First Assist

First Assist Opportunity

Do you have the career opportunities as a First Assist you want with your current employer? We have an exciting opportunity for you to join Methodist Hospital Metropolitan which is part of the nation’s leading provider of healthcare services, HCA Healthcare.

Our teams are a committed, caring group of colleagues. Do you want to work as a First Assist where your passion for creating positive patient interactions is valued? If you are dedicated to caring for the well-being of others, this could be your next opportunity. We want your knowledge and expertise!

Job Summary and Qualifications

The Surgical First Assistant works as a member of the perioperative team under the direction of the surgeon. He/she performs responsibilities of both the Surgical Technologist and the Surgical First Assistant based on department needs and as directed by the unit director or designee. The Surgical First Assistant practices within the scope of the job description and performs clinical and technical skills under surgeon supervision to assist with carrying out a safe operation with optimal patient results. This is done in collaboration with the circulating RN and other perioperative/OB team members. The Surgical First Assistant is educated and skilled in both the use of surgical instruments on tissues and the handling of instruments; however, the surgical first assistant does not concurrently function as the scrub nurse.

Minimum Education, Experience, Training, Required Knowledge, Skill, Abilities and Other Job-Related Characteristics:

1. Education: Must have completed ALL of the following:

• High School Diploma or GED
• Successful completion of an accredited surgical first assistant training program.
• Meets ONE of the following:

• Graduate/completion of CAAHEP Surgical First Assistant, Surgical Assistant Program, Medical School Graduate OR an allied health professional with 2250 hours of surgical rotation.
• Practiced as a surgical technologist prior to 9/1/2009

2. Experience: New hires as of 3/29/2011- 2 years experience in the perioperative setting within the last 4 years in either a surgical technologist or surgical first assistant role.

3. Employee completes initial and ongoing training and competencies as defined by service line, facility and department/unit which are specific to the needs of the patient population served (if applicable).

4. Minimum License, Certificates, or Registrations Required:

Must have and maintain ONE of the following:

A. Surgical Technologist Certification

• CST – Certified Surgical Technologist through the National Board for Surgical Technology and Surgical Assisting (NBSTSA) (formally the Liaison Council on Certification for the Surgical Technologist) OR
• TS-C- Tech in Surgery, Certified through the National Center for Competency Testing (NCCT)

B. Surgical First Assistant certification

• SA-C – Surgical Assistant, Certified through the American Board of Surgical Assistants (ABSA)
• CSA – Certified Surgical Assistant through the National Surgical Assistant Association (NSAA)
• CSFA (formally CFA) – Certified Surgical First Assistant through the National Board of Surgical Technology and Surgical Assisting (NBSTSA)

C. LSA- Licensed Surgical Assistant through the Texas Medical Board

Essential Job Functions:

1. Functions as a surgical first assistant at the direction of and under the appropriate supervision of the attending surgeon; always practices within the limitations of preparation and experience and within the scope allowed by the hospital.

2. A. Consistently functions at the direction of and under direct supervision (physical presence of the attending surgeon in the procedure/treatment room) of the attending surgeon. The surgical assistant scope includes:

• Providing visualization of the operative site through appropriate placement and securing of retractors with or without padding, packing or sponges; digital manipulation of tissue; suctioning, irrigation or sponging; manipulation of suture materials; proper use of body mechanics to prevent obstruction of the surgeon's view.
• Utilizing appropriate permanent and temporary techniques to assist with hemostasis. Permanent hemostasis techniques include clamping and/or cauterizing vessels and tissue, tying and/or ligating clamped vessels or tissue, applying hemostatic clips, or placing hemostatic agents. Temporary hemostasis techniques include applying tourniquets and demonstrating awareness of the indications/contraindications for use with knowledge of side effects of extended use; applying vessel loops, non-crushing clamps, or direct digital pressure.
• Administering post-operative subcutaneous local anesthetic injection
• Utilizing running or interrupted sutures with absorbable or non-absorbable material of wound layers, including muscle and fascia.
• Assisting with placement of implants
• Robotic procedures only: Insertion of subsequent (not initial) trocars. Must have documented training and competency validated (initially within by MHS Medical staff member privileged to perform robotic surgery. The documentation must include directly supervised trocar insertions on a minimum of 5 patients completed within a 12 month period with good patient outcomes.
• Saphenous Vein Harvesting only: May harvest saphenous vein through endoscopic or open technique. Must have documented training and competency validated by a MHS Medical staff member privileged to perform Cardiothoracic surgery. The documentation must include directly supervised saphenous vein harvests on a minimum of 10 patients completed within a 12 month period with good patient outcomes.

B. Under direct or general perioperative supervision (surgeon/proceduralist presence in the perioperative area (pre-op department, perioperative suite, PACU, OR/procedure waiting room)and is immediately available), the surgical assistant scope includes closure of body planes and applies wound dressings per the method indicated by the attending physician:

• Utilizing sub-cuticular closure technique with or without adhesive skin closure strips
• Skin closure with suture, staples and/or spray occlusive material/skin adhesive strips
• Securing drainage systems to tissue
• Application of immobilizing dressing

3. Consistently assists with maintaining the patient's expected physiologic responses to surgery including infection prevention (SCIP measures and practices, maintaining effective disinfection practices, instrument processing, and sterilization).

4. Demonstrates effective communication and works collaboratively with all members of the perioperative team to include active consistent participation in Universal Protocol and timely and accurate sponge and sharp counts to include initiating corrective action as appropriate.

5. Consistently applies a working knowledge of patient pre-operative deficits, risk for intraoperative injuries, and possible post-operative outcomes to assist in optimal patient outcomes. Demonstrates principles of safe patient positioning for best exposure in collaboration with the surgical team using appropriate positioning equipment to ensure padded pressure points, protection from nerve damage and unimpaired circulation.

6. Functions in the role of a Surgical Technician as needed by the department; however, does not concurrently perform as the surgical first assistant and surgical technologist. Wears proper surgical attire, opens sterile packs, instruments, and supplies for each procedure, scrubs, gowns, gloves, and drapes according to established aseptic technique and protocols. Monitors sterile field during procedure and takes appropriate measures to insure integrity of sterile field and maintenance of sterile techniques. Initiates corrective action for any break in technique.

Additional Job Functions

1. May handle, pick up, deliver and/or stock non-controlled medications as directed by a licensed team member.

2. Acts as a preceptor to help with the education of other Surgical First Assistants.

3. Maintains appropriate knowledge and training to use any equipment necessary for care of the patient and ensures it is in working order prior to use.

4. Supports the mission and vision of the Methodist Healthcare System and demonstrates excellent customer service at all times.

5. Understands and is committed to helping the Methodist Healthcare System and its associated facilities achieve its goals.

6. Must learn and comply with System and facility safety policies and rules; must use appropriate safety equipment and procedures at all times; must immediately report all unsafe conditions to supervisors; must be familiar with all safety features of equipment, tools or materials encompassed by job duties; and must check with supervisors (prior to job performance) if there is a question as to the safe procedure to be used for any job function.

7. Adheres to the MHS Code of Conduct and demonstrates ethical behavior as expected by our patients, colleagues and the community. Understands the personal obligation to report any activity that appears to violate applicable laws, rules regulations or the Code of Conduct itself.

8. Must learn and comply with System and facility safety policies and rules; must use appropriate safety equipment and procedures at all times; must immediately report all unsafe conditions to supervisors; must be familiar with all safety features of equipment, tools or materials encompassed by