Rnfa -- Operating Room -- Memorial Hospital

Job Summary

Demonstrate advanced clinical skills to meet needs of patient groups; formulate plans of care that have long range effect on patient care; assist unit staff members to perform advanced skills; act as a role model which facilitates positive behavior in dynamic group setting; recognize need for change in nursing practice and initiate change process on unit; proactive to identify potential legal/ethical/safety issues and implement strategies to prevent problems. Functions under direct supervision and direction of the surgeon in the expanded perioperative nursing role of first assistant. Performs all nursing activities in the pre-operative, intra-operative phase of the surgical procedures, but does not concurrently function as the scrub nurse.

Responsibilities

• Expedites the operative procedure by anticipating the needs of the surgeon. • Demonstrates advanced knowledge of normal and pathological anatomy and physiology. • Demonstrates knowledge of emergency situations, organization skills, and professional attitude. • Assist the operating room team by preparing the OR suite for surgical procedures in a timely manner. • Practice aseptic and sterile techniques. • Apply appropriate cleaning techniques in the operating room. • Participate during the course of the procedure by handing instruments and supplies to the surgeon. • Anticipate the needs of the surgeon during the course of the procedure. • Assist with applying the dressing to the incision. • Clean and restock the room assigned. • Assist with in-service and training of new personnel. • Take call as assigned. • Positioning the Patient The surgeon shall convey the exact position that will give the best exposure for the surgical procedure. The surgical assistant will carry out this order.
  
  Points of pressure shall be padded: elbows, heels, knees, eyes, face, and auxiliary region. Circulation shall not be impaired. (A tourniquet may be required for some procedures.) Nerve damage shall be guarded against. The temperature of the patient should be discussed with the anesthesia personnel and methods employed to maintain the desired temperature range.
  
  The surgical assistant shall be familiar with common positions as they relate to the surgical procedure and will be able to use the equipment necessary to provide the position. Competencies will include the following: 1)Fracture Table, 2) Head stabilizer, 3) Body stabilizers, 4) C-arm extensions, 5) Any other equipment needed Upon completion of the procedure, the patient shall be evaluated for any possible damage from positioning, which shall include assessment of the skin. The abnormal condition shall be reported to the surgeon and treatment and documentation shall be carried out. • Under the direct supervision of the surgeon: uses appropriate tissue dissection techniques to facilitate an optimum surgical outcome.
  
  If established competencies exist, this may include: Trocar Placement Preparation of Allografts Saphenous Vein Harvesting:
  
  Endoscopic and Open (Open EXCLUDES Femoral Triangle) (see Institutional Criteria) Radial Artery Harvesting:
  
  Endoscopic and Open (see Institutional Criteria) Ultrasound Guided Femoral Arterial Line Insertion (see institutional Criteria) Knot Tying Closure of Layers • Providing visualization of the operative site by the following: Appropriate placement and securing of retractors with or without padding. Packing with sponges.
  
  Digital manipulation of tissue. Suctioning, irrigating, or sponging. Manipulation of suture materials (e.g., loops, tags, running sutures). Proper use of body mechanics to prevent obstruction of the surgeon's view. • Utilizing appropriate techniques to assist with homeostasis.
  
  Permanent • • • Clamping and/or cauterizing vessels or tissue. • • • Tying and/or ligating clamped vessels or tissue. • • • Applying hemostatic clips. • • • Placing local hemostatic agents. Temporary • • • Applying tourniquets and demonstrating awareness of indications/contraindications for use with knowledge of side effects of extended use. • • • Applying vessel loops. • • • Applying non-crushing clamps. • • • Applying direct digital pressure. • Participating in volume replacement or auto transfusion techniques as appropriate. • Utilizing appropriate techniques to assist with closure of body planes. Utilizing running or interrupted subcutaneous sutures with absorbable or nonabsorbably material.
  
  Utilizing subcuticular closure technique with or without adhesive skin closure strips. Closing skin with method indicated by surgeon (suture, staples, etc.). • Selecting and applying appropriate wound dressings, including the following: Liquid or spray occlusive materials.
  
  Absorbent material affixed with tape or circumferential wrapping. Immobilizing dressing (soft or rigid). • Providing assistance in securing drainage systems to tissue.

Knowledge, Skills & Abilities

Patient Group Knowledge (Only applies to positions with direct patient contact) The employee must possess/obtain (by the end of the orientation period) and demonstrate the knowledge and skills necessary to provide developmentally appropriate assessment, treatment or care as defined by the department's identified patient ages. Specifically the employee must be able to demonstrate competency in: 1) ability to obtain and interpret information in terms of patient needs; 2) knowledge of growth and development; and 3) understanding of the range of treatment needed by the patients.

Competency Statement Must demonstrate competency through an initial orientation and ongoing competency validation to independently perform tasks and additional duties as specified in the job description and the unit/department specific competency checklist. Common Duties and Responsibilities (Essential duties common to all positions) 1. Maintain and document all applicable required education. 2.

Demonstrate positive customer service and co-worker relations. 3. Comply with the company's attendance policy. 4. Participate in the continuous, quality improvement activities of the department and institution. 5.

Perform work in a cost effective manner. 6. Perform work in accordance with all departmental pay practices and scheduling policies, including but not limited to, overtime, various shift work, and on-call situations. 7. Perform work in alignment with the overall mission and strategic plan of the organization. 8.

Follow organizational and departmental policies and procedures, as applicable. 9. Perform related duties as assigned.

Education

• Associate's Degree (Required) Education: Formalized Training RNFA Experience: 3 Years Practice in Perioperative Nursing and Practice as both Scrub and Circulator Comments:
  
  As of 1/1/2019 all RNFA's must have CNOR. If you were hired prior to 1/1/2019 in the RNFA position, it will not be required.

• Bachelor's Degree

• Formalized Training (Required) Experience: 3 Years practice in perioperative nursing and practice as both scrub and circulator

Credentials

• CNOR (Required)
• Registered Nurse (Required)
• Basic Life Support (Required) Within 30 days of hire

Within 30 days of hire

Work Schedule: Varies

Status: 72 hrs per pay

Location: Memorial Hospital

Location of Job: US:WV:Charleston

Talent Acquisition Specialist: Lauren R. Lane lauren.lane@vandaliahealth.org