Posted on November 10, 2023

Written by Kathryn O. Wright CRNFA

The Certified Registered Nurse First Assistant is the surgeons’ secret weapon. We straddle nursing and surgical departments, often bringing issues and/or concerns about the patient to the attention of the surgeon. We facilitate the surgeon’s endeavors while advocating for the patient. The patient is the most important person in the OR, and it is everyone’s job to safely and efficiently care for them.

A Registered Nurse First Assistant is a Registered Nurse who has worked in the Operating Room for a minimum of 2 years, has attained a Bachelors degree, holds a CNOR (Certified Operating Room Nurse) and has achieved advanced critical surgical skills under the direct supervision and tutelage of their surgeon sponsor for a minimum of 200 surgical hours. (Surgical hours are the time that the patient is physically in the Operating Room). Once the surgeon sponsor has verified and evaluated the skills learned by the RN, the RNFA designation is awarded.

A Certified Registered Nurse First Assistant is an RNFA who has a minimum of 2000 surgical hours of practice and has fulfilled the requirements in order to obtain National Certification by the designating body. (Currently held by the NASC)

A an RNFA/CRNFA, we assist the surgeon during surgery by being another set of hands and eyes. We take the place of another surgeon, fellow or resident during the actual performance of surgery. We are not authorized to perform surgery independently as an MD does, we operate under the direct supervision of the surgeon at all times. It is a highly technical career and our skills include (but are not limited to) tissue manipulation, suctioning, suturing, use of electric cautery and other surgical instrumentations and devices.

This differs from the Circulating RN or the Scrub Person who also work in the Operating Room.

The Circulating RN is a licensed registered nurse, in the non-sterile role who documents in the patient’s medical record during the surgery and performs the peripheral work to maintain a safe patient environment and an efficient OR during the surgery. (And this is not an exhaustive list of duties)

The Scrub Person is a sterile member of the surgical team that maintains the set-up, maintenance and careful watch of the sterile field. The Scrub Person coordinates/passes any instrumentation and soft goods on the sterile field, that the surgeon and the assist may require during the procedure. (Again, not an exhaustive list of duties)

A career as a CRNFA is fascinating, challenging and demanding (physically and mentally), as their sole focus is to assist the surgeon in the direct surgical interventions. A CRNFA actually gets to see the surgery directly, provide hands-on surgical activity, helping the patient in a physical and positive manner. You have an actual direct affect on the patients care, and that can be very exhilarating not to mention satisfying.

For further information on becoming a CRNFA, you can visit the National Assistant at Surgery Certification (NASC) website at https://nascertification.com