Registered Nurse First Assistant (RNFA)

Updated: about 2 months ago
Location: Duarte, CALIFORNIA

Thank you for your interest.  Please note, the purpose of this posting is to recruit for on-going and future positions.  

About City of Hope

City of Hope, an innovative biomedical research, treatment and educational institution with over 6,000 employees, is dedicated to the prevention and cure of cancer and other life-threatening diseases and guided by a compassionate, patient-centered philosophy.


Founded in 1913 and headquartered in Duarte, California, City of Hope is a remarkable non-profit institution, where compassion and advanced care go hand-in-hand with excellence in clinical and scientific research.  City of Hope is a National Cancer Institute designated Comprehensive Cancer Center and a founding member of the National Comprehensive Cancer Network, an alliance of the nation’s leading cancer centers that develops and institutes standards of care for cancer treatment.



Position Summary

The Registered Nurse First Assistant (RNFA) is a perioperative registered nurse who functions in an expanded role or an Advanced Practice Registered Nurse (APRN) functioning as a first assistant.

To carry out the functions that will assist the surgeon in performing a safe operation with optimal results for the patient. The RNFA practices peri-operative nursing and is therefore responsible for independent nursing behaviors of peri-operative assessment and post-operative evaluation of care:

  • works in collaboration with the surgeon and other healthcare team members to achieve optimal patient outcomes; 
  • has acquired the necessary knowledge, judgment, and skills specific to the expanded role of RNFA clinical practice; 
  • intraoperatively practices at the direction of the surgeon.


Key Responsibilities include:

  • Assess the health status of the patient in order to develop an individualized plan of care by collecting, categorizing, and interpreting data (physical and psychosocial) from documented information, observation, patient/family interview and other health care team members.
  • Assess the patient including nursing diagnosis, patient goals and nursing interventions necessary to achieve goals of care
  • Implement nursing care to provide optimal individualized patient outcome
  • Instruct the patient and family to assist the patient in the achievement of optimal health status
  • Document nursing activities to provide a permanent record, for continuity of care, quality improvement and professional accountability
  • Identify the patient to ensure the patient, procedure and operative site correspond
  • Plan, supervise and assist with the transfer of the patient to protect the patient and personnel from injury
  • Position the patient to provide access to the operative site while maximizing patient safety and comfort
  • Establish and maintain a surgically clean environment to reduce the potential for infection by applying the principles of the potential for infection by applying the principles of antisepsis, decontamination, disinfection, sanitation, sterilization and environmental monitoring
  • Establish and maintain a safe environment to protect the patient and the health care team by monitoring the patient (physiologically and psychologically) and the environment and by implementing safety procedures
  • Establish and maintain a sterile field to reduce potential for infection by teaching and supervising the application of principles of aseptic technique and continual monitoring of the sterile filed
  • Coordinate support services need during surgery by anticipating and communicating patient and surgical team needs
  • May function as a RN Circulator and/or Scrub Nurse

Basic education, experience and skills required for consideration:

  • BSN Required
  • Three years of experience in peri-operative nursing
  • Demonstrated proficiency in the scrub and circulating roles
  • Demonstrated knowledge and skill in applying principles of aseptic technique
  • Demonstrated knowledge of surgical anatomy, physiology and operative technique related to first assisting
  • Demonstrated ability to perform effectively and harmoniously as a member of the operative team
  • Demonstrated ability to recognize safety hazards and to initiate appropriate preventive and corrective action
  • Demonstrates skill in the following intra-operative nursing behaviors:
    • Handling tissue
    • Using instruments
    • Providing exposure
    • Providing hemostatsis
  • Successful completion of additional educational preparation specific to the role of RNFA including a supervised clinical component
  • Ability to work under pressure
  • Excellent oral/written communication and organizational skills
  • Using instruments and medical devices
  • Providing surgical site exposure
  • Suturing
  • Wound management


Required Certification/Licensure:

  • RNFA certification plus California RN License, BCLS, ACLS


Preferred education experience and skills:

  • MSN Preferred
  • CNOR Professional Organization Membership-AORN
  • CRNFA 



Additional Information:

  • Shift: Day
  • Job Status: Full-Time
  • This position is represented by a collective bargaining agreement
  • Certification pay may apply




City of Hope is committed to creating a diverse environment and is proud to be an equal opportunity employer.  All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, or status as a qualified individual with disability.



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