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    Registered Nurse-Operating Room First Assistant - Louisville, United States - Veterans Health Administration

    Veterans Health Administration
    Veterans Health Administration Louisville, United States

    3 weeks ago

    Default job background
    Description

    Summary

    The Registered Nurse First Assistant OR Circulator is responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient care. The RNFA will follow the VA policies and Directives and will demonstrate professional conduct and team work skills at all times.

    Duties

    Registered Nurse First Assistants (RNFAs) are functioning in an expanded perioperative nursing role and reports to the OR Nurse Manager. When performing delegated medical functions, RNFAs are practitioners who are agents of their supervising physician(s)/independent license practitioner(s) who are responsible for the RNFA's actions within the agreed upon scope of practice. The supervising physician(s)/independent license 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 RNFA must have acquired the necessary knowledge, judgment, and skills specific to the expanded role of RNFA clinical practice.

    Intra-operatively, the RNFA practices at the direction of the attending surgeon. The RNFA shall not concurrently function as a scrub nurse with responsibility as a surgical first assistant. The RNFA has the duty to verify the standardized procedures in effect before preforming the functions of a surgical first assistant. The full-time RNFA may function in the role of the OR Circulating Nurse, Scrub Nurse of RNFA depending on the need of the Service, however the RNFA can not do more than one of these roles at a time. The RNFA may be assigned process improvement projects and or Quality projects to assist Surgical services as the surgical workload allows.

    Specific practice settings include the perioperative arena. The practice of each RNFA is based on knowledge, experience, and research and has a direct impact on patient outcomes in the assigned area and for the facility.

    When directed by the attending surgeon, the RNFA's intra-operative functions include but are not limited to:
  • Positioning the patient, preparing, and draping the surgical site
  • Administrating local anesthetic
  • Providing exposure and retraction
  • Providing hemostasis utilizing electrosurgical cautery (ESU), suture ligation, hemostatic agents, and argon beam - Use and handling of surgical instrumentation
  • Tissue handling, dissection, suturing, and stapling
  • Making the skin incision or stab wound for laparoscopic surgery or drains and placement of trocar (based on State Board of Nursing) for laparoscopic access
  • Robotics insertion and removal of instrumentation
  • Securing drains
  • Closure of wounds and changing dressing, including wound vac therapy
  • Apply and remove casts and splints
  • Harvest vein and arteries for bypass conduit
  • Cleansing surgical area, including superficial, subcutaneous, muscle and fascia, bone and abdominal and pelvic cavities
  • Removal of surgical drains under the direction of the attending surgeon (Chest tubes, knee drains)
    • Additional RNFA behaviors in the perioperative arena include, but are not limited to:
  • Preoperative patient management in collaboration with other health care providers, such as: Performing focused preoperative nursing assessments and Communicating and collaborating with other health care providers regarding the patient plan of care
  • Postoperative patient management in collaboration with other health care providers in the immediate postoperative period and beyond, such as: Participating in postoperative rounds Assisting with patient discharge planning and identifying appropriate community resources.
    • VA offers a comprehensive total rewards package:

    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 Schedule: Monday - Friday, 7:00am to 3:30pm, with occasional flexibility in scheduling dependent on the Service's needs for RNFA assistance. (Call requirement during week and weekends, Holiday Call coverage)
    Telework: Not available
    Virtual: This is not a virtual position.
    Relocation/Recruitment Incentives: Not authorized
    Permanent Change of Station (PCS) : Not authorized
    Financial Disclosure Report: Not required
    Pay Schedule: N09M
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