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Surgical First Assist - Labor and Delivery

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San Antonio, TX, United States


SHIFT: No Weekends

SCHEDULE: Full-time

Methodist Children's Hospital
Surgical Technician – 1st Assist
Pediatric Surgery / OR
Full Time / Shift / Non-Exempt

Since opening in 1998 as the first and only hospital in San Antonio and South Texas designed and built just for children, Methodist Children’s Hospital has set the standard for treating the children of South and Central Texas. The hospital continues to lead the region in treating severely ill children, those with complex and chronic medical diagnoses, by providing the most sub-specialized care available. Our new tower is part of a landmark expansion which will increase the footprint of the Methodist Hospital campus by 445,000 square feet.

The new tower includes 150 rooms and a dedicated children’s imaging department with new, state-of-the art technology. The 94-bed neonatal intensive care unit, still the region’s largest, has board-certified neonatologists in-house 24/7 and is the city’s only Texas Department of Health-designated Level 4 neonatal intensive care unit. The new tower also includes 15 additional ER rooms, bringing the total to 40. Methodist Children’s Hospital has been nationally recognized by Leapfrog’s Hospital Safety Grade A. For more information, please visit our website at and select Methodist Children’s Hospital under Locations.

We offer you a generous benefits package including:

  • Medical, Dental, disability and life insurance

  • Flexible Spending Accounts
  • Paid Time Off
  • Employee Discount Program
  • 401K
  • Employee Stock Purchase Program
  • Tuition Reimbursement
  • Student Loan Repayment

Your Role: Surgical Technician – 1st Assist


The Surgical First Assistant works as a member of the perioperative team under the direction of the surgeon. He/she performs responsibilities of both the Surgical Technologist and the Surgical First Assistant based on department needs and as directed by the unit director or designee. The Surgical First Assistant practices within the scope of the job description and performs clinical and technical skills under surgeon supervision to assist with carrying out a safe operation with optimal patient results. This is done in collaboration with the circulating RN and other perioperative/OB team members. The Surgical First Assistant is educated and skilled in both the use of surgical instruments on tissues and the handling of instruments; however, the surgical first assistant does not concurrently function as the scrub nurse.

  1. Functions as a surgical first assistant at the direction of and under the appropriate supervision of the attending surgeon; always practices within the limitations of preparation and experience and within the scope allowed by the hospital.
  2. A. Consistently functions at the direction of and under direct supervision (physical presence of the attending surgeon in the procedure/treatment room) of the attending surgeon. The surgical assistant scope includes:
  • i. Providing visualization of the operative site through appropriate placement and   securing of retractors with or without padding, packing or sponges; digital manipulation of tissue; suctioning, irrigation or sponging; manipulation of suture materials; proper use of body mechanics to prevent obstruction of the surgeon’s view.

  • ii. Utilizing appropriate permanent and temporary techniques to assist with hemostasis. Permanent hemostasis techniques include clamping and/or cauterizing vessels and tissue, tying and/or ligating clamped vessels or tissue, applying hemostatic clips, or placing hemostatic agents. Temporary hemostasis techniques include applying tourniquets and demonstrating awareness of the indications/contraindications for use with knowledge of side effects of extended use; applying vessel loops, non-crushing clamps, or direct digital pressure.
  • iii. Administering post-operative subcutaneous local anesthetic injection

  • iv. Utilizing running or interrupted sutures with absorbable or non-absorbable material of wound layers, including muscle and fascia.

  • v. Assisting with placement of implants
  • vi. Robotic procedures only: Insertion of subsequent (not initial) trocars. Must have documented training and competency validated (initially within by MHS Medical staff member privileged to perform robotic surgery. The documentation must include directly supervised trocar insertions on a minimum of 5 patients completed within a 12 month period with good patient outcomes.

  • vii. Saphenous Vein Harvesting only: May harvest saphenous vein through endoscopic or open technique. Must have documented training and competency validated by a MHS Medical staff member privileged to perform Cardiothoracic surgery. The documentation must include directly supervised saphenous vein harvests on a minimum of 10 patients completed within a 12 month period with good patient outcomes.

            B. Under direct or general perioperative supervision (surgeon/proceduralist presence 
            in the perioperative area (pre-op department, perioperative suite, PACU, OR/procedure
            waiting room) and is immediately available), the surgical assistant scope includes
            closure of body planes and applies wound dressings per the method indicated by the
            attending physician:  
  • i. Utilizing sub-cuticular closure technique with or without adhesive skin closure strips
  • ii. Skin closure with suture, staples and/or spray occlusive material/skin adhesive strips
  • iii. Securing drainage systems to tissue
  • iv. Application of immobilizing dressing

     3.  Consistently assists with maintaining the patient’s expected physiologic responses to

          surgery including infection prevention (SCIP measures and practices, maintaining

          effective disinfection practices, instrument processing, and sterilization).

     4.  Demonstrates effective communication and works collaboratively with all members of the

          perioperative team to include active consistent participation in Universal Protocol and

          timely and accurate sponge and sharp counts to include initiating corrective action as


     5.  Consistently applies a working knowledge of patient pre-operative deficits, risk for

           intraoperative injuries, and possible post-operative outcomes to assist in optimal patient 

           outcomes. Demonstrates principles of safe patient positioning for best exposure in

           collaboration with the surgical team using appropriate

           positioning equipment to ensure padded pressure points, protection from nerve damage

           and unimpaired circulation.

     6.  Functions in the role of a Surgical Technician as needed by the department; however,

          does not concurrently perform as the surgical first assistant and surgical technologist.

          Wears proper surgical attire, opens sterile packs, instruments, and supplies for each

          procedure, scrubs, gowns, gloves, and drapes

          according to established aseptic technique and protocols. Monitors sterile field during

          procedure and takes appropriate measures to insure integrity of sterile field and

          maintenance of sterile techniques. Initiates corrective action for any break in technique.




Education: Must have completed ALL of the following:

  1. High School Diploma or GED

  2. Successful completion of a CAAHEP accredited surgical first assistant training program

  3. Meets ONE of the following:

    • Graduate/completion of a surgical technologist program OR

    • Practiced as a surgical technologist prior to 9/1/2009

  • New hires as of 3/29/2011- 2 years experience in the perioperative setting within the last 4 years in either a surgical technologist or surgical first assistant role.

Employee completes initial and ongoing training and competencies as defined by service line, facility and department/unit which are specific to the needs of the patient population served (if applicable).


Minimum License, Certificates, or Registrations Required:

Must have and maintain ONE of the following:

A. Surgical Technologist Certification

  • i. CST – Certified Surgical Technologist through the National Board for Surgical Technology and Surgical Assisting (NBSTSA) (formally the Liaison Council on Certification for the Surgical Technologist) OR
  • ii. TS-C- Tech in Surgery, Certified through the National Center for Competency Testing (NCCT)
B. Surgical First Assistant certification
  • i. SA-C – Surgical Assistant, Certified through the American Board of Surgical Assistants (ABSA)
  • ii. CSA – Certified Surgical Assistant through the National Surgical Assistant Association (NSAA)
  • iii. CSFA (formally CFA) – Certified Surgical First Assistant through the National Board of Surgical Technology and Surgical Assisting (NBSTSA)

C. LSA- Licensed Surgical Assistant through the Texas Medical Board









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Methodist Hospital
Facility: Methodist Hospital
Job ID: 02531-97434
Category: Nursing - Professional
Contract: Full-time
Shift: No Weekends
Job Class: Regular

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