Registered Nurse First Assistant in East Orange, New Jersey at CareWell Health

Job Summary

Follows the nursing process from preoperative holding area to PACU. Main role is to assist surgeons in cases requiring an assistant. Also assists surgeon in cases that do not require an assistant but there are no other cases in progress requiring the RNFAs skill set. Practices under criteria as developed by the Association of periOperative Registered Nurses for RNFAs. If certified, meets competencies as developed by Competency and Credentialing Institute. May take the lead in positioning, inserting and removing foley catheters, application of pneumatic tourniquet, clipping hair, prepping, and draping patient for surgery. Depending on the surgeon, may make initial incision. Participates actively with surgery under the surgeon’s direction by inserting retractors; maintaining hemostasis with direct pressure, application of surgical instrument, placement of ties, placement of suture ligatures, application of chemical hemostatic agent, or other measure; using electrocautery, ligasure, harmonic scalpel; clamp, ligate, and cut tissue; maintaining integrity of sterile field; closing all wound; inserting drainage; selecting and applying wound dressings. Knowledgeable of immediate use steam sterilization policies and principles. Communicates with surgeon, circulating nurse, and anesthesia care provider about relevant patient medical/surgical history and medication allergies; helps obtain supplies, instruments, and equipment needed for surgical case; performs or participates in the Time Out; is at the patient’s side during induction and intubation and extubation; assists with resuscitation of patient during cardiac arrest or other life-threatening events. Follows recommended practices of AORN. Provides assistance to the perioperative team for patient care. Provides coverage as an RN circulating nurse or scrub personnel as well as charge nurse when needed. Other duties as requested by surgeon or assigned by Nurse Manager

Essential Functions

• The Perioperative Registered Nurse First Assist is responsible for providing quality nursing care utilizing the nursing process as reflected in AORN Standards of Perioperative Nursing Practice while practicing as an RNFA, circulating nurse, scrub nurse, or when teaching or taking over the function of the charge nurse.
• Provides Safe and Appropriate Nursing Care to Patients Utilizing the Nursing Process and Demonstrates the Ability to Perform Clinical/Technical and Administrative Tasks
• Assists surgeons in cases requiring an assistant. Also assists surgeon in cases that do not require an assistant but there are no other cases in progress requiring the RNFA’s skill set.
• Coordinates use of instruments, supplies and equipment for intraoperative phase based on patient’s needs and surgeon’s preference card and requests.
• May take the lead in positioning, inserting and removing foley catheters, application of pneumatic tourniquet, clipping hair, prepping, and draping patient for surgery.
• Depending on the surgeon, may make initial incision.
• Participates actively with surgery under the surgeon’s direction by inserting retractors; maintaining hemostasis with direct pressure, application of surgical instrument, placement of ties, placement of suture ligatures, application of chemical hemostatic agent, or other measure; using electrocautery, ligasure, or harmonic scalpel; clamp, ligate, and cut tissue; suturing; using power instruments; closing all wound; inserting drainage; selecting and applying wound dressings.
• Maintains integrity of sterile field.

• Helps obtain supplies, instruments, and equipment needed for surgical case.
• Performs or participates in the Time Out.
• Is at the patient’s side during induction and intubation and extubation.
• Assists with resuscitation of patient during cardiac arrest or other life-threatening events.
• Demonstrates flexibility and adaptability to changes as they occur
• Adheres to hospital policy for sponge counts, sharps, and instrument counts
• Provides education consistent with the patient/family’s learning abilities and preferences; evaluates outcomes
• Assists surgeons in cases requiring an assistant. Also assists surgeon in cases that do not require an assistant but there are no other cases in progress requiring the PA’s skill set.
• Coordinates use of instruments, supplies and equipment for intraoperative phase based on patient’s needs and surgeon’s preference card and requests.
• May take the lead in positioning, inserting and removing foley catheters, application of pneumatic tourniquet, clipping hair, prepping, and draping patient for surgery.
• Depending on the surgeon, may make initial incision.
• Participates actively with surgery under the surgeon’s direction by inserting retractors; maintaining hemostasis with direct pressure, application of surgical instrument, placement of ties, placement of suture ligatures, application of chemical hemostatic agent, or other measure; using electrocautery, ligasure, or harmonic scalpel; clamp, ligate, and cut tissue; suturing; using power instruments; closing all wound; inserting drainage; selecting and applying wound dressings.
• Maintains integrity of sterile field.
• Helps obtain supplies, instruments, and equipment needed for surgical case.
• Performs or participates in the Time Out.
• Is at the patient’s side during induction and intubation and extubation.
• Assists with resuscitation of patient during cardiac arrest or other life-threatening events.
• Assists surgeons in cases requiring an assistant. Also assists surgeon in cases that do not require an assistant but there are no other cases in progress requiring the PA’s skill set.
• Coordinates use of instruments, supplies and equipment for intraoperative phase based on patient’s needs and surgeon’s preference card and requests.
• Helps with instruction of staff members and students during surgery.
• Systematically assesses the health status of the patient and records health data.
• Establishes nursing diagnoses; plans, implements, and evaluates nursing interventions – initiates changes when appropriate
• Demonstrates flexibility and adaptability to changes as they occur
• Adheres to hospital policy for sponge counts, sharps, and instrument counts
• Provides education consistent with the patient/family’s learning abilities and preferences; evaluates outcomes

Effectively Communicates with Physicians, Co-workers, Patients, Families

• Reports pertinent observations regarding patients to physicians and other health care team members
• Hand-off report is given accurately and concisely
• Documentation on the patient’s medical record is accurate, complete and concise to ensure continuity in the provision and coordination of patient care
• Patient advocate – ethical and moral decision making per patient or family member’s wishes

Patient Safety

• Maintains National Patient Safety Goals, including participation in the Time Out process
• Verifies, coordinates and carries out physicians orders/preferences accurately
• Coordinates interdepartmental transfers smoothly and efficiently
• Coordinates interdepartmental activities related to SCIP measures to ensure timely efficient care
• Communicates and coordinates with coordinator and other nurses to ensure patient satisfaction, and quality care along the continuum of care
• Practices Standard Precautions
• Demonstrated knowledge of and practices department safety procedures, including safe handling of equipment and hazardous substances
• Responds to emergency situations to promote optimal patient outcomes by recognizing changes in the patient’s health status
• Initiates incident reports appropriately

Administers Medications in an Accurate and Timely Manner

• Follows the 5 “rights” when administering medications (patient, route, time, dose, med) after checking for allergies
• Uses 2 patient identifiers before administering medications
• Initiates and effectively maintains IV therapy

Participates in Quality Improvement

• Acts as a resource and mentor for others
• Verbalizes unit specific quality improvement projects
• Verbalizes hospital-wide quality improvement initiatives
• Collects, interprets or relays quality improvement data for the unit

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Minimum Education/Certifications

• Graduate of an accredited school of nursing, preferably BSN program.
• Current NJ license or letter of permission from the New Jersey State Board of Nursing to practice in the state of New Jersey.
• CNOR required and CRNFA preferred with maintenance of the required continuing education.
• (BLS) from the American Heart Association and ACLS required

Working Conditions

Exposed to unpleasant odors, body waste, and communicable diseases. Encounters stress, emergencies, and death. On feet most of the day, lifts patients and moves heavy equipment. Interacts with family, visitors, health team members and other hospital personnel.