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The role of the registered nurse first assistant within the perioperative setting

11 February 2021
Volume 30 · Issue 3


Perioperative setting registered nurse first assistants (RNFAs) are described as non-medical practitioners who perform surgical interventions during surgery. They provide medical care to perioperative patients under the supervision of a consultant surgeon. First assistants in surgery can be an expanded perioperative nursing role. A review of the literature illuminates the need for continuous learning in developing skills in becoming competent RNFA practitioners and how they utilise acquired skills to assist, mentor and teach their colleagues within the perioperative setting. The RNFA is an advanced and expanded practice role. RNFAs contribute significantly to the provision of care within all phases of perioperative care (preoperative, intraoperative, postoperative). There is little literature on the role of the RNFA due to its relatively recent emergence in the healthcare sector and the small number of countries where it is implemented.

Advanced practice in nursing has been described as a means of expanding nursing care that enhances patient safety and improves the quality of patient care (Zarnitz and Malone, 2006; Association of periOperative Registered Nurses (AORN), 2013a; Boyle et al, 2014). The introduction of the European Union Working Time Directive reduced working hours for junior doctors, changed medical training, and increased the demand for non-medical staff to undertake assisting roles intraoperatively. These directives recommended that nurses and allied health professionals undertake expanded practice roles, including the registered nurse first assistant (RNFA) (Al-Hashemi, 2007; Timpany and McAleavy, 2010; Quick et al, 2014; Abraham et al, 2016; Simpson, 2017).

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