HCA, Hospital Corporation of America Certified First Assistant in Hermitage, Tennessee

TITLE: Certified First Assistant

*GENERAL SUMMARY OF DUTIES: *Under the direction of the operating surgeon, the Certified First Assistant contributes to the company’s mission and vision by assisting with the provision of safe and effective nursing care in accordance with a defined scope of practice and the standards and policies of the center that may include: function as first/second assistant to surgeon during the operative procedure, providing aid in exposure, hemostasis, and other technical functions to ensure safe and efficient outcomes, as well as restocking and changing over rooms between cases, and other designated patient care duties as assigned.

SUPERVISOR –Nurse Manager, Surgeon/Supervising Physician, or designee.



OPERATIONAL DUTIES INCLUDE BUT ARE NOT LIMITED TO: * Demonstrates necessary practical, technical or specialized knowledge and skills required for the role of the surgical assistant in accordance with ASA (Association of Surgical Assistants) and

other regulatory standards of practice.
  • Communicates with the surgeon prior to the case to ascertain specific needs. Shares information with the remainder of the surgical team in a timely manner.
  • Assists with patient positioning, skin preparation, and surgical draping according to surgeon’s protocol.
  • Anticipating the needs of the surgeon in order to expedite the procedure, while minimizing the patient’s exposure to surgical and anesthetic stress.
  • Temperature of patient is discussed anesthesia personnel to and methods used to maintain the desired temperature range.
  • Assists the surgeon by providing retraction and aiding exposure of the operative site.
  • Facilitates hemostasis of the surgical site by performing suction, irrigation and sponging the operative site during a surgical procedure.
  • Assists with skin or external suturing and stapling as per surgeon’s directive.
  • Assist with clamping and/or cauterizing vessels or tissue, as directed.
  • Applying hemostatic clips, as needed.
  • Applying tourniquets and demonstrating awareness of the indications/contraindications for use with knowledge of side effects of extended use.
  • Participate in volume replacement or autotransfusion techniques as appropriate.
  • Assists with securing drainage systems and dressings.
  • Provides hemostasis by clamping blood vessels, coagulation bleeding points, ligation of vessels and by other means as directed by the surgeon.
  • Assists with application of dressing splints, and casts.
  • Assists in preparing the operative suite for surgery by checking and gathering supplies, equipment, and instruments.
  • Ensures availability of adequate supplies, equipment and instruments for scheduled cases and assists in opening cases in a sterile manner.
  • Utilizes physician preference cards to set up each case; updates cards when indicated, and routing updated cards in the approved manner.
  • Ensures that instruments are working properly before and after each case.
  • Conscientiously observes and reports any breaks in sterile technique to attending surgeon and RN circulator.
  • Ensures that surgical asepsis is maintained in the handling of instruments, sponges, sutures, drains, needles, and dressings.
  • Ensures accurate sponge, needle, and instrument counts are completed when indicated and prior to patient leaving the OR, as appropriate.
  • Remove drapes at the completion of procedure and assist with preparing patient for transfer to the PACU staff to ensure continuity of care.
  • Facilitates effective and efficient transition between surgical procedures.
  • Assists in the turnover of the O.R. suites between cases, disposing of trash and linens, and cleaning of equipment and environmental surfaces, as required.
  • Utilizes appropriate body mechanics in moving patients, stretchers, and OR tables and other equipment to prevent injury to patient and self.
  • Participates in detailed time out process and ensures it is done according to policy.
  • Assists in the maintenance and care of specimens. Identifies specimen with surgeon and passes specimen to the circulating RN. Verifies correcting labeling, as per policy.
  • Recognizes emergency situations and responds effectively in a calm and controlled manner.
  • Assists circulating nurse during local procedures as assigned.
  • Adheres to Standard Precautions.
  • Utilizes Personal Protective Equipment, as per policy.
  • Remains aware of safety precautions required to minimize the possibility of patient injuries e.g. Prevention of Surgical Fires.
  • Handles instruments and supplies during and after procedure to minimize injury to self and others.
  • Demonstrates knowledge related to maintenance, cleanliness, and sterilization of instruments and equipment. Maintains a sanitary environment for the provision of patient care.
  • Appropriately handles the disposal of biohazardous materials/wastes.
  • Restocks area daily, using appropriate par levels and daily stock sheets, as per facility practice.
  • Prepares procedure room for use the following day by bringing in equipment, setting up, "pulling cases" accurately, and reporting to supervisor items that are needed and not available, as per facility practice.
  • Spends appropriate time and energy on tasks and assignments based on the policies that are supportive of the Center’s goals and objectives.
  • Functions independently according to job responsibilities and within scope of practice utilizing current standards of care.
  • Takes personal initiative to maintain current BCLS, and other required certification (if indicated) current as defined by job role.
  • Uses facility resources appropriately and avoids wasteful practices.
  • Attends all mandatory in-services, staff meetings, and participates in emergency drills.
  • Participates in the orientation of new employees.
  • Completes annual competency and other required education as assigned.
  • Maintains confidentiality of records and patient information at all times.
  • Practices and adheres to the “Code of Conduct” philosophy and “Mission and Value Statement”.
  • While this is intended to be an accurate reflection of the current Position, it is not necessarily an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Management reserves the right to revise the Position or require that other or different tasks be performed when circumstances warrant (i.e. emergencies, changes in personnel or staffing, workload, rush jobs, or technical developments).

