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Registered Nurse First Assistant

The RN first assistant (RNFA) is a perioperative registered nurse who works with the surgeon and health care team members to provide safe and competent care to patients. Intraoperatively, 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 perioperative arena may include:

  • preoperative 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 regarding the patient plan of care
  • intraoperative surgical first-assisting, including but not limited to,
    • using instruments/medical devices,
    • providing surgical site exposure,
    • handling and/or cutting tissue,
    • providing hemostasis
    • suturing; and
    • wound management
  • postoperative patient management with other health care providers in the immediate postoperative period and beyond, including but not limited to, participating in postoperative 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)