RNFA 'S

carcha · Mar 22, 2004

as an or rn who has never worked with first assistants I am interested in knowing who employs you, in the or who is "in charge" the head nurse or the FA, and can you still act as both scrub and fa on the same case if need be?

callbabe · Mar 26, 2004

Whoa - there's just attitude all over the place in this thread. Want to know why nurses will never ever band together to advance our profession? Because we're too busy back biting each other over who has what certification and who can do what better! Personally I don't care if you are a CNFA or a damn good scrub nurse, I'd just perfer you be a NURSE in the OR rather than an unlicensed scrub tech working under MY license.

Hey guys and gals I just visited this site to try to get some info. Haven't gotten it yet. Then I saw the RNFA forum and thought I would just visit for awhile.

All I really wanted was to ask a question. Does anyone take OR call on weekends, if so how many hours are you responsible for. We have to take 48 hours. I personally feel like that is to much. I have worked 25 of those in a row and I just wondered if it was legal, or if it was standard operating procedure elsewhere. I have e-mailed AORN with no response,even the Dept. of Labor no luck yet. Any help would be greatly appreciated. Back to the other issue, I love OR nursing. I also love first assisting. If you have not been there then you would not understand, so please do not knock a nurse that has paid her dues,worked her buns off to get where she is at. :) I'm happy hope you are to.

skypilot · Apr 1, 2004

In CA it is "against the law" for a surgical tech to assist - that is why you should not see any STs assisting, in CA. That is not to say you won't see them of course - it happens still (heard about the cover-ups that were told to the state on inspection) - if RN's want to keep the advanced roles in the OR they must work for it - lobby, work with the legislative issues people - in AORN, in state nursing associations - make your voice heard. And yes, I am an RNFA, and yes - one of the best surgical assistants I have ever worked with was a CSA - but even so - I still believe RNs should be in that role! I have also worked with many PAs that are not worth a darn as assistants and never will be - they had no training in the OR. And I will also add I have watched doctors assist with little assisting skills that are next to worthless in the role also. OR nurses that become RNFAs have the experience and knowledge to apply to the role.

My 20 cents worth... Karen

You'll have to enlighten us on the CSA thing. So far I haven't heard of ANY surgeon inmy area, SoCal that uses them, if they exist. All of the heart guys use PAs or RNFAs so I can't see where a CSA would be of much use around here. Maybe back where you live, I have heard the East is so much more advanced in nursing, LOL. As for the special forces thing, yes they do have much more experience in the surgical field, but it doesn't count for much when applying for nursing programs, maybe for PA school or whatever. Also what do you do, RN, PA or CSA? just curious. I know you will bring out a few on your demeaning of RNFAs. Good luck, Mike

shodobe · Apr 1, 2004

skypilot, I was kind of wondering why my quote was included in your response to Karen? That particular one was to an individual who was posting about how CSAs were the only true first assists and RNFAs were worthless. He was really trying to push some onscure CSA program back east. I agree with you totally and still have the opinion on CSAs. I have been in the OR for 27 years and still don't know where they are used in Ca. Most places use PAs, Kaiser or heart guys. You will notice that the guy in question has never returned. Mike

skypilot · Apr 1, 2004

Mike, I quoted your note because you stated that you had not seen any STs as assistants in SoCal... since I know the reason you would not, should not, see any STs assisting in CA - I chose to reply to your post. I am Karen, not sure who the Karen is that you are referring to... I guess I am just confused - I am new to this site and perhaps I missed something I was to do or not do... I will follow this as the days pass. thanks for the comment - skypilot Karen

skypilot, I was kind of wondering why my quote was included in your response to Karen? That particular one was to an individual who was posting about how CSAs were the only true first assists and RNFAs were worthless. He was really trying to push some onscure CSA program back east. I agree with you totally and still have the opinion on CSAs. I have been in the OR for 27 years and still don't know where they are used in Ca. Most places use PAs, Kaiser or heart guys. You will notice that the guy in question has never returned. Mike

Alnamvet · Apr 1, 2004

skypilot, I was kind of wondering why my quote was included in your response to Karen? That particular one was to an individual who was posting about how CSAs were the only true first assists and RNFAs were worthless. He was really trying to push some onscure CSA program back east. I agree with you totally and still have the opinion on CSAs. I have been in the OR for 27 years and still don't know where they are used in Ca. Most places use PAs, Kaiser or heart guys. You will notice that the guy in question has never returned. Mike

