00
• RN - Reg Nurse (Single State) 3.00 Required 3.00
• RN-COMPACT - RN - Multi-state Compact 3.00 Required 3.00
• CNOR - Cert Nurse Operating Room 4.00 Required 4.00

Additional Licenses and Certifications

• Current/active license as a registered nurse in the State of Georgia Required
• Must have a current BLS card from the American Heart Association on the first day of employment in position. Required
• RNAS-C or Certified Registered Nurse First Assistant certification (CRNFA) and CNOR Required