Job Title Registered Nurse First Assistant (RNFA)

Job Code: SS1703
PRN Days

ABOUT US

We are welcoming a new era in healthcare where achieving good health is just the beginning. At UVA Community Health (UVACH), we believe in caring for the whole person by getting to know – and making connections with – our patients. By combining the talent and expertise of our people, the breadth of capabilities across our system, and our commitment to helping our communities get better and stay healthy, we are improving the patient experience.

As a UVACH team member, you will have a voice in patient care decisions, support the most advanced medical technologies and feel a strong sense of satisfaction from making a difference in people’s lives every day.

JOB TYPE 

Classification: Non-Exempt

Supervises Positions: No

JOB SUMMARY 

Description: 

The Registered Nurse First Assistant (RNFA) is a perioperative registered nurse who functions in an expanded role to work collaboratively with the surgeon and the surgical team. The RNFA provides first-assist services during surgical procedures, performs perioperative nursing responsibilities, and ensures high-quality patient care throughout the surgical experience.

The RNFA practices under the RN scope of practice, Virginia Board of Nursing regulations, and facility policies, with documented RNFA training, competency, and surgeon delegation. This role integrates both circulating/scrub nursing responsibilities and technical first-assist duties.

Job Competencies:

First Assist Responsibilities 

• Provides first-assist duties including exposure, tissue handling, retraction, hemostasis, suturing, and wound management
• Applies knowledge of instrumentation, anatomy, and sterile/aseptic technique
• Independently scrubs and assists across specialties including, but not limited to Orthopedics, General, Robotics, Vascular, Gynecology, and Spine
• Anticipates surgeon needs and ensures safe, efficient operative flow
• Participates in preoperative planning with surgeons and the surgical team
• Demonstrates knowledge and skills appropriate to the age and needs of the patient

Perioperative RN Responsibilities

• Performs circulating nurse duties according to Operating Room standards and policies
• Prepares the operating room with supplies, instruments, and equipment needed for the scheduled procedure
• Supports anesthesia providers and ensures safe patient positioning
• Monitors compliance with aseptic technique and safety protocols
• Engages in preadmission, preoperative, and postoperative RN duties as applicable to Outpatient Surgery (Outpatient Surgery Center, Preadmission, Post-Anesthesia Care Unit)
• Provides patient and family education regarding the perioperative process
• Conducts nursing assessments and documents care in accordance with policy

Communication & Collaboration

• Utilizes SBARQ and other structured communication tools
• Coordinates patient care activities with physicians, anesthesia, surgical technologists, and perioperative staff
• Maintains timely and accurate documentation
• Communicates updates or issues to the leadership team and intra-operative staff

Patient Care & Advocacy

• Acts as an advocate for patient rights, privacy, and dignity
• Provides emotional support and individualized patient education
• Develops and implements nursing plans of care tailored to patient needs
• Ensures continuity of care across all perioperative phases

Quality, Safety & Competency

• Follows departmental and organizational policies and guidelines.
• Maintains, operates, and monitors equipment according to manufacturer and hospital standards.
• Completes department-specific competency validation and ongoing training.

• Participates in on-call rotation as assigned.

The incumbent may be asked to perform additional duties as assigned.

QUALIFICATIONS

Education:

• Graduate of an accredited School of Nursing required
• Bachelor’s Degree in Nursing required
• Completion of an accredited RNFA program required

Experience: 

• Minimum two years of perioperative RN experience required
• Experience as an RNFA preferred

Licensure:

• Current RN license in the Commonwealth of Virginia
• Certified Nurse Operating Room (CNOR) certification required 
• RNFA certification or documented completion of RNFA program required
• Refer to the Life Support Training policy for additional details

Additional Skills/Requirements Required: 

• Ability to independently scrub and first-assist across multiple specialties
• Strong critical thinking, assessment, and decision-making abilities
• Excellent communication, teamwork, and patient education skills
• Ability to multitask, prioritize, and respond effectively in emergencies

Must meet all competency validations for perioperative RN and RNFA duties.

Additional Skills/Requirements Preferred: 

PHYSICAL DEMANDS

Physical Demand Code: Nursing 20A / Medical Tech 17A 

Work Function/Activity:  Medium to Heavy Physical Demand

• Constant standing, frequent walking, bending/stooping
• Ability to lift/push/pull up to 100 lbs. with assistance (Safe Handling Equipment required >35 lbs.)
• Requires strong visual, auditory, and verbal communication abilities
• Frequent repetitive motions and ability to maintain attention to detail

OTHER

• May require the use of safety equipment, such as HEPA mask, for infection prevention: Yes

• On call responsibilities as directed: Yes

• Ability to travel between campus buildings, remote facilities, and out of town as needed: Yes