Mercy Health

  • RN - First Assistant, Full time

    Requisition ID
    Position Type
    Full Time
    Days, Varies/Rotating
    Operating Room Routine
  • Overview



    We’re a Little Different


    Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service.


    At Mercy, you’ll feel our supportive community every step of your day, especially the tough ones. We’re a team and love working that way. We have opportunities for nurses who are inspired to pioneer new models of care and want to transform the healthcare experience. Work with advanced technology and innovative procedures. Be state of the art, and never stop exploring. We’re expanding to help our communities grow, offering an exceptional opportunity to join our team.


    *For more about Washington, MO, please visit



    1. The RN will utilize the nursing process in perioperative practice
    1.1 A thorough assessment of the patient’s data will include physical, emotional, developmental, social,
    intellectual, cultural, and spiritual information. The assessment will be documented on the patient’s record
    during the perioperative phase.
    1.2 The RNFA will organize the patient data and identify Nursing Diagnosis, and formulate a perioperative nursing care plan in collaboration with the RN circulator or other perioperative
    1.3 The RNFA implements and coordinates the implementation of the care plan by performing nursing
    interventions and coordinates the nursing care throughout the patient’s entire
    perioperative experience..
    1.4 A written plan of care is developed based on identified patient problems and needs.
    1.5 The RNFA will continue to contribute to the patient’s evaluation and care through discharge of the patient.
    The RNFA will work in collaboration with other RN’s in area where the RNFA’s expertise can contribute
    to the patient’s care planning and outcomes.
    1.6 Supervises personnel team actions to promote readiness and timeliness for surgical procedures.

    2. The RNFA is aware of the appearance of various tissues and structures as they become visible during dissection techniques. The RNFA can anticipate expected locations of tissue planes, neurovascular bundles, and visceral structures. Understand the physiological consequences associates with manipulation or destruction of normal anatomy. For each surgical intervention within the RNFA experience and practice, the RNFA will:.
    2.1 Have knowledge of anatomy involved.
    2.2 Demonstrate understanding important nursing interventions related to the particular intervention such as positioning, skin prep, draping, special suture requirements, and special instrument and equipment needs.
    2.3 Identify unique first assisting requirements.
    2.4 Plan for wound closure in collaboration with surgeon.
    2.5 Plan for special postoperative needs for the patient.
    2.6 Determine methods of evaluating patient outcomes and document.

    3. The RNFA will apply principles of asepsis and infection control. RNFA has advanced knowledge in principles of wound healing, wound classification system, microbial transmission, and understanding of microorganisms of surgical importance. The RNFA serves as a resource to other perioperative staff members. .
    3.1 Proper OR attire is worn at all times according to written policy.
    3 2 Staff members follow established procedure for surgical hand scrub.
    3.3 Strictly adheres to principles of aseptic technique..
    3.4 Understands barriers to microbial transmission.
    3.5 Monitors for breaks in aseptic technique.
    3.6 Recognizes normal body defenses and identifies risks and compromised defenses.
    3.7 Keeps current on practices and techniques in the above area by reading reports, journals, and
    attendance in advanced educational offerings.
    3.8 Universal precautions and infection control guidelines are followed

    4. The RNFA has a working knowledge of methods of providing wound exposure
    4.1 The operative procedure, stage of operation, physical characteristics of the patient, types of tissue,
    location of tissue, anatomy, pathophysiology, and fragility of the tissue are considered when planning
    and implementing wound exposure techniques.
    4.2 The RNFA uses manual and retraction instruments appropriately and properly.
    4.3 The RNFA improves visualization of site with proper and appropriate suctioning techniques to avoid
    tissue trauma or aspiration injury.
    4.4 The RNFA improves visualization with appropriate and proper sponging techniques.

    5. The RNFA has a working knowledge of methods of providing hemostasis. Utilizes the
    following techniques appropriately and properly:
    5.1 Manual hemostasis
    5.2 Instruments for homeostasis including hemostasis, clips, and vascular devices.
    5.3 Chemical agents such as gelatin sponge, collagen sponge, oxidized cellulose, microfibrillar collagen, and
    topical bovine thrombin.
    5.4 Electrosurgery
    5.5 LASER surgery

    6. The RNFA has a working knowledge of wound closure
    6.1 Performs or assists suturing techniques: continuous, interrupted, subcuticular, simple, purse string,
    retention, figure-8, staples, skin closure tapes, knot-tying techniques.
    6.2 Plans appropriately for suture materials and needle types.

