Certified First Surgical Assistant / 40 Hours / Rotating - BWH Operating Room

Brigham And Women's Hospital

Boston , MA 02298


Certified Surgical Assistants are integral members of the surgical/nursing team in each Operating Room. Certified Surgical Assistants report the Nursing Director of the Operating room. They work under the supervision of the MD as a first assistant and with nurses and other health care professionals as part of a multi-disciplinary team as a first assistant or in the role of surgical technician providing quality care for an array of surgical patients. Major functions include, but are not limited to, preparation of an operating room suite and gathering surgical instrumentation and supplies for various surgical procedures.

Certified Surgical Assistants also referred to as first assistants or non-physician surgical assistants are members of the operating team. These professionals can do all the work that surgical technologists do such as:

  • Preparing the operating room for surgery, setting up the surgical instruments and equipment, maintaining sterile conditions, monitoring the patient and equipment during surgery and preparing patients and transport them to and from surgery.

Surgical Assistants often have a more hands-on role during the procedure. Surgical assistants help the surgeon with tasks such as these:

  • Sponging, suturing, suctioning, holding retractors, hemostasis (staunching bleeding), and treating wounds.


  • Perioperatively, surgical first assistants work with operating room staff to:

  • Verify correct patient information, operative procedure and surgical site and check the patients chart for any abnormalities.

  • Verify that the correct equipment and instrumentation is prepared and ready to use.

  • Carry out the surgeon's order for exact positioning for surgical procedure.

  • Assists circulator and anesthesia provider in preparation of patient to include but not limited to foley catheter placement, tourniquet application, placement of IVs, cricoid pressure application and other procedures as needed.

  • Intraoperatively, the surgical first assist provides:

  • Visualization of the operative site by appropriately placing and securing retractors,

  • Packing sponges

  • Digitally manipulating tissue, suctioning, irrigating or sponging

  • Manipulating suture materials (loops, tags, running sutures); and employing the proper use of body mechanics to prevent obstruction of the surgeon's view.

  • Surgical first assistants utilize appropriate permanent or temporary techniques to help achieve hemostasis by:

  • Clamping and/or cauterizing vessels or tissue

  • Tying and/or ligating clamped vessels or tissue

  • Placing local hemostatic agents

  • Achieving hemostasis by means of injection, manual, and topical methods and application of appropriate energy sources

  • Applying hemostatic clips

  • Applying tourniquets

  • Applying vessel loops, noncrushing clamps, and direct pressure

  • Surgical first assistants employ appropriate techniques to assist with the closure of body planes, including:

  • Utilizing running or interrupted subcutaneous sutures

  • Utilizing subcuticular closure technique

  • Closing skin as directed by the surgeon

  • Administering subcutaneous postoperative injections of local anesthetics when directed by the surgeon

  • select and apply appropriate wound dressings, including liquid or spray occlusive materials, absorbent material and immobilizing dressing

  • Secure drainage systems to tissue

  • Ensures the availability of supplies for all surgical procedures

  • Checks for completeness of case carts and supplies

  • Checks for expiration dates on sterile supplies

  • Ensures the appropriate par level is maintained

  • Resolves any deficiencies that are identified.

  • Makes appropriate use of supplies, equipment, and other resources helping to maintain a cost-effective program for patient, unit, and institution.

  • Prepares the room for patient admission in a timely manner to promote efficient room utilization.

  • Ensures the efficient and effective cleaning of the operating room according to established protocols.

  • Ensures the presence of all supplies and equipment required for subsequent procedures.

  • Efficiently organizes surgical tables with appropriate sterile supplies and equipment.

  • Checks for proper functioning of equipment.

  • Assists with patient positioning utilizing proper body mechanics and safety precautions.

  • Assists in the transfer of patients from stretcher/bed to OR table, ensuring that the bed is locked and secure during transfer.

  • Performs proper patient safety measures, i.e., safety strap application, protective padding and arm board placement

  • Positions patient maintaining proper body alignment of patient and self.

  • Prepares the instrumentation, supplies and equipment required for the various procedures performed within the area.

  • Maintains integrity of the sterile field, recognize and resolves any breaks in technique.

  • Anticipates the needs of the surgical team to facilitate the smooth and timely flow of the procedure.

  • Communicates essential information of the constantly changing requirements of the surgical team, i.e., updating preference cards/specialty carts.

