First Assistant (RNFA/PA) - Non-Exempt

First Assistant Job at GBMC Hospital

The First Assistant 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:

Demonstrates effective communication skills.

Delegates patient care activities to other healthcare team members and redirects unit activities a patient acuity and census changes.

Using evidence based practice model to works 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 turn-over. 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.

Utilizes standards, guidelines, and pathways for care delivery. Incorporates data and information to continuously improve care and practice to enhance outcomes.

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.

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.

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.

Interviews the patient and family preoperatively to assess patient care needs.

Collaborates with the surgical team members to plan perioperative patient care.

Reports lab results, x-rays. Diagnostic tests.

Discusses procedures and special techniques to be implemented during surgery.

Identifies any unusual instrumentation required.

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 i. Shaving ii. Positioning iii. Surgical Prepping

Draping

Surgical Site Exposure - under the direction and guidance by the surgeon i. Retraction ii. Wound Exposure i.e. Dissection, initial surgical incision/stab wound, secondary trocar insertion iii. Tissue Handling

Suctioning

Manual dexterity in appropriate use of surgical instrumentation

Hemostasis i. Electrosurgery ii. Bipolar cautery iii. Sponging iv. Clamping v. Collagens vi. Bone wax vii. Other:

Suturing skills i. Knot-tying ii. Stapling iv. Cutting v. Approximation vi. Ligating vessels vii. Skin closure viii. Subcuticular closure ix. Securing wound drains

Application of wound dressing

Assists in post-op 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 by clamping blood vessels, coagulating bleeding points, ligating vessels, and by other means as directed by the surgeon. Provides exposure through appropriate use of instruments, retractors, suctioning, and sponging techniques. Handles tissue as directed by the surgeon (i.e. dissecting, stab wound (nick) for laparoscopy surgery or drains). Performs wound closure as directed by the surgeon: sutures the peritoneum, fascia, subcutaneous tissue, and skin. Applies surgical dressings.

All roles must demonstrate GBMC Values:

Respect

Treats others with fairness, kindness, and respect for personal dignity and privacy

Listens and responds appropriately to others' needs, feelings, and capabilities

Excellence

Meets and/or exceeds customer expectations

Actively pursues learning and self-development

Pays attention to detail; follows through

Accountability

Sets a positive, professional example for others

Takes ownership of problems and does what is needed to solve them

Appropriately plans and utilizes required resources for various job duties

Reports to work regularly and on time

Teamwork

Works cooperatively and collaboratively with others for the success of the team

Addresses and resolves conflict in a positive way

Seeks out the ideas of others to reach the best solutions

Acknowledges and celebrates the contribution of others

Ethical Behavior

Demonstrates honesty, integrity and good judgment

Respects the cultural, psychosocial, and spiritual needs of patients/families/coworkers

Results

Embraces change and improvement in the work environment

Continuously seeks to improve the quality of products/services

Displays flexibility in dealing with new situations or obstacles

Achieves results on time by focusing on priorities and manages time efficiently

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.