But I have never left, and as I can see, there is a selective ignoring of the differences between a surgical tech and a Certified First Assistant. The program here in VA may be obscure to you, but it is one of many in the country that train and educate surgical assistants to fill the role of First Assist. You would, as well as perhaps others, do yourself a favor and research the net regarding their professional status. CSA's are forming surgical groups, can bill for services, and do not come under the nursing umbrella; they work with and for surgeons. The problem I see here is the same as back in the 70's when you asked a nurse what a PA was, most would roll their eyes and feign ignorance, or blurt out some ridiculous response such as ward clerk with a new name. California may not use CSA's, but they exist, and in large numbers. Check out the state of Texas Board of Medicine web page, and you may find yourself surprised with what they have legislated regarding CSA's. :)

Alnamvet · Apr 1, 2004

skypilot, I was kind of wondering why my quote was included in your response to Karen? That particular one was to an individual who was posting about how CSAs were the only true first assists and RNFAs were worthless. He was really trying to push some onscure CSA program back east. I agree with you totally and still have the opinion on CSAs. I have been in the OR for 27 years and still don't know where they are used in Ca. Most places use PAs, Kaiser or heart guys. You will notice that the guy in question has never returned. Mike

Never left Mike...it's apparent that there is still great confusion, or selective research regarding the huge difference between CSA's and Surgical Techs. The "obscure" program you allude to in the East is just one of several CSA programs that provide education and training for Surgical First Assists. The fact that they don't exist in Cali doesn't mean they are not professionals. Heck, you can be a NP in Cali with just a certificate of advanced NP studies, as opposed to having to have a MSN; does that mean Cali NP's are not valid elsewhere? CSA's will have had to have a graduate degree granted within the next 5 years; CSA's are not nurses, they are more often than not, health care providers who have received graduate level training in Surgery, well above and beyond what is provided in RFNA programs. CSA's do not come under the nursing umbrella, but under the Department of Medicine. CSA's have incorporated, have private practices, and can bill for services. Do a little more research before you dismiss something you apparently know nothing about. Check the state of Texas Board of Medicine web site, and see what legislation has passed in that state regarding CSA's. RFNA programs, and certainly PA programs do not provide in excess of 2000 clinical hours in the OR in addition to ~ 1000 hours of didactic education. The closest thing to a CSA is perhaps the PA program at Cuyohoga Community College, where they have a Physician Surgical Assistant program whose primary focus is training PA's in the First Assist role; otherwise, there is a no more qualified First Assist in the theater, other than another surgeon, than a CSA. :)

Alnamvet · Apr 2, 2004

Sorry for having posted twice in reponse to CSA's...for some reason, I thought it was not posted...

mitchsmom · Apr 4, 2004

I am just a measly nursing student and I don't know anything about anything, but it was stated above regarding CSA training

RFNA programs, and certainly PA programs do not provide in excess of 2000 clinical hours in the OR in addition to ~ 1000 hours of didactic education.

Ummm... the way I'm understanding RFNA's, you must have 2+ years of OR experience, a BSN, and more as a minimum before starting for RFNA qualification... am I wrong in figuring that this would indeed provide the hours and education that you are saying CSA training does?

Alnamvet · Apr 5, 2004

I am just a measly nursing student and I don't know anything about anything, but it was stated above regarding CSA training
Ummm... the way I'm understanding RFNA's, you must have 2+ years of OR experience, a BSN, and more as a minimum before starting for RFNA qualification... am I wrong in figuring that this would indeed provide the hours and education that you are saying CSA training does?

It begs the question....does a weekend in Lake Taos aand a few hours in a suture lab qualify an RN as a First Assist? :rolleyes:

orrnlori, RN · Apr 5, 2004

It begs the question....does a weekend in Lake Taos aand a few hours in a suture lab qualify an RN as a First Assist?

I don't know, does a week in Los Angelos qualify an ENT surgeon to do breast implants or face lifts? I know several who have done it.

Alnamvet · Apr 5, 2004

I don't know, does a week in Los Angelos qualify an ENT surgeon to do breast implants or face lifts? I know several who have done it.

Plastics is still not regulated, per se...any md or do can have a manufacturers rep come to his office and give him an inservice on inplants, etc, and the doc can start doing extreme makeovers at will...they just can't say they are Fellows of the American College of Surgeons in their advertising. Again, I suggest you all do your research first as to what exactly a CSA is, the required training and education involved, and then make an educated opinion. I do not know of an RNFA who had to have a years worth of didactics, followed by a years worth of OR clinicals as a condition of their certification. I don't care if you have a zillion years working the OR...I know of many OR nurses with more than 10 years experience, who if they had to document actual hours scrubbing in, would be embarrassed with the result. CSA's are trained and educated specifically to be First Assists...perhaps the best 1st Assist would be an RN/NP who has had formal CSA training...I don't see the RNFA requirements as solid foundation to practice as a 1st Assist.