Registered Nurse
First Assistant
Registered Nurse First Assistants (RNFAs), are on the cutting edge of their profession - literally.
The RNFA trains to take a step-up in perioperative nursing, working in collaboration with and under the direction of surgeons to handle tissue, suture skin, and subcutaneous tissue, provide hemostasis, apply clamps, and provide team leadership in the operating room.
The RNFA's place in the operating room is recognized by all state boards of nursing and supported by the American College of Surgeons. RNFAs are regulated by state nursing practice acts, institutional regulations, and specialty area practice standards.
Each RNFA candidate must complete all of the required First Assistant coursework and train under a surgeon for a year to be eligible for certification additionally, each RNFA must maintain a national certification by attending master level coursework and conferences.
The Association of Operating Room Nurses (AORN) dictates that all programs must be approved by AORN. Each program must qualify by meeting a very high standard with a proven track record including the equivalent of one academic year of combined classroom and supervised clinical education under surgeon preceptors. Formal RNFA training is provided in universities and community colleges.
The RNFA may be employed in hospitals, clinics or ambulatory care centers; physician practice groups; administrative or consulting positions; or, a freelance surgical assistant practice.
The future of nursing depends on the profession finding avenues for nurses to advance their practice without having to leave the clinical role. In the perioperative setting, the RNFA role provides nurses with such a growth opportunity. Federal legislation (HR 822) supporting the provision of safe intraoperative assistive care by maintaining high standards for RNFA training and working toward RNFA reimbursement was introduced in the 107th Congress.