[motorcycle mama]

My husband is about to undergo a radical nephrectomy. The urologist uses a First Assist. I've heard about First Assists before, but exactly what do they do?

[Fun2Care]

I'd like to know this too...from what I've gathered, it is an RN who has extra training to help with the surgery. I'm not sure what all they do as far as scope of practice, but I believe I have seen where they are trained to suture. (I am interestd in finding this info out for my future education choices as well.)

Hope the surgery goes well.




Found this:

What Does a RNFA do? The RNFA has preoperative, intraoperative and postoperative duties including patient history and assessment, collaborating with surgeon and other professionals for an optimal surgical outcome, assisting with patient positioning, skin preparation, and draping, providing wound exposure, handling tissue, controlling blood loss, suturing tissue, and performing follow-up care.
http://surgtech.gulfcoast.edu/careers/RNFA.asp

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[Annony RN]

If you look up "RNFA" on this site you should get some old threads. An RNFA is a nurse who has earned her CNOR- OR certification- then completed extra hourse of class and clinical to assist the surgeon with more advanced skills than the scrub role- suturing, hemostasis, etc. Besides being an RNFA, the first assist role can be filled by a PA-C, PE, or sometimes a scrub tech first assist.

[motorcycle mama]

Originally Posted by Annony RN

If you look up "RNFA" on this site you should get some old threads. An RNFA is a nurse who has earned her CNOR- OR certification- then completed extra hourse of class and clinical to assist the surgeon with more advanced skills than the scrub role- suturing, hemostasis, etc. Besides being an RNFA, the first assist role can be filled by a PA-C, PE, or sometimes a scrub tech first assist.

Well, I did do a search but did'nt find what I was looking for.

What's a PE?

[core0]

Originally Posted by motorcycle mama

Well, I did do a search but did'nt find what I was looking for.

What's a PE?

Not sure about PE either. The first assist is the primary assistant to the physician. I can also another physician. Unless it is a very small case there is generally the surgeon and the first assist. In really big cases you can also have a second and third assist. Depends on how many hands you need. The term is mostly used for billing purposes to designate the person who assists the surgeon (and gets the assist fee).

David Carpenter, PA-C

[ORTech2RN]

A First Assist can often be a Surgical Tech who underwent additional training in order to obtain a CSA (Certified Surgical Assistant) or CFA (Certified First Assistant). Similar to the RNFA, both the CSA's and CFA's have to be credentialed in order to bill as as assistant.

[motorcycle mama]

Do they do any clipping and cutting and removing?

[ShariDCST]

Originally Posted by motorcycle mama

Do they do any clipping and cutting and removing?

A First Assistant - a non-surgeon first assistant - is trained to help the primary surgeon with exposure of the surgical site, which may involve helping to place retractors, or holding them; with hemostasis, which may involve using a Bovie for electrocoagulation of bleeding vessels, clamping (hemostats) or tying and cutting vessels, positioning the patient, applying dressings, as well as other activities during the case - UNDER the supervision and guidance of the primary surgeon. The primary surgeon is responsible for doing the actual surgery, and for the actions of anyone who assists him under his guidance and supervision.

"As defined by the American College of Surgeons, the surgical first assistant provides aid in exposure, hemostasis, and other technical functions that will help the surgeon carry out a safe operation with optimal results for the patient. These functions include, but are not limited to, positioning of the patient and suturing and closure of body planes and skin, and the application of wound dressings."

If the First Assistant is also a CST/CFA, then they have had to go through more educational and clinical training and supervised practical experience as well as taking and passing a Certification Examination. In order to take the exam, the CST must first provide proof of the following:
"at least 350 cases and two full years of First Assistant experience during the last four years. Examination is required." This is experience that is closely supervised by surgeons, and documented in order for it to be acceptable to the Board responsible for administering the Certification Exam.

If the First Assistant is also an RN, then they must be a CNOR first, and then take additional training and have additional practical experience in order to get their RNFA credentials.

First assistants can also be Physicians Assistants with appropriate training, or resident surgeons in teaching institutions, or other surgeons working with the primary surgeon during the case.

[core0]

Originally Posted by ShariDCST

A First Assistant - a non-surgeon first assistant - is trained to help the primary surgeon with exposure of the surgical site, which may involve helping to place retractors, or holding them; with hemostasis, which may involve using a Bovie for electrocoagulation of bleeding vessels, clamping (hemostats) or tying and cutting vessels, positioning the patient, applying dressings, as well as other activities during the case - UNDER the supervision and guidance of the primary surgeon. The primary surgeon is responsible for doing the actual surgery, and for the actions of anyone who assists him under his guidance and supervision.

"As defined by the American College of Surgeons, the surgical first assistant provides aid in exposure, hemostasis, and other technical functions that will help the surgeon carry out a safe operation with optimal results for the patient. These functions include, but are not limited to, positioning of the patient and suturing and closure of body planes and skin, and the application of wound dressings."

If the First Assistant is also a CST/CFA, then they have had to go through more educational and clinical training and supervised practical experience as well as taking and passing a Certification Examination. In order to take the exam, the CST must first provide proof of the following:
"at least 350 cases and two full years of First Assistant experience during the last four years. Examination is required." This is experience that is closely supervised by surgeons, and documented in order for it to be acceptable to the Board responsible for administering the Certification Exam.

If the First Assistant is also an RN, then they must be a CNOR first, and then take additional training and have additional practical experience in order to get their RNFA credentials.

First assistants can also be Physicians Assistants with appropriate training, or resident surgeons in teaching institutions, or other surgeons working with the primary surgeon during the case.

For a non-OR person that means yes they do clipping, cutting and removing. Essentially the first assistant is an extension of the surgeon. There are time during the surgery that the physician may not have a good angle or good visualization on a particular structure. They rely on the the first assist to handle that part of the surgery. It is always done under the direct supervision of the surgeon. In addition the the surgeon choosing to work with the first assist the first assist has to be credentialed by the hospital which means that they have looked into their background and training as well as previous positions to make sure there is no derogatory information.

David Carpenter, PA-C