The Registered Nurse First Assistant (RNFA), under the direction of the Attending Physician, will assist in providing medical and/or surgical care of the department patients in the inpatient and outpatient setting. S/he provides direct patient care to surgical patients throughout the perioperative period. Assists surgeon during surgical procedures by positioning skin preparation, providing wound exposure, performing tissue dissection, suturing, and other surgical tasks. Administers as necessary. The RNFA reports all patient interactions to the supervising physician in support of providing quality, efficient, continuous and cost-effective patient care for NAH.

Patient Care
* Collaborates with the provider and other health care professionals to provide health care across the continuum of care for assigned patients.

* Demonstrates the ability to assess data reflective of the patient's status and interpret information relative to the patient's age-specific needs

* Provides patient care (obtaining a health history, performing a detailed physical exam, creating a comprehensive assessment of the patient, ordering and interpreting diagnostic tests, prescribing pharmacological agents, treatments, and non-pharmacological therapies).

* Completes documentation of all evaluations, care, and services rendered in the EMR (within 24 hours of the time care was provided in the outpatient setting; from the time of discharge in the inpatient setting).

* Documents patient's response to the treatment plan; recommends changes as deemed necessary.

* Prepares patients for procedures including education, positioning, skin preparation and administration of local anesthetic and preparation of equipment.

* Functions as a first or second assistant in the operating room (performing surgical exposure, surgical dissections, layer closure of wounds, harvesting of autologous graft materials).

Administrative
* Demonstrates accuracy of document of assessments, interventions and patient responses.

* Maintains timely and accurate patient EMR documentation.

* Demonstrates knowledge of medical procedures and terminology.

* Consults with colleagues, supervising physicians, specialists, referral providers and other healthcare professionals.

Education
* Participates in creating and sustaining a learning environment supported by evidenced based practice and research.

* Focuses on personal development areas, engaging in professional/collegial interactions with peers and students.

* Work collaboratively with peers and other health care providers, and participating in ongoing in-service and educational seminars.

* Participates in the mentoring and education of new hires and students.

Department Partnership
* Accurately processes and communicates provider preferences to RN

* Facilitates efficient room turnovers as a circulator as evidenced by appropriate insruments, supplies and equipment and assisting the team as needed.

* Assists with updating the physician preference cards as appropriate.

* Participates in training and education of new employees and othe staff in regard to aseptic techniques and process.

First Assist
* Assist surgeon with a varity of surgical techniques including placing and manipulate the retractor, sponge bodily fluids and stylizing suction techniques, apply clamps and tying off or applying electrocautery to the vessel, place hemostatic sutures or clamps, maintaining hemostasis, aiding in providing proper exposure, clamping blood vessels and assisting with closure.

* Utilizes on and two-handed know techniques according to surgeon’s preference and surgical circumstance.

* Utilizes deep tying techniqes to securely tie off deep sutures to avoid tissue damage or vessel control loss.

* Assists in positioning, skin preparation, and draping of the patient.

Compliance/Safety
* Adheres to regulatory and organizational standards affecting patient care and safety as well as all hospital and departmental policies and procedures. Practices in a safe and cost effective manner.

* Stays current and complies with state and federal regulations/statutes and company policies that impact the employees area of responsibility.

* If required for position, ensures all certifications and/or licenses are up-to-date and valid prior to expiration dates.

* Completes all company mandatory modules and required job specific training in the specified time frame.

* Responsible for reporting any safety related incident in a timely fashion through the Midas/RDE tool; attends all safety related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner.

Education: 

RNs hired on or after 7/1/2016: Must graduate from a BSN program within 6 years of hire into an RN position.

Certification: 

Active, unrestricted, Arizona RN License or valid, participating compact license- Required
BLS (American Heart Assoc.)- Required

RNFA- Registered nurse first assistant - Required

CNOR- Certified Nurse Operating room - Required

ACLS- Required

Employee will obtain and maintain appropriate clinical competencies for the roles assigned by their departmental leader.

Experience:

Healthcare is a rapidly changing environment and technology is integrated into almost all aspects of patient care. Computers and other electronic devices are utilized across the organization and throughout each department. Colleagues must have an understanding of computers, and competence in using computers and basic software programs.