RNFA - Surgical First Assist Assistant

Job Summary

The Surgical First Assistant to the surgeon during a surgical procedure carries out functions that will assist the surgeon in performing a safe operation with optimal results for the patient. This position practices peri-operative care and has acquired the knowledge, skills, and judgment necessary to assist the surgeon through organized instruction and supervised practice. The Surgical First Assistant practices under the direct supervision of the surgeon during the first assisting phase of the peri-operative role.  This position does not concurrently function as a scrub tech.



· Demonstrates thorough knowledge of the hospital’s mission, vision and values.

· Implements standards of practice, reviewing and revising as necessary to include respect for and sensitivity to culture, age, age-specific competencies, and persons with disabilities that reflect a change in practice.

· Promotes quality by incorporating current research findings, nationally recognized professional standards, and other expert literature into the provision of care, treatment and services.

· Promotes and supports the hospital wide Continuous Quality Improvement Process using the Plan/Do/Check/Act (PDCA) process.

· Demonstrates and maintains a thorough knowledge of Federal, State, Local laws and CMS/JACH Accreditation standards.

· Responsible for the delivery of direct and indirect patient care in the perioperative setting through the process of assessment, planning and implementation, and evaluation for neonates, pediatrics, adolescents, adults and older adults.

· Coordinates the care of the patient with the surgeon and the anesthesiologist, directs and guides the Surgical technician and other personnel while maintaining standards of professionalism.

· Works with other departments to provide a continuum of care and co-workers to provide continuous, quality patient care, efficient patient flow and unit maintenance and organization.

· Responsible for adherence to regulations, standards and hospital or unit policies and procedures. Responsible for participation in Performance Improvement activities, unit meetings and in services.

·  Is knowledgeable of all emergency codes and emergency preparedness procedures and understands his/her role in response to each of the emergency codes (Code Blue, Code Pink, Code Green, Code Stroke, Code Orange, Code Yellow, Code Gray, Code Silver, Code Violet, etc.).

· Will be responsible for tissue handing, providing exposure for the surgeon, using instruments, suturing, and providing hemostasis.

· Demonstrates knowledge of surgical procedures and aseptic technique.

· Performs all duties according to policy and procedure including infection control precautions and universal blood/fluid precautions.

· Assists with proper positioning, prepping, and draping of the patient.

· Provides exposure through appropriate use of instruments, retractors, suctioning, and sponging techniques.

· Provides hemostasis and keeps the operative site dry by clamping, electrosurgery, pressure/sponging, collagens/cellulose, bone wax and other means as directed.

· Demonstrates proper tissue handling and assist the surgeon in identifying any structure which should not be ligated.

· Demonstrates suturing skills by proper tying, ligating of vessels, and closure of surgical site including approximation of wound layers, subcuticular closure, staples, and skin closure.

· Recognizes changes in the patient's condition and informs the surgeon.

· Exhibits manual dexterity, anticipates the needs of the surgeon, and demonstrates appropriate table manners.

· Performs effectively in stressful and emergency situations.

· Assists with moving the patient on and off the operating table and transferring the patient from the operating room.

· Demonstrates ability to perform effectively and harmoniously as a member of the operative team.

· Performs other related duties when necessary and as directed (i.e. assists in workroom/instrument room, transports patients, helps orient new employees, etc.).

· Conducts timely and accurate assessments, initiates appropriate interventions, and communicates with surgeon and anesthesia.

· Evaluates and anticipates changes in patient condition or surgical course. Is able to manage and/or prevent emergencies or adverse events.

· Completes all work in organized and timely manner ensuring that all orders written are carried out within the appropriate time frame and documentation is performed in “real time” in the current operating room module.

· Able to prioritize workload to ensure appropriate tasks are completed in the order necessary to facilitate a smooth surgical case.

· Demonstrates a positive professional attitude as evidenced by respect towards co-workers, physicians, patients, families, and ancillary departments.