  • Performs appropriate counts with circulator according to OR policy and procedure and verifies removal of all countable items from surgical site in accordance with established procedure.

  • Receives medication from the RN to be administered by the surgical team. Assists the circulator and surgical team in accounting for amounts of medications and irrigations administered.

  • Handles all surgical specimens according to procedure. Records and relates the type and location of specimen to the circulator for proper labeling.

  • Disposes of all waste materials according to established protocols. Pays particular attention to the disposal of hazardous sharps or infected material.

  • Separates instrumentation into appropriate containers. Follows individualized protocols for the care and maintenance of specialized instrumentation. Utilize foam enzymatic cleaner on instrumentation.

  • Ensures that necessary equipment and furniture is available to prevent time consuming delays between procedures. Reorganizes room according to room setup for subsequent procedures/ day.

  • Functions in an on-call capacity for urgent and emergent situations.

  • Reports within specified times to the OR.

  • Is available at all times when on-call via phone.

  • Professional Development:

  • Keeps current regarding developments in technical instrumentation, trends and techniques through appropriate journals as well as internal and external programs.

  • Serves on appropriate nursing and hospital committees as requested.

  • Participates in staff meetings.

  • Assists in evaluation of products, equipment and systems which may have an impact on planning and implementing the budget.

  • Keeps informed of personnel policies and incorporates them in behavior as indicated.

  • Seek out new learning experiences as staffing numbers allow.


  • Certification as a Certified First Assistant

  • National certification is required in accordance with Mass state law.

  • Experience is desired, but not required, knowledge of patient care and aseptic technique is essential.

  • Personal attributes such as good judgment, dependability and initiative are necessary.


  • Must have knowledge of septic and aseptic technique and be conscious of both at all times.

  • Must be aware of safety standards and hazards in the room.

  • Must have knowledge of patient positioning and assist circulator when necessary.

  • Must have knowledge of care and handling of surgical instruments.

  • Must have knowledge of care and safety hazards of all specialty equipment.

  • Understands the normal and recognizes deviation from normal within his/her specialty.

  • Demonstrates expertise on the use and maintenance of equipment and/or machinery required for area of specialty. Most of this is expensive highly technical equipment requiring expert handling and care, i.e., $50,000 microscopes, $10,000 arthroscopes.

  • Is aware of and utilizes accepted standards of care and participates in the evaluation of those standards.

  • Must have ability to recall past experience in order to anticipate surgical team needs.

  • Must possess interpersonal skills sufficient to interact efficiently with other members.

  • Must possess ability to work in frequently stressful situation requiring quick action and adaptability to rapid change. (Emergencies or change in plan - up to 75% of work time.)

  • Work requires approximately up to 6 months of orientation to acquire familiarity with the specialty areas.

  • Work requires ability to carry through with identified skills as failure to do so may result in serious harm to patients, self or co-workers, i.e., infections, injuries, prolonged surgical and anesthesia times.


  • Works in a busy area often with a high stress atmosphere.

  • Works in an area with some physical discomforts due to unpleasant odors (cautery fumes, cement fumes), infectious specimens and high noise levels.

  • Works in an area with exposure to known hazards, i.e., communicable disease, anesthetic gases, x-rays, methylemthacrolate cement, U-V lights.

  • Work requires potential exposure to cuts on hands and fingers from frequent use of needles and blades.

  • Works underground with no windows or exposure to daylight.

  • Work requires intense physical effort: continuous standing (100% of work time), lifting of heavy supplies (over 20 pounds) lifting of patients, pushing heavy carts and beds, moving lights and machinery.

Brigham and Women's Hospital is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, creed, sex, sexual orientation, gender identity, national origin, ancestry, age, veteran status, disability unrelated to job requirements, genetic information, military service, or other protected status.

Brigham and Women's Hospital I CARE Standards

The I CARE Standards guide me in my interactions with patients, family members, visitors, colleagues, and neighbors in my workplace and surrounding community to optimize the Brigham experience and help fulfill my role in our mission of providing seamless, high quality patient and family centered care.

C. I will Communicate my commitment to high quality performance

A. I will Appear and act as a professional

R. I will Respect all individuals

E. I will Extend myself

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Certified First Surgical Assistant / 40 Hours / Rotating - BWH Operating Room

Brigham And Women's Hospital