RNFA 'S - page 4

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   OR1stRN
    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
    SEWING IN PROXIMALS?????!!!!! EGAD!!! Yes, I feel where you are coming from. Perhaps the hospital policy needs to be checked for privileges. The "captain of the ship" theory has it's limitations.
  2. by   OR1stRN
    Quote from carcha
    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?
    RNFA's may not work as scrub and FA.

    I am employed by my surgeon and am considered "medical and allied health staff". I was employed by the hospital at one time, but they were reluctant to let us assist everytime we were requested or even when not requested but needed. I sought a private employer by speaking to the surgeons I had assisted. I loved being able to assist in all specialities (except eye surgery).

    I do not consider myself "in charge" but as a team member. I facilitate the care of the patient in the OR and the hospital. I am used as a resource by the OR staff and hospital staff. I am expected to take the lead in the OR regarding equipment, patient positioning, etc... I don't think of myself as a prima donna nor a surgeon but as her assistant. I do what it takes to get the surgery started and make it go smoothly. I call the XR tech to get ready, make sure all the equipment is there, proper suture is out, hang films, check labs, check the consent, answer any questions the patient has regarding surgery. Almost 100% of the time the OR/Hospital staff are happy to see me. It is also a comfort for many of our patients to see me there, as well as the office. Many times, the patients, only then, understand why I don't answer their phone calls right away when they call the office. I am available to them after discharge, by pager, for questions or concerns.

    My surgeon was reimbursed about $50,000 last year. She pays me a salary which does not include any of the insurance money. I am a "cheap nurse" but I like the autonomy I have with my surgeon. I like seeing the patients before, during and after surgery (most of the time). I don't like the office, but it's better than dealing with many of the hospital politics. I also have flexible hours. (of course, it is a pretzel of a schedule at times).
  3. by   OR1stRN
    Quote from callbabe
    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.
    I believe, in most states, nurses are only allowed to work 16 hours with at least 6 hours off to rest between shifts. I've only known one hospital to uphold this. It is tough working so many hours in a row, as a nurse, let alone assisting in surgery. Have you checked the Nurse Practice Act for the info?
    I love assisting, too. We don't need to knock each other. Most assistants are good or they wouldn't be employed. Now, what surgeon wants a so-so assistant? I am an RNFA. I do believe there should be guidelines to delineate which assistants can do what. That's for the states to decide.(like California)
    There should also be credentially for skills learned like vein harvesting even after the guidelines are set. Some people have different talents and one who sutures well may not be one who take vein best. I'm not sure CST's should FA. (no license)
  4. by   aric
    Dear RNFA's,

    my name is Aric Leadabrand. I am a RNFA-Intern. I hope you don't mind me e-mailing you in the middle of this discussion. I need a bit of help. I have been trying to work on my RNFA for over a year now. I've had numerous hurdles to overcome, not the least of which was my only child being born last December with hypoplastic left heart syndrome. She has survived both Stage I and II Norwood Procedures. To complete this course I need to corresponde with three RNFA's. I would very grateful if you could briefly, by e-mail, answer these questions:

    1. What was your greatest hurdle to getting your practise started and how you overcame it?

    2. How did you get started working in your surgical area of expertise?

    Any answer would be greatly appreciated.

    Also if you know of any two other RNFA's who could help, I would be greatly appreciate it.

    I have only a few more days left for my final deadline.

    Thank you,
  5. by   ONEBADORT
    Quote from Alnamvet
    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.
    i have been reading this thread and wow, i have p---ed some people off here before but this is new, i am a cst and currently enrolled in a cfa course and by golly nurse or not, everyone goes throught the same fa training to get certified, it is hard and requires a lot of you, first assisting holds a big responsibility!!! i am the only person who will be a cfa within 60 miles of my hospital, why? i don't know but only did it because i had surgeons who wanted someone who knew what they were doing and they could call on when they needed someone with the experience, i have plenty of jobs waiting for me when im done, so yes us surgical techs with the experience are very important at least at my facility, and are as valuable as the rn's, thanks, hope nobody's mad about my opinion, people are too sensitive here!
  6. by   shodobe
    alnamvet, it wasn't you I was refering too, it was onebadort. Welcome back though, long time no hear. Mike
  7. by   shodobe
    also onebadort, people are sensitive so you shouldn't assume that you won't step on a few toes when you blatantly put down nurses for not being up to your level of competency. I can't believe there are no good, veteran OR nurses within 60 miles of wherever you work that a surgeon could use. Seems illogical. Just don't worry about what people think of you and do your job well.
    ps, I was reading old threads and thought alnamvet was back. He's a work of art.
  8. by   Marie_LPN, RN
    I'm still trying to stop laughing about the begging doctors!!
  9. by   carcha
    This thread has really got me thinking. Thank you OR1stRN for listing some of your duties but and I dont mean to be insulting, what do you do that an RN dosent. We organize the list at the start of the day. We ensure the equipment is prepared. We check bloods, consent. We ensure the patient is informed of whats ahead. We in fact run the show. To me the surgeon walks in an hour after we do, scrubs and does his part, however the OR RNs actually call the shots. Here in London our surgeons have junior doctors to hold retractors, close skin ect. Its considered a very basic duty for those wanting to become surgeons some day. However for CST, this basic duty is now considered a career. Wont you get tired of such a mundane task eventually?.
  10. by   mbruns37
    Quote from Alnamvet
    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.
    You apparently don't know many RNFA's. RNFA's are first educated with a bachelors degree. Then atleast 2 years of ciruclating and scrubbing before they can even attend RNFA training. Then they must be certified as OR nurses. Then complete a year long program which includes didactic and precepted first assisting. Then if they choose to certify as an assistant they have to document 2000hrs of assisting to sit for the exam. Then they must maintain CME's every 5years to recertify. What basis of education does a CSA have? I happen to be an RNFA and completing my FNP degree in Dec. so perhaps I am 2/3 the best 1st Assistant.
  11. by   Marie_LPN, RN
    However for CST, this basic duty is now considered a career. Wont you get tired of such a mundane task eventually?.
    I'd think if i were a CST i would be MORE tired of people constantly finding ways to insult my chosen field or work.
  12. by   sunnyjohn
    CST's get insulted all the time by well meaning persons. I guess it comes with the territory.

    That's not to say we don't have our supporters.
  13. by   Marie_LPN, RN
    CST's get insulted all the time by well meaning persons. I guess it comes with the territory.
    Still not a reason why they have to tolerate it though.