· Demonstrates a willingness to help others and offer help without being asked.

· Adheres to the current Patient safety standards, OSHA bloodborne pathogens standards and CDC guidelines, such as proper hand washing and using two patient identifiers (MAR’S, SBAR, Hand off communication).

· Demonstrates knowledge and environmental awareness by maintaining clean/unobstructed work area.

· Communication style (verbal and nonverbal) is professional, courteous, polite, and respectful to all customers.

· Provides emotional support, shows sensitivity and consideration for others’ feelings and/or cultural backgrounds.

· Demonstrates good listening skills.

· Demonstrates advocacy and positive interpersonal skills as it relates to patients, families, colleagues and other departments.

· Makes clear and logical decisions while using resources appropriately (including self).

· Role models professional practice with patients, families, visitors and the interdisciplinary team.

· Participates in unit based and house wide activities, if applicable.

· Demonstrates flexibility to assignments, schedules, and staffing.

· Prepares surgical suite for the operation. Demonstrates appropriate counting of instruments, sponges, and sharps per departmental protocol/policy. Exhibits knowledge of appropriate protocol for an incorrect count.

· Ensures that all proper documents are on the chart and completed within the designated time frame prior to leaving the Holding Room. (anesthesia consent, surgical consent, H&P, etc.). Ensures the patient is marked by the appropriate staff per policy if undergoing a procedure with a predetermined laterality.

· Monitors sterile field until released by anesthesia, reports and corrects any break in sterile technique.

· Monitors all instrumentation and equipment during use, (i.e. electrocautery instruments, electric & pneumatic drills, light sources, insufflation devices, etc.) for placement, settings and functioning, paying attention to any and all audible alarms.

· Checks medication name, route, dosage, and expiration date with surgical tech. Ensures medication on the field has been labeled by the surgical tech.

· Demonstrates appropriate handling/labeling of surgical specimens.

· Consistently and appropriately performs “time out” according to facility policy.

· Independently recognizes and performs duties which need to be done without being directly assigned. Establishes priorities: organizes work and time to meet them.

· Recognizes and responds to priorities, accepts changes and new ideas. Has insight into problems and the ability to develop workable alternatives.

· Accepts criticism in a constructive manner.

· Adheres to attendance and punctuality requirements per hospital policy. Provides proper notification for absences and tardiness. Takes corrective action to prevent recurring absences or tardiness.

· Uses time effectively and constructively. Does not abuse supplies, equipment, and service. Observes all hospital and departmental policies governing conduct while at work (e.g., telephone and computer use, electronic messaging, smoking regulations, parking, breaks and other related policies.)

· Understands, respects and displays sensitivity to culture, age and persons with disabilities.

· Participates actively in and positively affects the outcomes of customer service activities.

· Uses effective collaborative effort strategies as evidenced by peer relationships that enable the group to work together to accomplish the daily workload within the allotted time frame and achieve departmental goals.

· Recognizes and understands that as a member of an interdependent group, collaboration and compromise is required in order to maintain the effectiveness of the group as a whole to effectively resolve problems.

· Timely notification to Director of Surgical Services of potential problems or concerns. When faced with a problem or concern, is proactive by presenting suggested solutions at the time that the Director of Surgical Services is made aware of the problem.

· Displaying teamwork ability to promote cooperation and collaboration: gaining support for programs and goals.

· Supports Patient Rights

· Displays honesty and respect for others, and respect for the organization.

· Treats internal and external customers as the most important part of the job.

· Is sensitive to customer’s emotion’s, thoughts and feelings

· Refrains from negative comments of any kind where the public or other customers can hear.

· Takes appropriate actions to resolve a patient’s concerns.

· Effective and timely processing of customers' requests according to hospital and departmental policies

· Utilizing verbal communication methods, which enable others to clearly understand what is being said.

· Utilizing verbal and nonverbal behaviors without being defensive, manipulative, aggressive or controlling.

· Using written communication that is legible, timely and at a level based on the position specific requirements.

