Practice Questions Related to Registered Nurse First Assistant (RNFA)

Registered Nurse - First Assistant (RNFA)

At its December, 1995 meeting, the Board adopted the Association of Operating Room Nurses (AORN) Recommended Education Standards for RN First Assistant Programs, and determined that an advanced practice registered nurse does not automatically qualify as a registered nurse first assistant in the operating room but must meet the same requirements as set forth in the AORN's recommended standards.

At its March 11-12, 2015 meeting, the Board reviewed the 2014 AORN Position Statement on Advanced Practice Registered Nursing in the Perioperative Environment and the Position Statement on the Certified Nurse-Midwife//Certified Midwife as First Assistant during Surgery by the American College of Nurse-Midwives (ACNM) and determined that a certified nurse midwife must provide documentation of appropriate education, training and demonstrated competency as a first assist based on facility/organization policies and procedures and credentialing processes or complete a registered nurse first assist program prior to functioning in the perioperative setting and assisting with cesarean birth, tubal ligation, and other OB/GYN surgery.

Endoscopic Gastrostomy

The Board at its February 16-17, 1994 meeting reiterated its position with respect to RN First Assistants and percutaneous endoscopic gastrostomy. The RN First Assist may assist during surgery, but may NOT perform this procedure.

History and Physical

The Board at its June 15-16, 1993 meeting determined that it is not within the scope of practice of a RN First Assistants to (1) take histories and perform physical exams; (2) make patient rounds; and (3) write medical orders.

The Board at its February 16-17, 1994 meeting clarified that the intent of the Board was to disallow the RN First Assistant in the O.R. from being utilized as a physician extender, i.e. performing the history and physical examination that is clearly the physician's responsibility.