Duke Careers
Location
Durham, North Carolina
The RNFA provides expert intraoperative first assistance, including tissue handling and suturing, to support surgeons and surgical residents. They also manage preoperative evaluations and postoperative care coordination to ensure continuity of care for perioperative patients.
Requires a BSN and at least 3 years of experience in perioperative nursing. Candidates must hold a current North Carolina RN license, BLS, and CNOR certification, with RNFA or CSFA certification required or obtainable.
Expert intraoperative first assistance Support and education for surgical residents Second assist coverage across multiple specialties Leadership and clinical guidance for perioperative staff Seamless coordination of care for patients of all ages
In this fast‑paced academic environment, RNFAs at Duke participate in complex and innovative surgical procedures while contributing to an exceptional patient and team experience.
Work Performed To provide preoperative patient management in collaboration with other health care providers, including, but not limited to: preoperative evaluations, communicate/collaborate regarding the patient plan of care, writing preoperative orders according to established protocols; intraoperative surgical first assisting, including, but not limited to using instruments/medical devices, providing exposure, handing and/or cutting tissues, providing hemostasis, and suturing; postoperative patient management in collaboration with other health care providers in the immediate postoperative period including, but limited to writing postoperative orders/operative notes according established protocols, participating in postoperative rounds, and assisting with discharge planning. To provide a qualified CRNFA to the operating surgeon during the operative procedure and comprehensive nursing management of care during the Perioperative phase. The CRNFA does not concurrently function as the Scrub Nurse. Preoperative Patient Management
Conduct preoperative assessments and screenings Participate in planning and coordination of individualized care plans Collaborate and communicate with the surgical team Write preoperative orders according to established protocols
Intraoperative First Assisting Provide skilled and safe intraoperative assistance, including:
Using surgical instruments and medical devices Providing optimal exposure of the surgical field Handling and/or cutting tissues Achieving hemostasis Suturing and closing incisions Anticipating surgical needs to support efficient workflow
The RNFA does not simultaneously function as the Scrub Nurse. Postoperative Patient Management
Write postoperative orders and operative notes based on protocol Participate in postoperative rounds and clinical evaluation Assist with discharge planning and transitions of care Collaborate with multidisciplinary teams to support positive outcomes
CRNFA must have sound clinical knowledge of technologyand treatment applications; must also possess skills to educate/train staff, and complies with AORN education standards for the CRNFA;, and a demonstrated knowledge of the surgeries in which the CRNFA participates. Must have sound clinical OR skills (scrubbing and circulating) and have excellent interpersonal skills and organizational capability. Level Characteristics CRNFA must have sound clinical knowledge of technology and treatment applications; must also possess skills toeducate/train staff, and complies with AORN education standards for the CRNFA;, and a demonstrated knowledge of the surgeries in which the CRNFA participates. Must have sound clinical OR skills (scrubbing and circulating) and have excellent interpersonalskills and organizational capability.
Education BSN required, MSN preferred. Must be a graduate of an accredited school of Nursing. Completion of a RNFA (or CSFA program, if hired prior to 2/1/26) that includes didactic and supervised clinical practice, is based on AORN's core curriculum for the RNFA. Experience 3 years of experience in Perioperative Nursing is required. Degrees, Licensures, Certifications Must have current or compact RN licensure in the state of North Carolina. BLS required. Successful completion of the CNOR exam required. Must currently possess RNFA (Registered Nurse First Assist) certification or obtain within two years of employment. CSFA (Certified Surgical First Assistant) certification accepted in lieu of RNFA, if hired prior to 2/1/26. Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status. Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values. Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
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