The registered nurse first assistant, or RNFA, is a registered nurse who has undergone additional training to learn how to directly assist surgeons during operations in various medical specialties. Their duties may also include preoperative and postoperative nursing care. RNFAs must complete a formal training program accredited by the Association of Operating Room Nurses. These programs typically involve 100 to 200 hours of clinical training in addition to 100 to 200 hours of classroom lectures.
Preoperative care takes place from the time the patient enters the hospital for surgery until he is taken to the operating room. The RNFA's duties in this phase include checking in, evaluating and marking the patient for surgery; confirming the planned care with the surgeon and nursing team; writing preoperative orders as is allowed by the hospital and state; and other duties that may be required by the surgeon. The RNFA may also help take the patient to be prepped for surgery.
The intraoperative phase of care starts at the first incision and ends after the dressings are placed and the patient leaves the operating room. The RNFA's duties here include prepping the patient for surgery, providing exposure by retracting tissue, dissecting and cutting tissue, controlling bleeding and suturing the wound. The RNFA may close the wound and dress the patient as well.
The postoperative phase begins when the patient leaves the operating room and heads to the recovery room. The RNFA may write orders in the patient's chart concerning her care, in accordance with hospital and state guidelines. The RNFA may also follow the patient to the hospital floor and in the office after discharge.
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