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Official State of Iowa Website Here is how you know

As of July 1, 2023, licensing and other health and occupational licenses will become part of the Iowa Department of Inspections, Appeals and Licensing (DIAL) as a new organizational structure for state government goes into effect. Government departments and agencies that provide related services or have similar business functions are aligning to better serve Iowans.

Iowa Board of Nursing

Registered Nurse First Assistant

The RN first assistant (RNFA) is a peri-operative registered nurse who works with the surgeon and health care team members to provide safe and competent care to patients. Intra-operatively, the RN first assistant practices at the direction of the surgeon and should not concurrently function as a scrub nurse.

RN first assistant behaviors in the peri-operative arena may include:

  • pre-operative patient management with other health care providers, including but not limited to, performing focused preoperative nursing assessments, and communicating/collaborating with other health care providers about the patient plan of care
  • intra-operative surgical first-assisting, including, but not limited to:
    • using instruments/medical devices
    • providing surgical site exposure
    • handling and/or cutting tissue
    • providing hemostasis
    • suturing
    • wound management
  • post-operative patient management with other health care providers in the immediate post-operative period and beyond, including but not limited to, participating in post-operative rounds, and assisting with discharge planning and identifying appropriate community resources as needed.

The education and competency of the RN first assistant builds upon the educational preparation leading to licensure as an RN. The RN first assistant must then acquire the necessary knowledge, judgment and skills specific to the expanded role through a formal RN first assistant educational program. When education and clinical requirements have been met, the RNFA is encouraged to obtain and maintain certification (CRNFA).

(Adopted from the Association of periOperative Registered Nurses official statement on RN First Assistants, revised 12/2013)