Registered Nurse First Assist

Summary

The First Assist Registered Nurse (RN) is a proficient nurse who demonstrates proficiency in decision-making and using the nursing process for complex situations that affect performance outcomes at the point of care. Practice is enhanced through the development of collegial relationships. Demonstrates collaboration by using the group process to solve problems.

Duties

The First Assist Registered Nurse (RN) is a proficient nurse who demonstrates proficiency in decision-making and using the nursing process for complex situations that affect performance outcomes at the point of care. Practice is enhanced through the development of collegial relationships. Demonstrates collaboration by using the group process to solve problems. The focus is on leadership in strategically planning long-term goals for the microsystem (unit, team, or workgroup) that impacts operations or resources. They demonstrate critical thinking with efficiency and accuracy in assessing and managing situations. First Assist RN's, function in an expanded perioperative nursing role. When performing delegated medical functions, First Assist RNs are practitioners who are agents of the supervising physician(s)/independent licensed practitioner(s) who are responsible for the First Assist RN's actions within the agreed upon scope of practice. The supervising physician/independent licensed provider is to direct and review the work and practice on a continuous basis to ensure that appropriate directions are given and understood, and appropriate care is rendered. The First Assist RN must have acquired the necessary knowledge, judgment, and skills specific to the expanded role of First Assist RN clinical practice. Duties include, but are not limited to: Delivers fundamental, knowledge-based perioperative nursing care to assigned patients, developing technical skills based on age-specific components and patient needs. Assesses, plans, implements, and evaluates nursing care for patients in the perioperative setting, with a focus on education, safety, satisfaction, and self-management throughout the surgical continuum. Applies professional nursing practice as an RNFA, including all validated competencies and functions delegated by the supervising surgeon. RNFA duties include: Assisting in patient positioning and prepping/draping of the surgical site Providing exposure through tissue manipulation, using surgical instruments, suctioning, and retraction Controlling bleeding and providing hemostasis using standard and advanced technologies (e.g., electrosurgical units, ligatures, suture, topical agents, argon beam, bipolar/ultrasonic devices) Suturing and stapling of tissue, and closure of surgical wounds and application of dressings including wound vac therapy Making skin incisions, creating laparoscopic access (stab wounds/trocars) as allowed by the State Board of Nursing Placing and securing drains, inserting and removing surgical instrumentation (including robotics) Application and removal of casts and splints Harvesting veins and arteries for bypass conduit as delegated Administration of local anesthetic under surgeon direction Cleansing surgical site (superficial, subcutaneous, muscle/fascia, bone, abdominal/pelvic cavities) Removal of surgical drains (chest tubes, orthopedic/joint drains) Other intraoperative, preoperative, and postoperative RNFA tasks as permitted by certification and defined by hospital policy. Note: This functional statement serves as a summary of major duties, responsibilities, and qualification requirements for the RNFA. Additional duties may be assigned at the discretion of the supervisor or owing to patient care needs. Validation of RNFA competency is required before assignment of RNFA-specific responsibilities. VA offers a comprehensive total rewards package: VA Nurse Total Rewards Pay: Competitive salary, regular salary increases, potential for performance awards Paid Time Off: 50 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year) Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement) Licensure: 1 full and unrestricted license from any US State or territory Work Location: VA St. Louis Health Care System - John Cochran Campus Work Schedule: Monday - Friday 6:30 AM to 3:00 PM with required on-call rotation Telework: Ad-Hoc, as determined by agency policy. Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized

Qualifications

Basic Requirements: English Language Proficiency. In accordance with 38 U.S.C. 7403(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English. Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE); OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. Upon achievement of a State license, the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program. (Reference VA Handbook 5005, Appendix G6); OR In cases of graduates of foreign schools of professional nursing, possession of a current, full, active, and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program. Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD). Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia. Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements, but do not possess the required licensure, may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.) NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and performing the duties as described in the qualification standard on the effective date of the standard (1/29/2024) are considered to have met all qualification requirements for the grade held including positive education and licensure/certification. Grade Determinations: The following Scope, Education and Dimension criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade. The Dimension requirements (Practice, Veteran/Patient Driven Care, Leadership, Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment: https://apply.usastaffing.gov/ViewQuestionnaire/13082734. Grade/Level Scope Education Nurse I, Level I Delivers fundamental, knowledge-based care to assigned clients while developing technical competencies. An Associate Degree (ADN) or Diploma in Nursing, with no additional professional nursing required. Nurse I, Level