RNFA 'S - page 3

Are there any RNFA's that are MAD or getting Mad about the Surgical scrub first assisting? Maybe we should be! #1 This is a job we have worked very hard for, we went to school to get a degree and... Read More

  1. by   skypilot
    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

    Quote from shodobe
    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
  2. by   shodobe
    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
  3. by   skypilot
    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

    Quote from shodobe
    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
  4. by   Alnamvet
    Quote from shodobe
    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.
  5. by   Alnamvet
    Quote from shodobe
    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.
  6. by   Alnamvet
    Sorry for having posted twice in reponse to CSA's...for some reason, I thought it was not posted...
  7. by   mitchsmom
    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?
  8. by   Alnamvet
    Quote from mitchsmom
    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?
  9. by   orrnlori
    Quote from Alnamvet
    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.
  10. by   Alnamvet
    Quote from orrnlori
    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.
  11. by   callbabe
    Quote from Alnamvet
    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?
    Are you a nurse or what. I think you are suppose to be from your credentials. :angryfire I personally attended a formal RNFA program, to validate my job,my experience. I do scrub everyday and have done so for 30 years. These CSA's you refer to are probably quite capable, the bottom line is non nursing personnel do not belong in the OR. And if they are there I am quite certain that I would be supervising them. Remember there is no I in the word TEAM. Yes I am very protective of my job. I am a firm believer that if someone is caring for a patient they need to have a nursing background,training,license mandatory. Are you military. If you are than you probably do have alot of experience. What I got in the program was nothing compared to everyday work. Sorry for repeating, but the program was simply to validate my practice. I am really not mad, well maybe just alittle.
    What really###***ME OFF IS THESE ST THE DOCS HIRE. These guys, are harvesting,veins, and sewing in proximals. that is pretty scary. Not on me they won't. enough said
  12. by   Alnamvet
    Quote from callbabe
    Are you a nurse or what. I think you are suppose to be from your credentials. :angryfire I personally attended a formal RNFA program, to validate my job,my experience. I do scrub everyday and have done so for 30 years. These CSA's you refer to are probably quite capable, the bottom line is non nursing personnel do not belong in the OR. And if they are there I am quite certain that I would be supervising them. Remember there is no I in the word TEAM. Yes I am very protective of my job. I am a firm believer that if someone is caring for a patient they need to have a nursing background,training,license mandatory. Are you military. If you are than you probably do have alot of experience. What I got in the program was nothing compared to everyday work. Sorry for repeating, but the program was simply to validate my practice. I am really not mad, well maybe just alittle.
    What really###***ME OFF IS THESE ST THE DOCS HIRE. These guys, are harvesting,veins, and sewing in proximals. that is pretty scary. Not on me they won't. enough said
    Yes...an OR TECH should not be doing procedures outside their scope of practice...BUT, a CSA is well within his scope of practice regarding the procedures you have mentioned. I think the key word here is NURSING..CSA's are trained to be 1st Assists...nothing more; after a procedure, it's nurses who provide the continuum of care. If it becomes an issue with RFNA's that there are others who have specific training to be a 1st Assist, than it's the nurses problem. CSA's are not out to replace nurses, they are a a hugh step above an OR tech...a logical progression for OR techs to move up the ladder, if you will, to become better educated, and better trained so that they can practice the advanced surgical skills that many OR Techs shouldn't be doing. CSA's are cost effective...the reimbursement for their services is much less than would be paid to a 1st Assist who happens to have an MD. Would it not be so much of a problem if a CSA also happens to be a nurse? Or would would the nursing community shut them out 'cause they chose not to be RFNA's?
  13. by   orrnlori
    Quote from callbabe
    Are you a nurse or what. I think you are suppose to be from your credentials. :angryfire I personally attended a formal RNFA program, to validate my job,my experience. I do scrub everyday and have done so for 30 years. These CSA's you refer to are probably quite capable, the bottom line is non nursing personnel do not belong in the OR. And if they are there I am quite certain that I would be supervising them. Remember there is no I in the word TEAM. Yes I am very protective of my job. I am a firm believer that if someone is caring for a patient they need to have a nursing background,training,license mandatory. Are you military. If you are than you probably do have alot of experience. What I got in the program was nothing compared to everyday work. Sorry for repeating, but the program was simply to validate my practice. I am really not mad, well maybe just alittle.
    What really###***ME OFF IS THESE ST THE DOCS HIRE. These guys, are harvesting,veins, and sewing in proximals. that is pretty scary. Not on me they won't. enough said
    I have to agree with you and like I said previously, I don't care if you are a RNFA or a scrub nurse, I'd just prefer you be a nurse in the OR. I've been in the OR 6 years, at least 50% of the time scrubbing so I figure I have somewhere near 6,000 hours scrubbing. They don't use RNFA's at our university hospital because we have residents who assist with all surgeries. If they did allow them, I would likely go through the certification program myself. I"ve never heard of a program for nurses where a weekend in Lake Taos gets you that certification. Maybe that's true but I've not heard of it. I've never heard of CSA's and have no reason to know about them or their training.

    For me it just goes back to the fact that I'd rather see nurses in the OR, not other personnel that don't have nursing backgrounds. We do have a PA that scrubs a little in sports medicine (maybe twice a year), he's a nice enough guy, but he's not a nurse and I see nothing he does that can't be done by the nurses who scrub that service regularly. But's he's one of the 'boys', you know? So the docs like him. As far a scrub tech's, they are there just to save the hospital money. I've talked about it with management. Management states that there are not enough nurses in the OR to carry both positions all the time and the scrubs save money. Bingo, they save the hospital money but they don't have a clue to taking care of the patient. For every tech they hire they save at least 400.00 per week per tech over what they would pay the nurse to do the complete job. But my position is that they are ancillary personnel, not nurses and it shows every day. Not only do I not want a tech harvesting veins from me, I also don't want them sewing me closed, period. I think doctors bringing in private ST's would be a real nightmare in the OR, I'm thankful everyday that I work in a university hospital where they don't allow that.

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