RNFA 'S

crackerjack · Dec 22, 2006

Why Do nurses have to fight for respect in the OR? When Certified Surgical Techs. and Certified First Assistant dont. Why do nurses know nothing about surgery when they come out of school (ADN or BSN)? Why are nurses fighting to keep there jobs in the OR? Why do nurses feel threatened by CST CFA's? If nurses are so much better why feel threatened? Is it because Certified Surgical Techs. and Certified First Assistant are trained for the OR?
Why do RNFA's think they will lighten the surgeons case load? Its not like you can round for them write there orders for them do a central line placement or read a x ray for them. You cant bill Medicare & Medicaid. You are not Nurse Practitioners oh can they bill medicare or medicaid lol. I know PA's can lmao.
Lets talk about how bad the doctors make fun of the nurses. I hate to tell you all this, but even the experieced nurses The doctors dont like you. They dont like the chip on your shoulders. Why havent you wondered why the Surgeons are not sticking up for you. This is why you have a tough time in passing legislation or why they will not let you use the wording you want in the legislation.

Boy does someone have a burr under their saddle! As an OR nurse I feel absolutely no need to "fight for my job" nor do I feel threatened by any CST/FA/ORT. We have totally different jobs and it requires both of us. I *DO* have surgeons sticking up for me as well as other RN coworkers. Do surgeons get testy with RNs? with CSTs etc.? Sure!! They get testy with one another and themselves for that matter. They demand and scream "I always want xxxsuture on my card for xxx cases..." yet the next xxx case they scream that they always want yyysuture on the card. :trout: Whatever! ROFL

Yes, an NP can bill. RNFAs may not be able to round, write orders, etc. for the surgeon but by golly they can close (CST can't) and free some time for the surgeon to take care of some of those other things. You really need to get a grip. The CST is very important in the scheme of things for surgery but don't go building a pedestal for yourself, you're gonna fall off and hurt yourself.

CSTCFA · Dec 22, 2006

Boy does someone have a burr under their saddle! As an OR nurse I feel absolutely no need to "fight for my job" nor do I feel threatened by any CST/FA/ORT. We have totally different jobs and it requires both of us. I *DO* have surgeons sticking up for me as well as other RN coworkers. Do surgeons get testy with RNs? with CSTs etc.? Sure!! They get testy with one another and themselves for that matter. They demand and scream "I always want xxxsuture on my card for xxx cases..." yet the next xxx case they scream that they always want yyysuture on the card. :trout: Whatever! ROFL
Yes, an NP can bill. RNFAs may not be able to round, write orders, etc. for the surgeon but by golly they can close (CST can't) and free some time for the surgeon to take care of some of those other things. You really need to get a grip. The CST is very important in the scheme of things for surgery but don't go building a pedestal for yourself, you're gonna fall off and hurt yourself.

I agree im sorry for the way that post sounds, but it seem a lot of nurses like putting down CST's. From all the different hospitals i have worked at some hospitals do let CST's close. It depends on hospital policy. Me im a CST/CFA i do close, position patients, ill do the time out.

I will do what ever it takes to speed up the start of the case. I will also do what it take to speed up the turn over. I do feel that some people do try to take advantage of me cause I work hard.

crackerjack · Dec 22, 2006

I agree im sorry for the way that post sounds, but it seem a lot of nurses like putting down CST's.

(((hugs))) it does sound as if you've dealt with some hard times. Apology accepted...I've been known to open my mouth (fingers) and say how I feel only to realize later how it sounded to others. *smiles*

Me im a CST/CFA i do close, position patients, ill do the time out.

It is always helpful to have another set of eyes on the situation. There are times where someone else from another angle has been able to see something a tad awkward about a patient's position that could've caused a problem if left that way. Sometimes it's just a matter of being pushed for that record turnover time or yet one more special something happening that will cause a person to miss what is normally instinctual and the extra set of eyes and hands catches it. It's all good. However, when it comes to the time out, because so many things have been known to happen between the time something is scheduled and the patient is actually in the room that on occassion a consent is different than originally written and the nurse is the one who has hashed all this out with the doc, anesthesia and the patient so I, personally, feel this is best left to the person freshest on the scene, usually the nurse. We have an occassional surgeon who likes to do his/her own time outs and that's great.

I will do what ever it takes to speed up the start of the case. I will also do what it take to speed up the turn over. I do feel that some people do try to take advantage of me cause I work hard.

