RNFA 'S

[CATHY RNFA]

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 had to pass the Boards. Then we had to aquire a place in the O.R. and work many hard hours to be experienced in our jobs. We had to prove ourselves to the surgeons and our peers.We then moved on to being a CNOR again to prove our knowledge and ability. Then we chose to go to an RNFA program for which we put in 120 documented and audited hours with case studies etc..

To become a CRNFA we had to aquire 2000 documented hours buy books and take a test that cost about $500 all of this and now our jobs and licences are on the line for ST's that go to school for 9mo have no licenece and then proceed to skip 10 steps and want to be First Assistants I say it's time to get MAD and do something. I don't plan on watching someone take something I worked very hard for. If the techs want to First Assist then they can go to school and get the proper licence and degree and I will support them Does anyone have an opinion on this or Do I stand alone??

[callbabe]

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

[Alnamvet]

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?

[orrnlori, RN]

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.

[OR1stRN]

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.

[OR1stRN]

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). :)

[OR1stRN]

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)

[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,

Aric

[email protected]

[ONEBADORT]

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!

[ONEBADORT]

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!

[shodobe]

alnamvet, it wasn't you I was refering too, it was onebadort. Welcome back though, long time no hear. Mike

[shodobe]

alnamvet, it wasn't you I was refering too, it was onebadort. Welcome back though, long time no hear. Mike

[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.