Status:  Full Time

Shift:     6:30am-7:00pm, 3 shifts per week, Monday - Friday, with rotating call.

Exempt: No 

Summary:

To assist the RN team leader with specialty specific products and education. To act as a staff/physician liaison.

The Certified Surgical First Assistant is a specially trained individual who actively assists the surgeon during the pre-op, intra-op and post-op phases of care. The Certified Surgical First Assistant provides aid in exposure, hemostasis, closure and other intraoperative technical functions that aid the surgeon in providing a safe operation with optimal results for the patient. The Certified Surgical First Assistant performs these functions under the direction and supervision of the surgeon and in accordance with hospital policy and appropriate laws and regulations.

Other information:

1. Graduate from Surgical Assisting Program accredited by CAAHEP

2. Current certification/CSFA or CFA

3. OR experience preferred

A. Manual or Physical Skill Required:

1. Must be capable of assisting with the lifting and moving of patients. Must have a thorough knowledge of body mechanics. Must be capable of prolonged standing and walking.

2. Physical Effort Required:

Strength: Medium
Push: Frequently
 Pull: Frequently
Carry: Frequently
Lift: Frequently
Sit: Occasionally
Stand: Frequently
 Walk: Frequently

Responsibilities:

A.Current Scrub Tech and First Assist certification required.

B.Possess knowledge in all procedures/equipment relating to the specialty including Robotics.

C.Will perform duties in a pleasant professional manner.

D.Serves as preceptor for new hires as needed.

E.Acts as assistant instructor for surgical tech students rotating through NOHS as needed.

F.Will be flexible, approachable and maintain good rapport with nursing and medical staff.

G.Accepts call rotation for the General or Cardiovascular Services.

A. Role of Surgical First Assistant in the OR:

1. The surgeon shall convey the exact position that will give the best exposure for the surgical procedure. The surgical assistant will carry out this order. Consideration will be given to the patient’s comfort and safety.

2. Points of pressure shall be padded: elbows, heels, knees, eyes, face, and axillary region.

3. Circulation shall not be impaired. (A tourniquet may be required for some procedures.)

4. Nerve damage shall be guarded against.

5. The temperature of the patient should be discussed with the anesthesia personnel and methods employed to maintain the desired temperature range.

6. The surgical assistant shall be familiar with common positions related to the surgical procedure and will be able to use the equipment necessary to provide the position. Competencies will include the following:

a. Fracture tables

b. Head stabilizers

c. Body stabilizers

d. C-arm extensions

e. Any other equipment needed

7. Upon completion of the procedure, the patient shall be evaluated for any possible damage from positioning which will include assessment of the skin. The abnormal condition shall be reported to the surgeon and treatment and documentation shall be carried out.

B. Provides visualization of the operative site by the following:

1. Appropriate placement and securing of retractors with or without padding

2. Packing with sponges

3. Digital manipulation of tissue

4. Suctioning, irrigating, or sponging

5. Manipulation of suture materials (e.g., loops, tags, running sutures)

6. Proper use of body mechanics to prevent obstruction of the surgeon’s view

C. Utilizes appropriate techniques to assist with hemostasis

1. Permanent

a. Clamping and/or cauterizing vessels or tissue

b. Tying and/or ligating clamped vessels or tissue

c. Applying hemostatic clips

d. Placing local hemostatic agents

2. Temporary

a. Applying tourniquets and demonstrating awareness of the indications/contraindications for use with knowledge of side effects of extended use

b. Applying vessel loops

c. Applying non-crushing clamps

d. Applying direct-digital pressure

D. Utilizes appropriate techniques to assist with closure of body planes

1. Utilizing running or interrupted subcutaneous sutures with absorbable or non-absorbable material

2. Utilizing subcuticular closure technique with or without adhesive skin closure strips

3. Closing skin with method indicated by surgeon (suture, staples, etc.)

4. Postoperative subcutaneous injection of local anesthetic agent as directed by the surgeon

E. Selects and applies appropriate wound dressings, including the following:

1. Liquid or spray occlusive materials

2. Absorbent material affixed with tape or circumferential wrapping

3. Immobilizing dressing (soft or rigid)

F. Provides assistance in securing drainage systems to tissue

G. Other

1. Complies with AORN/ASA Standards

2. Maintains a safe environment by following established OR policies/protocols

3. Demonstrates good interpersonal relationships

4. Maintains an employment record in accordance to hospital policy

5. Maintains and increases standards of performance and education

6. Flexibility of hours and assignments as needed

7. Function as scrub nurse in all specialties as needed

8. Performs other duties as requested by charge nurse or coordinator