I understand what you are saying. I'm still the new kid on the block, sorta, so more willing to say 'yes' to requests for extra help, staying late, covering for someone else, etc. I also just don't mind *finding something to do* when I have down time between/before cases when others will be chatting at the desk or sitting in the break room. I get lots of strange stares when I offer to help followed by comments about 'nobody ever offers to help'. I have also quite literally worked myself out of a job in the past by being too efficient. So I know what you're talking about when you say you feel like some try to take advantage because you work hard. Now that I'm becoming more of a regular fixture and less of a newb to them I still help whenever I see the need and can lend a hand but I'm not as willing to say yes to every request for extras. I don't want to be a doormat.

ewattsjt · Dec 26, 2006

i don't want in on the argument of who is who in the or. it is silly and does not help with the safety of the patient. we are all a valuable part of the team that ensures a great outcome for the patient. we both have specialized training, one in the procedure itself and the other in direct patient care.

i do want to clarify some misconceptions that i have seen posted:

school lengths for surgical tech programs vary depending on type (i.e. diploma 12 mth. or aas 2 yr). both programs have approximately 9mths in clinical. it is similar to nursing lpn 12mth asn 2yr. there are other programs that offer technical degrees for st that are not ast, caahep, ar-cst or nbstsa approved. there are other schools that may offer substandard teaching. that is one reason that licensure for cst should be mandated. it would ensure adequate training of surgical technologists (patient safety). it would also incorporate what role is what (teamwork).

there are only three states that have a law(s) that gives a scope of practice for surgical technologists (ca, wa, and ny). the other states go by hospital policy and schooling (i.e. my facility allows cst to close sub-q and fascia as long as they have had a suture class). our facility also allows rnfa, cfa, c-sa, sa-c and pa to close deeper layers (once again, all these positions should be licensed for patient safety). i must add that most of the facilities do go with aorn standards.

the policy where i work also mandates that the person in the “scrub role” initiates the time out and the “circulating rn” verifies and documents it (patient safety and teamwork again).

instead of bickering we should be developing a better relation to ensure the best outcome for the patient.

sunnyjohn · Dec 26, 2006

i don't want in on the argument of who is who in the or. it is silly and does not help with the safety of the patient. we are all a valuable part of the team that ensures a great outcome for the patient. we both have specialized training, one in the procedure itself and the other in direct patient care.
i do want to clarify some misconceptions that i have seen posted:
school lengths for surgical tech programs vary depending on type (i.e. diploma 12 mth. or aas 2 yr). both programs have approximately 9mths in clinical. it is similar to nursing lpn 12mth asn 2yr. there are other programs that offer technical degrees for st that are not ast, caahep, ar-cst or nbstsa approved. there are other schools that may offer substandard teaching. that is one reason that licensure for cst should be mandated. it would ensure adequate training of surgical technologists (patient safety). it would also incorporate what role is what (teamwork).
there are only three states that have a law(s) that gives a scope of practice for surgical technologists (ca, wa, and ny). the other states go by hospital policy and schooling (i.e. my facility allows cst to close sub-q and fascia as long as they have had a suture class). our facility also allows rnfa, cfa, c-sa, sa-c and pa to close deeper layers (once again, all these positions should be licensed for patient safety). i must add that most of the facilities do go with aorn standards.
the policy where i work also mandates that the person in the “scrub role” initiates the time out and the “circulating rn” verifies and documents it (patient safety and teamwork again).
instead of bickering we should be developing a better relation to ensure the best outcome for the patient.

as a cst it make me so angry when i see folks taken advantage off, paying all that money, coming from these substandard schools. it puts them at a disadvantage, makes all sts look bad and most importantly, puts the patients at risk.

ast, arc-st and nbstsa have woked hard to assure regulation of the education, but they need help.

this is the main reson i support licensure for csts. these bad schools need to be shut down and negligent techs who just leave one job for another need to be taken out of the game.

the patients deserve our best- surgeon, anesthesia, circulating nurse and cst. :lol2:

Marie_LPN, RN, LPN, RN · Dec 26, 2006

Instead of bickering we should be developing a better relation to ensure the best outcome for the patient.

I agree, but even on this board, it's way too much to ask for from a few people.

jelorde37 · Mar 14, 2008

CFA sounds interesting. i might just do that instead of RNFA since itll take less time and i get a class that focuses just on surgery. i think the dual certification complements each other and decreases any weaknesses one or the other might have. think about it clearly....

RNs are very well rounded coupled with the fact that they are masters of providing care. although nurses are trained to practice nursing in any type of field, truth is, that majority of nurses rarely get to work in the OR and many do bedside nursing. now this is where the strength of the CFA/CSA comes to play. in a way, this idea can produce highly trained/skilled care givers.

i dont know... what do you guys think?

