RN FIRST ASSISTANT- Duke University Hospital

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About Duke University Hospital


Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States. The largest of the four Duke Healthhospitals with 1062 patient beds, it features comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.

Occ Summary

The Certified Registered Nurse First Assistant will support the continuity of care for Perioperative patients. The scope of practice includes preoperative patient care management, intraoperative surgical first assisting and postoperative patient care management. The role will help expedite surgical productivity, support the education of surgical residents, 2nd assist where needed, and first assist the Surgeons when surgical Residents are not available. The RNFA will provide patient care for all ages and/or provide leadership and direction to the perioperative team where needed.

The Certified Registered Nurse First Assistant (RNFA) plays a critical role in supporting continuity of care for perioperative patients across the preoperative, intraoperative, and postoperative phases. As a key member of the surgical team, the RNFA helps optimize workflow, enhance patient safety, and elevate clinical outcomes.

This highly skilled role provides:

• Expert intraoperative first assistance
• Support and education for surgical residents
• Second assist coverage across multiple specialties
• Leadership and clinical guidance for perioperative staff
• Seamless coordination of care for patients of all ages

In this fast-paced academic environment, RNFAs at Duke participate in complex and innovative surgical procedures while contributing to an exceptional patient and team experience.

Work Performed

To provide preoperative patient management in collaboration with other health care providers, including, but not limited to: preoperative evaluations, communicate/collaborate regarding the patient plan of care, writing preoperative orders according to established protocols; intraoperative surgical first assisting, including, but not limited to using instruments/medical devices, providing exposure, handing and/or cutting tissues, providing hemostasis, and suturing; postoperative patient management in collaboration with other health care providers in the immediate postoperative period including, but limited to writing postoperative orders/operative notes according established protocols, participating in postoperative rounds, and assisting with discharge planning. To provide a qualified CRNFA to the operating surgeon during the operative procedure and comprehensive nursing management of care during the Perioperative phase. The CRNFA does not concurrently function as the Scrub Nurse.

Preoperative Patient Management

• Conduct preoperative assessments and screenings
• Participate in planning and coordination of individualized care plans
• Collaborate and communicate with the surgical team
• Write preoperative orders according to established protocols

Intraoperative First Assisting Provide skilled and safe intraoperative assistance, including:

• Using surgical instruments and medical devices
• Providing optimal exposure of the surgical field
• Handling and/or cutting tissues
• Achieving hemostasis
• Suturing and closing incisions
• Anticipating surgical needs to support efficient workflow

Note: The RNFA does not simultaneously function as the Scrub Nurse.

Postoperative Patient Management

• Write postoperative orders and operative notes based on protocol
• Participate in postoperative rounds and clinical evaluation
• Assist with discharge planning and transitions of care
• Collaborate with multidisciplinary teams to support positive outcomes

Knowledge, Skills and Abilities

CRNFA must have sound clinical knowledge of technologyand treatment applications; must also possess skills to educate/train staff, and complies with AORN education standards for the CRNFA;, and a demonstrated knowledge of the surgeries in which the CRNFA participates. Must have sound clinical OR skills (scrubbing and circulating) and have excellent interpersonal skills and organizational capability.

Level Characteristics

CRNFA must have sound clinical knowledge of technology and treatment applications; must also possess skills toeducate/train staff, and complies with AORN education standards for the CRNFA;, and a demonstrated knowledge of the surgeries in which the CRNFA participates. Must have sound clinical OR skills (scrubbing and circulating) and have excellent interpersonalskills and organizational capability.

Minimum Qualifications

Education

BSN required, MSN preferred. Must be a graduate of an accredited school of Nursing. Completion of a RNFA (or CSFA program, if hired prior to 2/1/26) that includes didactic and supervised clinical practice, is based on AORN's core curriculum for the RNFA.

Experience

3 years of experience in Perioperative Nursing is required.

Degrees, Licensures, Certifications

Must have current or compact RN licensure in the state of North Carolina. BLS required. Successful completion of the CNOR exam required. Must currently possess RNFA (Registered Nurse First Assist) certification or obtain within two years of employment. CSFA (Certified Surgical First Assistant) certification accepted in lieu of RNFA, if hired prior to 2/1/26.

Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.


Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.



Essential Physical Job Functions:

Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.