Job Summary: Provides assistance to the surgical team during the intra-operative phase of surgical care for the Northwest Surgical Services region. Works in collaboration with the surgeon and health care team in the performance of surgical procedures, including assessment, planning, directing, providing and evaluating advanced nursing care. All RNFAs will participate in a regional on-call rotation to provide surgical assistance for elective, emergent and urgent surgical cases. Essential Responsibilities: • Representative Functions or Duties: Practice standards of performance: Pre-operative. Performs pre-operative assessment and evaluation. Collaborates with the surgical team on plan of care. Intra-operative: Provides knowledge based technical assistance to the surgeon during the operative procedure according to AORN standards, licensure, state regulation and facility/practice protocols, including: Using instruments and medical devices. Providing surgical exposure. Handling and/or cutting tissue. Providing hemostatis, clamp, cut, and ligate tissue as directed by the surgeon. Suturing as directed by the surgeon. Post-Operative. Evaluates the patient post-operatively according to facility protocols. • Assessment Standard of Performance & Planning: Communicates information so that continuity of care is maintained. Communicates with patient, family and other staff in a professional and courteous manner. Obtains and demonstrates the skills and knowledge needed to provide appropriate population based and culturally sensitive care to patients and families through education, training and experience. Provides continuous reassessment through the intra operative period. Utilizes knowledge of type of procedure to plan for appropriate set up. • Practice standards of performance: Function as an assistant in all surgical specialties at the direction of the attending surgeon. Performs RNFA responsibilities in accordance with the Nurse Practice Act of the State of Oregon, institutional policies and procedures of Kaiser Permanente and the AORN Position Statement on RN First Assistants. Practice within limitations of preparation and experience. Demonstrate RNFA specific clinical skills. Review and update skills checklist on an ongoing basis as specified by policies of Kaiser Permanente. Intra operative nursing behaviors include: handling tissue, providing exposure, using instruments, clamp, cut, and legate as directed by the surgeon, providing homeostasis, suturing as directed by the surgeon. Assists with room preparation in collaboration with the Circulating Nurse and scrub person. Brings patient X-rays into room NOTE: Notifies Charge Nurse or designee if films are not available. Assists in patient transport to the operating room and patient transfer to the operating room table. Provides assistance to Anesthesia during induction. Participates in pre-op briefing time out process. Assists in patient position. Assists in patient preparation, i.e., prepping, catheterization, shaving, as necessary. Assists in patient draping. Sets up ESU, lights, suction for the sterile field. Monitors free counted items on the sterile field. Observes for breaks in sterile technique and takes appropriate action as necessary. • Assists with instrumentation and equipment as requested. Applies dressings and secures drainage tubes. Assists with patient transfer and positioning post operatively. Assists with room tear down and turn over in collaboration with the Circulating Nurse and scrub person. May perform pre and post-operative patient education as designated. Review chart for pertinent data. Assist in maintaining a safe environment and promoting efficiency in surgical. Procedures.