Job Outlook: Registered Nurse First Assist

[2020Grad]

ME: Male nursing student, graduating Dec. of 2020 (an accelerated BSN program). I am older (35), and at this moment don't see myself aiming for a Master's degree like CRNA.

Student nurse trying to figure out his "niche" right now. With the whole COVID-19 issue, it is impossible to get job shadowing right now (all hospitals have shut it down). I did some shadowing before the COVID-19 shut downs, one of those being the OR. I really liked the vibe of the OR, but to me it seems like a dead end; (1) once in OR, you're stuck in OR and (2) limited growth opportunities (maybe you become a manager). By nature, the OR skill set is totally different and guessing you are easily passed over if you choose to move out of it?

Registered Nurse First Assist seems to be one of the only things you can "ladder up" with as an OR nurse. Does anyone have any personal experience with this and can offer any incite about the "opportunities" that are out in the real world right now (I never believe government statistics). I've heard that PA programs are beginning to take over what use to be for First Assist's.

[Rose_Queen, BSN, MSN, RN]

Many surgeon practices are indeed opting to utilize PAs or NPs as their first assistants as they can do things outside of the OR such as rounding on patients, writing prescriptions, seeing patients in the office, etc. Unlike PA and NP, an RNFA is an expanded clinical role but not a provider role.

What you'll want to do is check out job postings not only within facilities but also with surgeon practices to see if any are hiring RNFA. My entire organization employs 7 first assistants, 1 RNFA and 6 CSFAs. Many of our surgeons employ their own PA or NP who act as the first assistant.

Growth options within perioperative roles include management as you mentioned, education, nursing informatics (did you know that Epic, one of the widely used EMRs, has an entire section specific to periop care that is nothing like what is used on the nursing units?), first assistant (both RN and surgical technologist), specialty line supervisor (fits into the management structure similar to an assistant nurse manager), and advanced practice roles such as NP, PA, or CRNA.

[2020Grad]

Thank you for your response. So it sounds like the RNFA might be stuck in the middle? The surgeon's are beginning to prefer PA or NP, and the facility might prefer the Surg Tech over the RN for cheaper costs? If you don't mind me asking, how big is your organization? I am trying to grasp what 7 FA's means as part of the "total employee" picture. There are three very big hospital systems in the area I live. So am trying to understand how many jobs might be out there (when I go to job sites like Indeed and even the hospital websites themselves, it appears to be a niche with jobs few and far between).

[Rose_Queen, BSN, MSN, RN]

Our OR employs around 200 nurses and surg techs for the intraopertive phase, not including preop/postop or PACU.