RN First Assist Certified Operating Room in San Antonio, Texas, United States
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Methodist Hospital Specialty and Transplant

RN First Assist Certified Operating Room

San Antonio, TX, United States
Full-time  Eves 7-10 Hrs/Wkends Rotate 
Category: Registered Nurse • Job ID: 191854

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Methodist Specialty and Transplant Hospital is licensed for 382 beds and has been nationally recognized by Leapfrog’s Hospital Safety Grade A. It receives international acclaim for its outstanding and dynamic kidney, liver and pancreas transplant programs, setting record numbers for volume and outcomes. Methodist Specialty and Transplant Hospital is home to the Texas Transplant Institute, a nationally recognized center that recently performed the world’s first 16-way kidney donor exchange chain during three consecutive days at a single hospital.

Methodist Specialty and Transplant Hospital earned designation as a Center of Metabolic and Bariatric Surgery Excellence from the American Society for Bariatric Surgery in 2008. Our Sexual Assault Response Team provides a compassionate environment for sexual assault survivors ages 13 and up. This program serves as a model for hospitals and agencies all over the world. For more information, please visit our website at www.sahealth.com and select Methodist Specialty and Transplant Hospital under Locations.

In this role you will have the opportunity to support our OR (or CVOR). Key features include:

  • Excellence in Patient Safety Across the Board Award Recipient    
  • Leapfrog “A” Grade for Patient Safety
  • Certified First Assistant readily available for surgeons    
  • Successful Surgical Services, Joint Commission Triennial Survey, with 0 Variances
We offer you a generous benefits package including:
  Medical, Dental, Disability and Life Insurance
  • Flexible Spending Accounts
  • Paid Time Off
  • Employee Discount Program
  • Employee Stock Purchase Program
  • Tuition Reimbursement
  • Student Loan Repayment

As a professional Registered Nurse (RNFA) at Methodist, you would serve as an advocate for the patient and their family. We are looking for RNs who have a passion for serving humanity and want to deliver exceptional care to those they serve.


The Registered Nurse First Assistant (RNFA) provides comprehensive nursing management and care during the perioperative phase and maintains a high level of communication, collaboration, and interaction with physicians and other health team members. Will perform RNFA interventions under the direction and supervision of the operating surgeon in accordance with the AORN and state scope of practice requirements consistent with the mission of the hospital.

Essential Job Functions:

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 appropriate.


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 Registered Nurse as needed by the department; however, does not concurrently perform as the surgical first assistant and registered nurse. 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.



Minimum Education, Experience, Training, Required Knowledge, Skill, Abilities and Other Job-Related Characteristics:


  1. Education:

  • Bachelor ofScience in Nursing OR RNFAs practicing prior to January 1,2020 are not required to have a baccalaureate degree: Professional Associate orDiploma Nursing Program required.

  • Successful completionof an RNFA program that meets AORN standards for RN first assistant educationand is accepted by the National Assistant at Surgery Certification (NASC)


2. Experience: minimum 2 years OR experience  

3. 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).


MinimumLicense, Certificates, or Registrations Required:

  •    RN License to practice as a professionalregistered nursing in the state of Texas or Active Multi-State RN Compact License (Employees with RNCompact License are required to obtain Texas RN License within 90 days of hiredate.)

  •  ACLS Certification
  • CNORCertification

If you find this opportunity to improve the lives of our patients compelling, we encourage you to apply and learn more about how we can work together in “Serving Humanity to Honor God”.

Apply Now


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