    7. Assists in the care of equipment and supplies to insure availability when needed
    7.1 Cleans the room and carefully removes equipment, according to infection control procedure, and to
    insure safety, after procedure is terminated
    7.2 Assists and knows procedure for cleaning, sterilizing, and storing instruments and equipment, according  to procedure to insure availability and safety.
    7.3 Assist with inventory once a year as assigned, and daily by reporting and documenting use of supplies
    and malfunctioning equipment, upon discovery, to insure availability when needed.
    7.4 Assures that consignment instruments and implants are available prior to case start

    8. Demonstrates effective and accurate verbal, written and electronic communication
    8.1 Creates a positive climate for communications.
    8.2 Takes ownership in resolving conflicts appropriately in the work place.
    8.3 Maintains the confidentiality of patient, staff, and hospital information from written, verbal, electronic
    8.4 Communication is timely, accurate, concise, complete, and appropriate with proper body language.
    8.5 Utilizes constructive problem solving techniques to promote change and deal with issues.
    8.6 Follow established channels for addressing issues, concerns, and problems.
    8.7 Documentation of the Nursing Process is completed according to organizational policies and
    8.8 Maintains relevant knowledge of hospital forms, and completes in a timely, accurate and complete
    manner. ( i.e. Quality Improvement reports, Patient care documentation forms, co-worker/patient incident
    reports, etc.)
    8.9 Actively participates in achieving units patient satisfaction goal.

    9. Participates in unit and organizational activities
    9.1 Participates in at least 75% of staff meetings.
    9.2 Participates in Process Improvement activities such as data collection, in-services, and meetings as
    appropriate and required.
    9.3 Participates in a hospital committee, special project or service (i.e. preceptor to student or new co-
    worker, care management) as requested.
    9.4 Reads communication book and looks at e-mail at least weekly.

    10. Demonstrates effective patient safety techniques
    10.1 Attends all mandatory in-services.
    10.2 Complies with all organizational policies, procedures and protocols with no documented violations.
    10.3 Maintains current certification in CPR, CNOR or (CRNFA if eligible).
    10.4 Complies with JCAHO patient safety goals. Adheres to OSHA standards regarding appropriate safety
    regulations and procedures.
    10.5 Complies with medication administration as per hospital policies and procedures.
    10.6 Performs patient hand offs utilizing patient safety tools (SBAR, Report at Bedside, etc.) both from shift-
    to-shift and interdepartmentally.

    11 Demonstrates professional conduct and development
    11.1 Uses current knowledge achieved through research, evidence based practice oreducational activities
    to enhance or improve clinical practice or patient care.
    11.2 Establishes goals and objectives with each annual performance appraisal, and provides evidence for
    goal attainment from previous evaluation period.
    11.3 Completes Hospital and nursing competency within 3 months of employment and annually within
    required time frame, submits to Nurse Manager.
    11.4 Maintains hospital property and the hospital environment in a safe, clean and intact condition per SJMH
    policy and procedure.
    11.5 Accepts responsibility as charge nurse as indicated.
    11.6 Maintains knowledge base required to provide professional standard of care.The nurse will be
    responsible for individual professional growth and development,demonstrating that growth by:
    (1) ability to care for more complex patients and daily assignments;
    (2) ability to care for more complex patient care issues and consistently act as a resource person for
    colleagues; and
    (3) effectively serve as role models, and/or preceptors




    Licensure: Must have either a current RN Temporary Permit/RN license in the State of Missouri.

    Experience: Minimum of two (2) years intraoperative experience with documentation of proficiency in perioperative nursing practice as a scrub and circulating nurse.
    Certifications: CNOR and RN-First Assistant class required within one year of hire/transfer. BLS/ACLS required within first year.


    We’ll Support You at Work and Home


    Getting respect doesn’t come easy in healthcare. Modern Healthcare Magazine named us as a “top 100 places to work.” We go out of our way to help people feel welcomed. We offer day-one comprehensive health, vision and dental coverage, PTO, and employer-matched retirement funds, even to part-time employees. We’re proud to provide tuition reimbursement to help you grow and learn new skills.



    What Makes a Good Match for Mercy


    Compassion and professionalism go hand-in-hand with us. Having a positive outlook and a strong sense of advocacy is in perfect step with our mission and vision. We’re also collaborative and are not afraid to do a little extra to deliver excellent care-that’s just part of our commitment. If that sounds like a fit for you as well, we encourage you to apply.


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