GBMC HealthCare
First Assistant (RNFA/PA) - Non-Exempt
GBMC HealthCare, Baltimore, Maryland, United States, 21276
Overview
The First Assist works in collaboration with the surgeon and the health care team members to achieve optimal patient outcomes. The First Assist must have acquired the necessary knowledge, judgment, and skills specific to the expanded role. Intraoperatively, the candidate practices under the direction and guidance of the surgeon.
Education Successful Completion of an accredited course in RN first assisting program that meets the ‘AORN standards’. Equivalent work experience as a RN First Assistant may be substituted for completion of accredited RNFA course.
Licensures/Certifications
Current registration with the Maryland State Board of Examiners of Nurses as a Registered Nurse.
Healthcare Provider (CPR Certification).
ACLS preferred
Current CNOR certification.
CRNFA certification preferred
Experience Minimum of 5 years diversified Perioperative nursing experience: both scrubbing and circulating proficiency.
Skills
Advanced knowledge of anatomy, physiology, surgical interventions, surgical techniques and surgical hazards relative to operative procedures wherein the RNFA assists.
Advanced knowledge and skill in handling surgical instrumentation, in aiding in exposure, retraction, hemostasis, suctioning, tissue handling including dissecting, suturing, tying, stapling and stab wound.
Analytical ability to conduct pre-operative and post-operative patient assessment, to evaluate physical and laboratory findings and to conduct patient teaching appropriate to age, background, psycho-social needs, medical/physical condition of the surgical patient.
Ability to communicate effectively and appropriately with surgical patients and their significant others to enlist their involvement and cooperation in the entire treatment process.
Ability to perform effectively in stressful and emergency situations with behaviors that are unique to functioning as a first assistant.
Principal Duties and Responsibilities
Clinical competency - Provided a safe, therapeutic core by collaboration with the surgeons and healthcare team in performing a safe operation with optimal outcomes for the patient. The RNFA practices perioperative nursing and must have acquired the necessary knowledge, skills, and judgment specific to clinical practice.
Teamwork – Communicates effectively and works cooperatively with others. Has respect for and understanding of clinical disciplines. Uses an integrated approach toward patient outcomes.
Demonstrates effective communication skills.
Delegates patient care activities to other healthcare team members and redirects unit activities according to patient acuity and census changes.
Uses evidence-based practice to work with a multidisciplinary team to implement practice changes and other initiatives in a positive and productive manner.
Assists the clinical partner/charge nurse by coordinating the staff and surgery schedule and handling day-to-day issues with positive outcomes.
Assists as needed with the staffing schedule coverage to meet daily department needs.
Assists with room set-up, opening supplies and room turnover. Helps with lunches and breaks. Assists with patient positioning and safe transport of patient to the PACU.
Assists staff to identify learning needs and helps to educate and train as needed. Acts as a preceptor.
Collaborates with the team in keeping costs under control and controls wastage in the room with regard to supplies; promotes maximum productivity.
Assists team leader, clinical partner, charge nurse in updating and developing physician preference cards.
Quality/Best Practices
The RNFA acts as a leader or participates in quality improvement process. Actively identifies variances and explores alternatives to care or practice.
Evaluates staff on practice delivery and recommends additional education if needed. Assists with implementation of practice initiatives.
Professional Development Ensures improvements in practice settings by assuming responsibility for self-development in life-long learning. Provides direction and guidance to others regarding practice, serves as a resource, preceptor, and mentor. Leadership skills demonstrated in decision making and problem solving.
Clinical and Technical Skill
Demonstrates knowledge of procedures to which assigned.
Participates in clinical decision making and modifies techniques based on clinical findings.
Identifies normal and abnormal anatomy.
Anticipates the needs of surgeon, steps in surgical procedure.
Assesses, plans, implements, and evaluates patient care needs.
Interviews the patient and family preoperatively to assess patient care needs.
Collaborates with the surgical team members to plan perioperative patient care.
Communicates relevant data to team members.
Reports lab results, x-rays, and diagnostic tests.