Age Specific Care: * The patient care requirements may include those of pediatric, child and adolescent when such patient populations are served, as well as adult and geriatric.

BEHAVIORAL SPECIFIC EXPECTATIONS: · Supports and adheres to all company and Center policies and procedures. · Supports and adheres to HCA Code of Conduct, related Ethics and Compliance policies, and HIPAA requirements.

· Supports and adheres to personnel policies and programs which specify privileges and responsibilities of employment, including compliance with an adverse incident reporting system, quality improvement program, patient safety initiatives, and risk management program. · Participates in Best Practices, Quality/Risk Initiatives, RCA’s and other teams to improve patient care. · Interacts with patients, fellow employees, physicians, and other stakeholders in a manner which encourages quality patient care, harmonious working relationships, positive customer relations, and which enhances the image and reputation of the center. · Demonstrates dependability and accountability. · Demonstrates a willingness to help others. · Supports the center’s mission by providing flexibility in assignment changes, dependability in attendance, punctuality, timely completion of assignments. · Maintains a professional image through proper attire, language, and conduct. · Keeps management informed of any malfunctions in instruments, equipment, and supplies. · Displays willingness to speak up about safety issues or change practices to enhance safety; asks for help when needed; enhances teamwork; follows the safety standards/practices/policies.


  • Maintains current knowledge of surgical procedures and techniques.
  • Knowledge of Standards and Recommended Guidelines of Association of Surgical Assisting (ASA) and Association of Surgical Technology (AST).
  • Ability to identify and select instruments and equipment i.e. fracture tables, head stabilizers, body stabilizers, C-arm extensions and other equipment necessary for surgical procedures and appropriately interpret information on preference cards.
  • Knowledge and high awareness of patient positioning in accordance with surgeon’s instruction, pressure points, impairment of circulation, nerve impingement, and temperature of room.
  • Knowledge of current practice related to hand hygiene, aseptic and sterile technique.
  • Knowledge of current practice of decontamination, high level disinfectant and sterilization procedures.
  • Demonstrates attention to detail by ensuring that all documentation is legible, complete, accurate, and factual.
  • Maintains current knowledge of advances in operating room trends.
  • Knowledge of organizational policies, procedures, systems and objectives.
  • Has knowledge of patient rights and strives to improve patient outcomes by respecting each patient’s cultural, psychosocial, and spiritual values.
  • Knowledge of applicable regulatory, compliance, and accreditation standards and requirements.
  • Possesses critical thinking skills.
  • Demonstrates a willingness to listen to others and openly expresses respect for differing opinions.
  • Demonstrates leadership, effective organizing, and planning skills.
  • Effective problem solving skills to include data analysis and judgment to make effective decisions.
  • Ability to work with minimal supervision.
  • High Impact Communication - Effective oral and written communication skills
  • Computer Skills – Knowledge and basic use of computer skills.
  • Maintains high level of confidentiality at all times.
  • Ability to build trust and gain respect through effective team leadership and participation skills.

*EDUCATION: * * Graduate of a CAAHEP-accredited program in surgical assisting and attain the CSFA credential administrated by theNational Board of Surgical Technology and Surgical Assisting.


· One year experience in an operating room setting; preferably in an ambulatory surgery center.

CERTIFICATION/LICENSE: * Certified Surgical Assistant (CSA)

· Valid BCLS Certification upon employment**online certification not acceptable.


· Work hours are variable based on patient care needs; · Ability to sit and stand for prolong periods of time, ability to walk, some bending, stooping and stretching; · Capability for overhead and low reaching activities; · Requires hand-eye coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, and occasional use of other office equipment; · Requires normal range of hearing/eyesight/voice projection to record, prepare, and communicate appropriately; · Physical strength for equipment needs and patient care activities; may require frequent lifting/moving up to 50 pounds and occasional lifting/moving in excess of 50 pounds; · Ability to move quickly in response to patient needs; · Ability to make constant/frequent judgment/response to problem; · Exposure to noisy equipment; · Subject to varying and unpredictable situations, high stress/pressure, handles emergency or crisis situations, regular interaction with emotional patients and/or family members; · Work is performed in a patient care setting and may involve exposure to infections, communicable diseases and hazardous materials, radiation/laser, waste gases and blood and body fluids. Frequent exposure to water and chemicals used in disinfection/sterilization process.

Title: Certified First Assistant

Location: Tennessee-Hermitage-Summit Surgery Center

Requisition ID: 09884-54363