· Interacts with coworkers, other hospital staff, physicians, and the public in a courteous, professional and efficient manner.

· Establishes good rapport and working relationships with coworkers, other hospital staff, physicians and the public.

· Observes dress code policy and wears hospital identification as required by our policies and procedures.

· Understands and abides by all departmental policies and procedures as well as the Code of Ethics, HIPPA requirements and patient rights.

· Complies with federal, state local laws the govern business practices. Complies with all Department of Health Services requirements for the State and CMS standards that apply to the position.

· Is knowledgeable and adheres to JACH/CMS standards specific to the position.

· Participates actively in ensuring that all state and federal rules and regulations are followed as they apply to this position.

· Conducts business in an ethical and trustworthy manner at all times when dealing with patients, visitors, physicians, and fellow employees.

· Attends scheduled in-service and mandatory in-services. Communicates ideas to Director for a safer layout of equipment, tools, and/or processes.

· Follows standard precautions and transmission-based precautions as shown by consistent use of appropriate personal protective equipment.

· Adheres to procedures for the disposal of waste – household waste and biohazard waste as well as the proper disposal of sharps.

· Uses proper body mechanics at all times. Seeks assistance when necessary to move heavy objects or to transport or transfer a heavy patient.

· Is knowledgeable in the hospital safety program and takes steps to maintain a safe environment. Adheres to safe work practices in order to prevent injuries and illnesses.

· Is familiar with emergency codes and emergency preparedness procedures and understands their role in response to each of the emergency codes.

· Maintains the department in a neat, clean, orderly manner, especially in own work area.

· Eliminates or assists in eliminating any seen or known hazards in the workplace. Reports any unsafe conditions to the Director of Surgical Services or to Biomed.

· Demonstrates good safety habits and judgement by maintaining a safe environment at all times

· Complies with all hospital safety and injury prevention policies and regulations (seven Environment of Care plans and hospital safety policies and procedures).

· Understands the Continuous Quality Improvement Process and applies it in performing everyday tasks/duties. Active participant in Continuous Quality Improvement program by assisting in finding new and better ways of performing duties and responsibilities.

· Understands performance improvement concepts and demonstrates understanding by defining performance improvement, and verbalizing at least one major goal of the performance improvement program within the hospital setting.

· Cooperates with others in the improvement of services offered at our institution. Continually makes recommendations that assist in the improvement of services.

· Continually strives for self-improvement in the areas of responsibility by attending continuing education classes.

· Monitors patient safety/well-being during construction/remodeling activities in the facility.

· Performs other duties as assigned or required.

· Participates actively and positively affects the outcome of customer service activities.

· Complies with federal, state and local laws that govern business practices.

· Understands and actively participates in the Quality Improvement program.

· Is able to define performance improvement and verbalize at least one departmental or hospital wide improvement initiative that has occurred in the last 12 months using the Plan Do Check Act (PDCA) process.


Education and Experience:

· Must be an RN or Surgical Tech with First Assistant Certification.

· Minimum of 3 years of experience in an acute care hospital.

· Knowledge of theory, techniques and practices of First Assistant role.

· Strong interpersonal, written and oral communication skills.

· BLS and ACLS upon hire and maintain current.


Required Skills/Abilities:

· Excellent analytical and writing skills.

· Strong computer skills to include Microsoft Word, Excel, PowerPoint, and database products.

· Must be highly motivated and willing to assume additional jobs and duties as needed.

· Must be able to handle stress of working efficiently with frequent interruptions and distractions.

· Hours must be flexible to accommodate for needs during call shifts, Accreditation surveys or other unscheduled events.

· Must be able to prioritize tasks and adhere to strict deadlines.

Physical Requirements:

· Sitting 3-6 hours a day

· Standing 3-6 hours a day

· Wrist deviation (side to side and up and down) 3-6 hours a day

· Occasionally lift up to 50 pounds

· Occasionally be exposed to hazardous chemicals or infections