Discusses procedures and special techniques to be implemented during surgery.
Identifies any unusual instrumentation required.
Analyzes critical situations and initiates appropriate corrective or preventative action.
Applies principles of aseptic technique and reports any variances.
Identifies and reports safety hazards.
Monitors changes in patient’s condition and reports concern to appropriate team members.
Prioritizes calmly and efficiently in emergency situations.
Demonstrates the following skills: preparation of the surgical site, shaving, positioning, surgical prepping, draping, surgical site exposure (under the direction of the surgeon), retraction.
Wound exposure – i.e. dissection, initial surgical incision/stab wound, secondary trocar insertion.
Tissue handling, suctioning, manual dexterity in instrument use, hemostasis, electrosurgery, bipolar cautery, sponging, clamping, suturing, knot-tying, stapling, cutting, approximation, ligating vessels, skin closure, subcuticular closure, securing wound drains, application of wound dressing.
Assists in post-operative care and transfer of the patient from the operating room.
Intra-operative Phase Under the direct supervision and direction of the operating surgeon. Positions, preps, and drapes patient. Provides hemostasis and exposure as directed. Handles tissue as directed by the surgeon. Performs wound closure and applies dressings.
All Roles Must Demonstrate GBMC Values
Respect
- Treats others with fairness, kindness, and respect for dignity and privacy; listens and responds to needs, feelings, and capabilities.
Excellence
- Meets or exceeds customer expectations; pursues learning and self-development; pays attention to detail.
Accountability
- Maintains professionalism; takes ownership and uses resources effectively; reliable attendance.
Teamwork
- Works cooperatively; resolves conflicts positively; values diverse ideas.
Ethical Behavior
- Demonstrates honesty, integrity and good judgment; respects patient and coworker needs.
Results
- Sets goals, seeks improvement, and achieves results on time.
Pay Range $38.64 - $64.33
Final salary offer will be based on the candidate's qualifications, education, experience and alignment with our organizational needs.
COVID-19 Vaccination All applicants must be fully vaccinated against Covid-19 or obtain a GBMC approved medical or religious exemption prior to starting employment at GBMC Healthcare, to include Gilchrist and GBMC Health Partners.
Equal Employment Opportunity GBMC HealthCare and its affiliates are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.
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Education Successful Completion of an accredited course in RN first assisting program that meets the ‘AORN standards’. Equivalent work experience as a RN First Assistant may be substituted for completion of accredited RNFA course.
Licensures/Certifications
Current registration with the Maryland State Board of Examiners of Nurses as a Registered Nurse.
Healthcare Provider (CPR Certification).
ACLS preferred
Current CNOR certification.
CRNFA certification preferred
Experience Minimum of 5 years diversified Perioperative nursing experience: both scrubbing and circulating proficiency.
Skills
Advanced knowledge of anatomy, physiology, surgical interventions, surgical techniques and surgical hazards relative to operative procedures wherein the RNFA assists.
Advanced knowledge and skill in handling surgical instrumentation, in aiding in exposure, retraction, hemostasis, suctioning, tissue handling including dissecting, suturing, tying, stapling and stab wound.
Analytical ability to conduct pre-operative and post-operative patient assessment, to evaluate physical and laboratory findings and to conduct patient teaching appropriate to age, background, psycho-social needs, medical/physical condition of the surgical patient.
Ability to communicate effectively and appropriately with surgical patients and their significant others to enlist their involvement and cooperation in the entire treatment process.
Ability to perform effectively in stressful and emergency situations with behaviors that are unique to functioning as a first assistant.
Principal Duties and Responsibilities
Clinical competency - Provided a safe, therapeutic core by collaboration with the surgeons and healthcare team in performing a safe operation with optimal outcomes for the patient. The RNFA practices perioperative nursing and must have acquired the necessary knowledge, skills, and judgment specific to clinical practice.
Teamwork – Communicates effectively and works cooperatively with others. Has respect for and understanding of clinical disciplines. Uses an integrated approach toward patient outcomes.
Demonstrates effective communication skills.
