Fact Sheet


The RNFA can...

» Assist for all types of surgery, from general surgery, urology and gynaecology to orthopaedics, cardiac and neurosurgery.

» Obtain a client's history and perform a health/physical assessment.

» Provide client support.

» Initiate the perioperative* nursing plan of care in collaboration with the client and family and communicate this to the operating room staff.

» Provide client/family/community teaching. This may occur when surgery is recommended in a surgeon's office or clinic, or immediately before or after operations.

» Perform post-operative assessments.

» Perform post-operative follow-up telephone calls to assess patient pain, mobility, potential complications, coping mechanisms, etc.

» Monitor wound management for tissue healing and surgical site infection.

» Work effectively as a multi-disciplinary team member.

» Evaluate the effectiveness of care.

» Participate in research.

Summary Statement

The RNFA assists with patient care throughout a client's perioperative experience.

Did you know that a RNFA…

1. Completes a formal educational process.

» To graduate as a RNFA, one must be a Registered Nurse with operating room experience and have attained certification as a perioperative nurse [CPN(C)].

» In Canada, there are two RNFA programs, one in French (Quebec) and one in English. In the United States, there are approximately 14 RNFA programs.

» Most RNFA programs are based on the following model:
    » Distance education component (12 - 16 weeks)
    » Didactic component (one week, classroom/lab)
    » Mentored clinical internship (120 - 175 hours)
    » Earn 6-12 university credits*

2. Functions within the scope of nursing practice.

» In July 1999, The College of Nurses of Ontario (CNO) acknowledged the role of RNFA to be within the scope of practice of nursing**. The additional knowledge, skill and decision making abilities required for the RNFA role can be acquired through a formal first assistant educational program that includes a surgeon-mentored clinical component. No additional regulatory or legislative authority is required for RNs to practice in the role of surgical first assistant.

3. Is accountable for his/her practice.

» Liability/malpractice protection is available through the Canadian Nurses Protective Society (CNPS) for RNFAs (and all registered nurses) who are members in good standing with the Registered Nurses Association of Ontario (RNAO). The Legal Assistance Program is an additional voluntary program to assist RNs with certain legal problems arising from work-related circumstances. Another optional benefit for those who want to supplement their CNPS protection is NurseInsure, a malpractice insurance plan. For more information on any of these programs, contact RNAO (416) 599-1925.

Summary Statement

The accountability of the RNFA is supported by comprehensive education, regulation by the CNO and liability protection by RNAO.

Did you know...?

The RNFA works collaboratively with the surgeon to produce positive outcomes for the patient.

» Many operative procedures require a surgical assistant.

» A shorter operation correlates with improved patient outcomes*.

» The shortage of general practitioners that traditionally function as the assistant during surgery has facilitated the introduction of the RNFA as a viable alternative. In some instances, the family physician chooses not to act as the surgical first assistant. Several hospitals in Ontario have designated funding for RNFA positions through their global budget.

» With their previous operating room nursing experience, RNFAs bring a unique perspective to the assistant's role. Understanding the patient's perioperative experience, coupled with specific knowledge of a surgeon's preferences, helps to facilitate a quicker, smoother operative experience for the patient.

» The RNFA works collaboratively with the surgeon, anaesthesiologist, nursing, medical and auxiliary staff, and can play an important role in the learning experiences of nursing and medical students.

Summary Statement

The RNFA works collaboratively with all health care workers to provide high quality, consistent perioperative care.