Scrubby · Mar 14, 2008

edited: just noticed how old this thread is. Topic has probably been done to death

ewattsjt · Mar 15, 2008

Although this is an older thread; I am responding only to the last post by jelorde37. I think there are a lot of misconceptions about being able to sit for a certification in surgical assisting. I hope to clear the water a little. It used to be that one could “grandfather” into eligibility for assisting certifications. That has disappearing as the main bodies see the obvious need for assisting programs. A lot of people do not understand how the CFA or CSA is earned and many think anyone can just attend a program and sit for the exams. This may be true if you meet certain eligibility requirements. Here is what is required for the two certifications.

To sit for the CFA exam administered by the National Board of Surgical Technology and Surgical Assistants (NBSTSA) you must meet one of these requirements:

Current CFA who wants to renew certification by examination.
Current CST with 350 verified surgical assisting cases with a precepting surgeon and assisting for at least two years (as soon as there are enough SA programs; this route will end).
CST and a graduate of a CAAHEP surgical assisting program.
Graduate of a CAAHEP surgical assisting program.

The CAAHEP’s 2002 Standards and Guidelines require that a program admission eligibility requires the applicant to have had college level courses in: Microbiology, Pathophysiology, Pharmacology, Anatomy and Physiology, and Medical Terminology.

Most CAAHEP programs will only accept CSTs, RNs with CNOR and PA-Cs. It is because the CAAHEP recommended eligibility requirements for admission into a surgical assisting program are:

Bachelor of Science degree (or higher) or

Associate Degree in an allied health field with three years of recent experience

CST, CNOR, or PA‑C, with certification currency.

Three years of current operating room scrub and/or assisting experience within the last 5 years.

Military medical training with surgical assistant experience.

Proof of Liability Insurance.

Current CPR/BLS certification.

Acceptable health and immunization records.

Computer literacy.

The National Surgical Assisting Association (NSAA) also offers a certification in surgical assisting-Certified Surgical Assistant (CSA). Their certification requires one of the following:

Graduate of a CAAHEP accredited SA program, or a SA program from Rochester, MN Mayo Clinic Training Program; or Canton, OH Aultman Hospital Training Program.
Medical Graduates and Allied Health Professionals - US or Foreign trained medical school graduates with appropriate number of hours (2250) or Licensed PAs and RNs with appropriate number of hours of surgical first assisting (2250).
Documentation required:
a) NSAA application
b) NSAA affidavits (2)
c) Letters of recommendation from five (5) surgeons the individual has assisted
d) One (1) year of case log showing the name of the assistant and the type of surgery.
US Military Trained – Individuals who present verifiable documentation of graduation from a United States Military Program that emphasized surgical assisting.
Documents required:
a) A copy of DD214 or Certificate/Diploma from a military training program, showing OR training
b) The NSAA application and one letter of recommendation from a surgeon the individual has assisted.

Jelorde37, since you are already an LVN (according to your profile); I would think the best route for you would be to do a transition to RN program (most can be done online now); get your CNOR then RNFA and/or CRNFA. The RN credential will allow you to be more flexible and move to other departments if you wanted to. Also management is more favorable to promotions to RNs. I would also consider your age and say you should set your goals high and become a Nurse Practitioner (NP). They see patients in the office, do rounds, assist in surgery etc… and are well compensated for it. PAs too!!!

pitkid10 · Jan 26, 2010

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??

calm down Sooo what Surgical techs r qualified health care practitioners. Im a nursing student but my mom was a Surgical Technologist and as a nurse u should respect them. First off they have to go through alot of training to even step into the shoes as a first assist. And if ur mad or jelious of them idk y u would be u shouldnt become a RNFA cause its not for u .

linda2097 · Jan 26, 2010

Seems to me that an RNFA complaining about a CSTFA is no different than an MD FA complaining about an RNFA, or an anesthesiologist complaining about a CRNA. First assistants were originally MD jobs, so RNFA's are lucky to be able to do it.

jdg0719 · Aug 22, 2010

calm down Sooo what Surgical techs r qualified health care practitioners. Im a nursing student but my mom was a Surgical Technologist and as a nurse u should respect them. First off they have to go through alot of training to even step into the shoes as a first assist. And if ur mad or jelious of them idk y u would be u shouldnt become a RNFA cause its not for u .

Yes they are qualified care providers. Some of the best Surgical Techs that I work with have gone through extensive training in schools, the military(yes, some in Iraq and Afganistan too). Please do not insult them with vile comments. How about everybody respects everybody? That might sound like a better idea. You ever heard of a CFA or CSA? Alot of Surgical Technology programs are starting to go to A.A.S degrees, just like those ADNs. Yes they also have to take A&Ps, Micro, Chem, English, etc as well. In many states now, they must take a certifying exam to find employment and work as a CST, just like a GN has had to take boards to work as an RN.