Delegates patient care activities to other healthcare team members and redirects unit activities according to patient acuity and census changes.
Uses evidence-based practice to work with a multidisciplinary team to implement practice changes and other initiatives in a positive and productive manner.
Assists the clinical partner/charge nurse by coordinating the staff and surgery schedule and handling day-to-day issues with positive outcomes.
Assists as needed with the staffing schedule coverage to meet daily department needs.
Assists with room set-up, opening supplies and room turnover. Helps with lunches and breaks. Assists with patient positioning and safe transport of patient to the PACU.
Assists staff to identify learning needs and helps to educate and train as needed. Acts as a preceptor.
Collaborates with the team in keeping costs under control and controls wastage in the room with regard to supplies; promotes maximum productivity.
Assists team leader, clinical partner, charge nurse in updating and developing physician preference cards.
Quality/Best Practices
The RNFA acts as a leader or participates in quality improvement process. Actively identifies variances and explores alternatives to care or practice.
Evaluates staff on practice delivery and recommends additional education if needed. Assists with implementation of practice initiatives.
Professional Development Ensures improvements in practice settings by assuming responsibility for self-development in life-long learning. Provides direction and guidance to others regarding practice, serves as a resource, preceptor, and mentor. Leadership skills demonstrated in decision making and problem solving.
Clinical and Technical Skill
Demonstrates knowledge of procedures to which assigned.
Participates in clinical decision making and modifies techniques based on clinical findings.
Identifies normal and abnormal anatomy.
Anticipates the needs of surgeon, steps in surgical procedure.
Assesses, plans, implements, and evaluates patient care needs.
Interviews the patient and family preoperatively to assess patient care needs.
Collaborates with the surgical team members to plan perioperative patient care.
Communicates relevant data to team members.
Reports lab results, x-rays, and diagnostic tests.
Discusses procedures and special techniques to be implemented during surgery.
Identifies any unusual instrumentation required.
Analyzes critical situations and initiates appropriate corrective or preventative action.
Applies principles of aseptic technique and reports any variances.
Identifies and reports safety hazards.
Monitors changes in patient’s condition and reports concern to appropriate team members.
Prioritizes calmly and efficiently in emergency situations.
Demonstrates the following skills: preparation of the surgical site, shaving, positioning, surgical prepping, draping, surgical site exposure (under the direction of the surgeon), retraction.
Wound exposure – i.e. dissection, initial surgical incision/stab wound, secondary trocar insertion.
Tissue handling, suctioning, manual dexterity in instrument use, hemostasis, electrosurgery, bipolar cautery, sponging, clamping, suturing, knot-tying, stapling, cutting, approximation, ligating vessels, skin closure, subcuticular closure, securing wound drains, application of wound dressing.
Assists in post-operative care and transfer of the patient from the operating room.
Intra-operative Phase Under the direct supervision and direction of the operating surgeon. Positions, preps, and drapes patient. Provides hemostasis and exposure as directed. Handles tissue as directed by the surgeon. Performs wound closure and applies dressings.
All Roles Must Demonstrate GBMC Values
Respect
- Treats others with fairness, kindness, and respect for dignity and privacy; listens and responds to needs, feelings, and capabilities.
Excellence
- Meets or exceeds customer expectations; pursues learning and self-development; pays attention to detail.
Accountability
- Maintains professionalism; takes ownership and uses resources effectively; reliable attendance.
Teamwork
- Works cooperatively; resolves conflicts positively; values diverse ideas.
Ethical Behavior
- Demonstrates honesty, integrity and good judgment; respects patient and coworker needs.
Results
- Sets goals, seeks improvement, and achieves results on time.
Pay Range $38.64 - $64.33
Final salary offer will be based on the candidate's qualifications, education, experience and alignment with our organizational needs.
COVID-19 Vaccination All applicants must be fully vaccinated against Covid-19 or obtain a GBMC approved medical or religious exemption prior to starting employment at GBMC Healthcare, to include Gilchrist and GBMC Health Partners.
Equal Employment Opportunity GBMC HealthCare and its affiliates are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.
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