Registered Nurse First Assist (RNFA) - Operating Room

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

About Duke University Hospital

Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States and is the number one hospital in North Carolina, according to U.S. News and World Report for 2023-2024. Duke University Hospital is the largest of Duke Health's three hospitals and features 1048 patient beds, 65 operating rooms, as well as comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.

Join one of the nation’s leading academic medical centers and help shape the future of surgical excellence.
At Duke University Hospital, our Operating Room is home to cutting-edge procedures, world-renowned surgeons, and a collaborative perioperative environment that empowers nurses to practice at the top of their profession. We invite you to bring your expertise and passion for surgical care to our RN First Assistant team.

Shift: 10hr shifts

General Description

The Certified Registered Nurse First Assistant (RNFA) plays a critical role in supporting continuity of care for perioperative patients across the preoperative, intraoperative, and postoperative phases. As a key member of the surgical team, the RNFA helps optimize surgical workflow, enhance patient safety, and elevate clinical outcomes.

This highly skilled role provides:

Expert intraoperative first assistance
Support and education for surgical residents
Second assist when needed across a variety of surgical specialties
Leadership and clinical guidance for perioperative staff
Seamless coordination of care for patients of all ages

In this fast-paced academic environment, RNFAs at Duke have the opportunity to participate in complex and innovative surgical procedures while contributing to an exceptional patient and team experience.

Duties and Responsibilities

The RNFA functions autonomously and collaboratively alongside surgeons, anesthesiologists, residents, and perioperative staff. Responsibilities include:

Preoperative Patient Management

Conduct preoperative assessments and screenings
Participate in planning and coordination of individualized care plans
Collaborate and communicate with the surgical team
Write preoperative orders according to established protocols

Intraoperative First Assisting

Provide skilled and safe intraoperative assistance, including:

Using surgical instruments and medical devices
Providing optimal exposure for the surgical field
Handling and/or cutting tissues
Achieving hemostasis
Suturing and closing incisions
Anticipating surgical needs to support efficient workflow

Note: The RNFA does not simultaneously function as the Scrub Nurse.

Postoperative Patient Management

Write postoperative orders and operative notes based on protocol
Participate in postoperative rounds and clinical evaluation
Assist with discharge planning and transitions of care
Collaborate with multidisciplinary teams to support positive outcomes

The RNFA ensures that patients receive comprehensive nursing management throughout the perioperative phase while supporting the mission of high-quality, evidence-based care at Duke.

Required Qualifications

Education

BSN required; MSN preferred
Graduate of an accredited School of Nursing
Completion of an RNFA program based on AORN’s Core Curriculum with supervised clinical practice

Experience

Minimum of 3 years of perioperative nursing experience required

Licensure & Certification

Current or compact RN license in North Carolina
BLS required
CNOR certification required
RNFA certification must be obtained within 2 years of employment

Knowledge, Skills, and Abilities

The ideal candidate will have:

Strong clinical knowledge of perioperative technologies and procedures
Demonstrated ability to educate and mentor perioperative staff
A thorough understanding of the surgical cases in which they assist
High-level competency in circulating and scrubbing
Excellent communication, teamwork, and organizational skills
Commitment to AORN standards and evidence-based practice

Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.

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