Registered Nurse First Assistant (RNFA)
Program Description
The Registered Nurse First Assistant (RNFA) is a perioperative registered nurse (RN) or an Advanced Practice Registered Nurse (APRN) who functions in an expanded role as a surgical first assistant. The RNFA works in collaboration with the surgeon and other health care team members to achieve optimal patient outcomes; utilizes the necessary knowledge, judgment, and skills specific to the expanded role of RNFA clinical practice; and practices intraoperatively at the direction of the surgeon” (AORN, 2015).
The RNFA role is recognized within the scope of nursing practice by the nurse practice acts in all 50 states and may vary depending on patient populations, the environment in which the RNFA practices, services provided, availability of fiscal resources including reimbursement policies, and institutional credentialing regulations. (AORN, 2015).
RNFA Program Outcomes
Upon successful completion of the RNFA program, the RN or APRN is able to:
- Explore potential surgical hazards and safety measures to prevent injury including patient and occupational related hazards.
- Explain the design and use of key surgical instruments used for surgical procedures.
- Demonstrate knowledge of common surgical procedures incorporating an understanding of anatomy, physiology and pathophysiology.
- Demonstrate proper sequence of procedures, assisting behaviors, operative technique and knowledge of potential complications related to the surgical procedure.
- Exhibit proper handling and knowledge of surgical instruments and medical devices, providing surgical site exposure, handling tissue, cutting tissue, providing hemostasis, suturing, and wound management.
- Develop a continuous and applicable nursing assessment, plan of care and patient evaluation throughout the perioperative period in collaboration with other health care providers.
- Document intraoperative patient management in the surgical first-assisting clinical experience.
- Document postoperative patient management such as participation in postoperative rounds and assisting with discharge planning including identification of appropriate community resources intraoperative clinical experiences precepted by Board-Certified Surgeons.
Course Requirements
| Course ID | Title | Credits |
| RNFA 540G | Surgical Techniques (Online - Fall)* | 3 |
| RNFA 541G | Advanced Perioperative Nursing I (Online - Spring) | 3 |
| RNFA 542G | Advanced Perioperative Nursing II (Spring or Summer)** | 3 |
| Total | 9 |
* One week (40 hours) on-campus simulation workshops offered during Fall term.
**180 clinical hours of perioperative practicum in Spring or Summer term precepted
by Board-Certified Surgeons in area of student residence.
- Individual course details and descriptions can be viewed in the College of Nursing section of the 2022-2023 Academic Bulletin.
Technical & Performance Standards
Students in the RNFA certificate program must meet the Technical and Performance Standards expected of all students in the College of Nursing educational programs. In addition, RNFA program students are expected to possess the mental, auditory, visual, sensory, strength, manual dexterity, and communication skills to:
- Manage common, acute, and life-threatening problems encountered with patients in the perioperative setting.
- Nurture interprofessional relationships that promote optimal patient care.
- Collaborate with the surgeon and other interprofessional team members to achieve optimal patient outcomes.
- Develop the necessary knowledge, judgment, and skills specific to the expanded role of RNFA clinical practice.
- Utilize evidence-based care for meeting the needs of perioperative patients.
- Performs comprehensive health assessments of perioperative patients.
- Fosters patient advocacy and safety.
Accreditation
UTHSC RNFA program meets AORN educational standards and is recognized by National Assistant at Surgery Certification (NASC) as an acceptable program for the CRNFA examination.
One Student's Story
When Wesley Gray, DNP, ACNPC-AG, RNFA; decided to pursue his Doctor of Nursing Practice degree at UTHSC, he also chose to take advantage of a unique certificate program offered by the university – the Registered Nurse First Assistant (RNFA) certificate.
“With my RNFA certification, I am open to many more career opportunities. Being able to scrub in with a surgeon inside the operating room is a skillset that is in high demand,” Gray said.
UT Health Science Center is the only college in Tennessee that offers an RNFA approved by the National Association of Assistants at Surgery. “Going through the RNFA program helped me gain a deeper understanding of what patients go through during surgery,” he said. “The RNFA program was a worthwhile addition to my time at UT Health Science Center.”
Admission Eligibility
Applicants must have: (1) current unencumbered RN license, (2) BCLS, ACLS (required), (3) minimum cumulative Grade Point Average of 3.0 or higher or a cumulative GPA of at least 3.2 earned during the applicant's most recently completed degree program; AND (4) one of the following:
- BSN (CNOR/CNOR eligible required prior to the start of the RNFA program)
- MSN/DNP/PhD with APRN certification
- BSN/MSN/DNP/PhD seeking APRN and/or CNOR certification
To be awarded a Certificate of Completion you must successfully complete the 3 RNFA courses (9 credit hours).
Application deadline is March 1
Applicants should contact the Office of Student Affairs at 901-448-6139 for questions on state authorization. Students accepted into certificate programs are not eligible for federal financial aid.
See complete admission requirements
on NursingCAS. A fee of $70 is charged for application.