The RN first assistant at surgery collaborates with the surgeon and the health care team in performing a safe operation with optimal outcomes for the patient. The RN first assistant practices perioperative nursing and must have acquired the necessary knowledge, skills, and judgment specific to clinical practice. The RN first assistant practices in collaboration with and at the direction of the surgeon during the intraoperative phase of the perioperative experience. The RN first assistant does not concurrently function as a scrub nurse. The scope of practice of the nurse performing as first assistant is a part of perioperative nursing practice.
Perioperative nursing is a specialized area of practice.
The activities included in first assisting are further refinements of perioperative nursing practice which are executed within the context of the nursing process. The observable nursing behaviors are based on an extensive body of scientific knowledge. These intraoperative nursing behaviors may include handling tissue, providing exposure, using instruments, suturing, and providing hemostasis. These behaviors may vary depending on patient populations, practice environments, services provided, accessibility of human and fiscal resources, institutional policy, and state nurse practice acts. The decision by an RN to practice as a first assistant must be made voluntarily and deliberately, with an understanding of the professional accountability that the role entails.