What is a first assistant in the O.R?

  1. 0
    I am a 3rd semester nursing student; I will be graduating with a BSN in August. I had a wonderful experience today in the O.R. I certainly want to work in the O.R, I noticed people assisting the doctor with surgery; I found out that they were first assistant. What exactly is a first assistant? How much additional education do I need?
    ! Thank you in advance!
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  4. 5 Comments so far...

  5. 1
    That would depend on what education they have. My facility has physician assistants, nurse practitioners, certified first assists (CFAs), and RN first assists (RNFAs) who all assist the surgeon. CFAs (at least at my facility) are surgical technologists who have furthered their education and attended an accredited program. RNFAs are RNs who have completed additional training. Generally, programs require several years of experience in the OR. More info on RNFAs: First Assisting (RNFA) : Association of periOperative Registered Nurses
    GrnTea likes this.
  6. 0
    First Assists are employed by the surgeon instead of the hospital. Each surgeon has their own way of performing a surgery. Instead of the surgeon having to ask for every instrument or suction, they have someone that assists him on every surgery and knows his process. This can speed up a surgery because the first assist knows what the surgeon needs next without him asking for it. This also means that they can perform more surgeries per day which increases the income for the surgeon plus they can bill for the first assist.
  7. 2
    Quote from Don1984
    First Assists are employed by the surgeon instead of the hospital.
    Not necessarily. My facility employs 5 PAs, 6 CFAs and 8 RNFAs. Very facility dependent.
    ORnurseCT and GrnTea like this.
  8. 0
    My experience was from the hospital I work at. You are correct, it is evidently facility dependent.
  9. 0
    Since you're already in nursing school, you would go the RNFA route. Your first step after school is to apply to OR internships so you can learn to scrub and circulate in surgery. After you get 2 years of experience under your belt, you can apply and take the CNOR exam. It's the certification exam for OR nurses, and passing the exam is the only way to advance to become a RNFA. You'll learn that the exam will actually prepare you for a lot of the material in the program. After completing the RNFA program and obtaining 120 hours of first assisting, you'll be a RNFA. After obtaining 2000 hours, you can become a CRNFA (certified RNFA). Go to cc-institute.org, they're the makers of both the CNOR and CRNFA exams. There's a lot of info about RNFA programs and course content. Good Luck!


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