Facility: Wellstar West Georgia Medical Center

Job Summary:

Within his or her scope of practice, the RN First Assist identifies the patient's surgical needs, prioritizes care based on continuous assessment, and executes therapeutic physician orders and therapeutic nursing interventions. He or she is accountable for outcomes of patient care delivered during the surgery. The Registered Nurse First Assist collaborates with the surgeon in performing a safe operation with optimal outcomes for the patient and practices under the supervision and direction of the surgeon during all surgical procedures. The Registered Nurse First Assist does not concurrently function as a scrub nurse. The RN First Assist may function independently as a scrub nurse, but not concurrently act as First Assist, when it meets the needs of the department. The RN First Assist will take scrub or circulator nurse call to meet the needs of the surgical department.

Core Responsibilities and Essential Functions:

Essential Functions:
Initiates assessment based on the patients presenting problems or needs and the physicians medical diagnosis Completes on-going assessments during the surgical case. Performs therapeutic and surgical interventions as ordered by the physician. Demonstrates correct, appropriate use of related equipment; use, care and handling of instruments; and use, care and handling of sterile supplies. Assures the operating room is ready for patient use for the appropriate procedure. Applies and monitors the principles of aseptic technique. Coordinates the activities of other health care professionals, as necessary. Provides complete, accurate documentation appropriate for the surgery performed. Functions as RN circulator and/or scrub is appropriate competencies are maintained. Employee may not concurrently function as an RNFA, RN circulator, or RN scrub. Assists in maintaining correct sponge, needle, and instrument count throughout the surgical procedure. May participate in counts. Prepares the incision site according to established procedure. Assists in identifying, labeling, and/or dispatching specimens from the sterile field to the RN Circulator. Scrub, gown, and glove self and another team member if necessary. Drapes patient per physician preference. Anticipates surgeons needs and requests additional items from the RN circulator in time for surgical case. Verifies solutions and medications prior to them being dispensed to the sterile field. Label all solutions and medications immediately after them being dispensed to the sterile field. Applies surgical dressings per protocol and physician preference Assists with room preparation and set up of sterile tables, cleaning of operating room post-surgery and containment of contaminated needles and sharps. Assists in the orientation and training of new employees. Demonstrates knowledge of surgical anatomy, physiology, and operative techniques appropriate to the surgical procedures to which providing assistance. Provides exposure through appropriate use of instruments, retractors, suctioning and sponging techniques. Although not an exhaustive list, under the direction of the surgeon, handles tissue; appropriately uses instruments and equipment; provides hemostasis by clamping, coagulation, and/or ligating vessels; performs wound closure; places and secures drains; and assists with cannulation. Attends all required in-services and training. Performs other duties as assigned, within the skill set and competency level of the individual. Exemplary Practice and Outcomes
Performs the Nursing Process (assessment; diagnosis; identification of outcomes; planning; implementation and evaluation) in the performance of clinical care evidence-based practice, uses analytical/critical thinking and ensuring that care is individualized; coordinating care through effective partnerships recognizing that caring is central to achieve optimal patient care outcomes. Provides relationship-based patient centered care that is consistent with population specific characteristics (e.g., age, gender, disease, etc.) in a manner that adapts service delivery to reflect an understanding of cultural diversity. Always partners with the patient and significant others (as appropriate) using such appropriate method for setting and purpose (e.g., bedside shift report; interdisciplinary rounds; just in time and planned patient teaching; keeping the patient and significant others updated and making the patients goals the focus of the care plan. Practices using current clinical practice standards. Teamwork and Collaboration
Coordinates the delivery and documentation of safe quality patient care that promotes the professional care delivery model. This includes, but is not limited to diverse and inclusive interdisciplinary communication methods (interdisciplinary rounds, case review, etc.); completion of timely documentation and promotion of respectful, inclusive clinical environment. Demonstrates teamwork and collaboration by practicing in a manner that is fiscally responsible and promotes the recruitment and retention of all healthcare team members. Participates and supports performance improvement inclusive of all stakeholders, research and research utilization to promote safe, quality patient care including initiating and/or leading such activities as well as, promoting an inter/intra-disciplinary process and actively support/participates in shared governance at all levels in the system. Professional Development and Initiative
Completes all initial and ongoing professional competency assessment, required mandatory education, population specific education. Serves as a preceptor and/or mentor for other professional nurses (and staff or students for all disciplines) to ensure that there is a current and future qualified workforce, modeling the professional practice of nursing and creating a health work environment. Evidence Based Practice and Research
Promotes Evidence Based practice, nursing research and performance improvement in nursing. Participates in activities such as value analysis as part of the decision-making process in evaluating patient care products. Upholds all health care system/organizational policies and procedures and clinical competencies put forth by this job description and professional association including legal, regulatory and accreditation requirements and standards ensuring by way of example, such goals as TJC Patient Safety Goals and WellStar Health Systems safety absolutes. Participates in data collection, poses relevant clinical questions to advanced evidence-based practice. Consults appropriate experts and uses appropriate resources and evidence to address practice questions. Resources and Support
Proactively plans for the care of patients across the care continuum in the course of giving direct patient care. Participates in the development or protocols and procedures when called upon or through self-initiation in collaboration with care managers and other members of the health care team t achieve best practice outcomes (i.e., decrease in re-admission rates; avoidable days; adverse events; etc.). Supports efficient and effective use of human and material resources.

Required Minimum Education:

• Graduate of an Accredited School of Nursing with Current Georgia Licensure.

• Proof of successful completion of an organized program of study on RN First Assisting, including clinical practice that has been accepted by CBPN (Certification Board Perioperative Nursing).

• This course of study must follow the format of the Core Curriculum for the RN First Assistant published by AORN.

Required Minimum License(s) and Certification(s):
All certifications are required upon hire unless otherwise stated.

• Cert Nurse Operating Room

• Basic Life Support or BLS - Instructor

• Reg Nurse (Single State) or RN - Multi-state Compact

• Pediatric Adv Life Support or PALS - Instructor or PALS - Provisional

Additional License(s) and Certification(s):

Required Minimum Experience:

• Minimum 2 years scrubbing and circulating proficiency

• Prior First Assist experience

Required Minimum Skills:

• The Registered Nurse First Assist demonstrates a thorough knowledge of new trends and techniques in General and Gynecological surgery.

• Ability to multi-task using critical thinking skills anticipate s surgeons needs.

• Capable of prioritizing appropriate patient care in emergency situations.

• Current CPR certification and participates in annual safety and infection control programs.

• Emergency call coverage is required for weekdays, weekends, and holidays.

• Attendance and punctuality must be commendable.

• Must be able to effectively communicate and understand verbal and written English language.

• Must be able to communicate effectively in clear, courteous, professional, and tactful manner, especially in stressful situations.

• Demonstrates excellent organizational skills.

• Basic keyboarding skills required.

• Flexible in hours and work shifts due to need of continued patient care.