RN First Assistant
RNFA behaviors include but are not limited to:
- preoperative patient management in collaboration with other health care providers, including but not limited to,
- performing preoperative evaluation/ focused nursing assessment,
- communicating/collaborating with other health care providers regarding the patient plan of care, an
- writing preoperative orders according to established protocols;
- intraoperative surgical first-assisting, including but not limited to,
- using instruments/medical devices,
- providing exposure,
- handling and/or cutting tissue,
- providing hemostasis, and
- suturing; and
- postoperative patient management in collaboration with other health care providers in the immediate postoperative period and beyond, including but not limited to,
- writing postoperative orders/operative notes according to established protocols,
- participating in postoperative rounds, and
- assisting with discharge planning and identifying appropriate community resources as needed.
The RNFA should have a diversified background in scrubbing and circulating and should have achieved perioperative nursing certification (CNOR).
The RNFA role is recognized within the scope of nursing practice by the state nurse practice acts in all 50 states. A registered nurse who is interested in becoming an RNFA should contact his or her state board of nursing for rules and regulations defining RNFA behaviors in that state. For more information on the rules governing RNFA Practice and contact information for the state board of nursing go to the AORN Legislative map, and select the state where you will practice.
To become an RNFA, the perioperative registered nurse should complete a formal education program that meets the "AORN Recommended Education Standards for RNFA Programs." A listing of RNFA program locations and admission requirements can be found by doing an internet search or going to the website for the Competency & Credentialing Institute at 888-257-2667.
For more information on the RNFA role, consult:
- The RN First Assistant Guide to Practice
The RN First Assistant Guide to Practice provides ideas and suggestions pertinent to an RNFA's practice including information to assist the novice in choosing an education program to prepare for certification, defining the various practice settings, meeting the basic competencies of RNFA practice, and obtaining practice privileges from health care facilities. It also provides the more experienced RNFA with tips on securing reimbursement, broadening their professional network, and taking an active role in influencing public health care policy. This book may be purchased from the AORN Perioperative Bookstore at aornbookstore.org or by calling 1-800-755-2676, Ext 1. - Information on the necessary requirements for taking the examination for RNFA certification may be obtained by contacting the Competency & Credentialing Institute at 888-257-2667.
- AORN's RNFA Specialty Assembly provides useful resources and educational events to its members. For more information, or to join the RNFA Specialty Assembly, contact AORN's Member Services at 800-755-2676, Ext. 275.
- For assistance in finding related articles in recent periodicals, please contact the AORN Library or your local librarian.
Other Resources
Rothrock, J C. The RN First Assistant: An Expanded Perioperative Nursing Role, Third ed Philadelphia: J B Lippincott Co, 1999.
Association of Operating Room Nurses, Inc. Core Curriculum for the RN First Assistant. Denver: Association of Operating Room Nurses, 2005.
Perioperative Nurse Specialists in the AORN Center for Nursing Practice are available for clinical practice consultation.