Registered Nurse First Assist

First Assist Registered Nurse (RN)

The First Assist Registered Nurse (RN) is a proficient nurse who demonstrates proficiency in decision-making and using the nursing process for complex situations that affect performance outcomes at the point of care. Practice is enhanced through the development of collegial relationships. Demonstrates collaboration by using the group process to solve problems. The focus is on leadership in strategically planning long-term goals for the microsystem (unit, team, or workgroup) that impacts operations or resources. They demonstrate critical thinking with efficiency and accuracy in assessing and managing situations. First Assist RN's, function in an expanded perioperative nursing role. When performing delegated medical functions, First Assist RNs are practitioners who are agents of the supervising physician(s)/independent licensed practitioner(s) who are responsible for the First Assist RN's actions within the agreed upon scope of practice. The supervising physician/independent licensed provider is to direct and review the work and practice on a continuous basis to ensure that appropriate directions are given and understood, and appropriate care is rendered. The First Assist RN must have acquired the necessary knowledge, judgment, and skills specific to the expanded role of First Assist RN clinical practice.

Duties Include, But Are Not Limited To:

• Delivers fundamental, knowledge-based perioperative nursing care to assigned patients, developing technical skills based on age-specific components and patient needs.
• Assesses, plans, implements, and evaluates nursing care for patients in the perioperative setting, with a focus on education, safety, satisfaction, and self-management throughout the surgical continuum.
• Applies professional nursing practice as an RNFA, including all validated competencies and functions delegated by the supervising surgeon. RNFA duties include:
• Assisting in patient positioning and prepping/draping of the surgical site
• Providing exposure through tissue manipulation, using surgical instruments, suctioning, and retraction
• Controlling bleeding and providing hemostasis using standard and advanced technologies (e.g., electrosurgical units, ligatures, suture, topical agents, argon beam, bipolar/ultrasonic devices)
• Suturing and stapling of tissue, and closure of surgical wounds and application of dressings including wound vac therapy
• Making skin incisions, creating laparoscopic access (stab wounds/trocars) as allowed by the State Board of Nursing
• Placing and securing drains, inserting and removing surgical instrumentation (including robotics)
• Application and removal of casts and splints
• Harvesting veins and arteries for bypass conduit as delegated
• Administration of local anesthetic under surgeon direction
• Cleansing surgical site (superficial, subcutaneous, muscle/fascia, bone, abdominal/pelvic cavities)
• Removal of surgical drains (chest tubes, orthopedic/joint drains)
• Other intraoperative, preoperative, and postoperative RNFA tasks as permitted by certification and defined by hospital policy.

Note: This functional statement serves as a summary of major duties, responsibilities, and qualification requirements for the RNFA. Additional duties may be assigned at the discretion of the supervisor or owing to patient care needs. Validation of RNFA competency is required before assignment of RNFA-specific responsibilities.

VA offers a comprehensive total rewards package: VA Nurse Total Rewards

Pay: Competitive salary, regular salary increases, potential for performance awards

Paid Time Off: 50 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year)

Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA

Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement)

Licensure: 1 full and unrestricted license from any US State or territory

Work Location: VA St. Louis Health Care System - John Cochran Campus

Work Schedule: Monday - Friday 6:30 AM to 3:00 PM with required on-call rotation

Telework: Ad-Hoc, as determined by agency policy.

Virtual: This is not a virtual position.

Relocation/Recruitment Incentives: Not Authorized

Permanent Change of Station (PCS): Not Authorized