Senior Cardiac Surgery First Assist: Registered Nurse First Assistant (RNFA)

Cardiac Surgery First Assistant

Under the direction and supervision of a licensed Cardiothoracic surgeon, assists in the performance of surgical procedures in Cardiac surgery. During the intraoperative phase of heart surgery, the first assist practices in collaboration with and at the direction of the attending surgeon or his designee. This position is hiring for an Acute Care Nurse Practitioner (NP), Physician Assistant (PA) or RN First Assist.

I. General Summary Under the direction and supervision of a licensed Surgeon and/or physician in the Cardiac Surgery assist department, the First Assistant, Cardiac Surgery performs professional duties and surgical assistance.

II. Principal Responsibilities and Tasks The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

1. Performs tissue handling including making incisions, retracting, dissecting, tying, ligating, stapling, suturing and providing hemostasis. Performs chest tube insertions and closes leg and chest incisions.

2. Performs endoscopic or open harvesting of the saphenous vein during coronary artery bypass procedures and preparation of the vein for bypass.

3. Prepares and loads the vein on an Aortic Connector System for proximal anastomosis.

4. Performs endoscopic or open harvesting of the radial artery during coronary artery bypass procedures and prepares radial artery for bypass.

5. May take cases in the Cardiac Surgery Intensive Care Unit (CSICU) as needed.

6. Regularly visits pre- and post-operative patients, independently or with attending physician and/or students, to monitor patient progress in accordance with Medical System policies and procedures and generally accepted professional practice and The Joint Commission standards.

A. Notifies attending physician on call, house physician on call or supervising physician (or surgeon) regarding any unusual or unexpected events or problems requiring direct physician consultation.

B. Assists in the preoperative planning and documentation in keeping with protocols.

7. May take call during non-routine working hours to assist attending physicians in urgent and emergency procedures.

8. Performs clinical procedures such as the application of dressings and bandages, casting and splinting, removal and adjustment of frames, suturing. Performs these tasks independently, using universal precautions and following prescribed protocols of the hospital.

A. First and second assistance during surgery requires: prepping and draping patients, placing foley catheter, giving pre and post operative health care instruction to the patient, and transporting the patient from the O.R. to the PACU.

B. Collects data for prospective studies and manipulates via computer for various reporting or research purposes.

9. Performs in-service training for medical paramedical personnel locally, nationally and internationally. Assists in supervising students; designs, directs, instructs and evaluates the activities of first assistant students.

Qualifications

III. Education and Experience

1. Graduation from a Physician Assistant Training Program approved by the Board of Physician Quality Assurance is required. Evidence of current certification as a Physician's Assistant by the Maryland Board of Physician Quality Assurance.

2. Certification or eligibility for certification by National Commission for Certifying Physician's Assistants is required. Current Basic Cardiac Life Support Certification is required.

3. Registration by Maryland State Board for Medical Examiners as a Physician's Assistant is required.

4. Copy of a letter of agreement approved by Board of Physician Quality Assurance is required.

5. A minimum of 5 years of experience as a Physician Assistant is required.

OR;

1. Successful completion of a recognized planned program of instruction designed for the Registered Nurse Surgical First-Assistant to include:

a. Didactic instruction of at least 50 hours which includes:

b. Pre-operative and post-operative assessment, evaluation of physical and laboratory findings, patient pain management and patient and staff teaching.

c. Intraoperative considerations including anatomy and physiology and surgical interventions as related to each system.

d. Surgical techniques.

e. Surgical hazards and appropriate interventions.

f. Clinical instruction and experience including:

2. A minimum of 200 hours assisting in major surgical procedures including positioning, prepping and draping, siding in exposure, retraction, hemostasis, surgical instrumentation, etc

3. Instruction provided by qualified surgeons participating in the program.

4. The surgeon preceptor(s) written documentation of the registered nurse's competency in the intraoperative surgical first assistant role.

5. A minimum of 5 years of experience as a Registered Nurse First Assist is required.

IV. Knowledge, Skills and Abilities

1. Ability to demonstrate knowledge and skills necessary to provide care appropriate to the patient populations(s) served. Ability to demonstrate knowledge of the principles of growth and development over the life span and ability to assess data reflective of the patient's requirements relative to his or her population-specific and age specific needs.

2. Highly effective verbal and written skills are required to work with all levels of hospital personnel, administrators and clinical staff.

3. Ability to work in a team atmosphere and maximize efficient system operations.

Additional Information

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