Provides direct patient care to an assigned group of patients, assesses, and evaluates and implements patient’s plan of care for an assigned period of time. The team leader manages the service line teams including robotics and orthopedics and provides effective guidance. Acts as the point person for all team members and services within the service lines. Proactively ensures smooth team operations and effective collaboration.  Sets clear goals and delegates tasks and deadlines. Creates an inspiring team environment with an open-communication culture. Demonstrates Competency and Professional Responsibility in the Team charge role. Performs and provides aid in exposure, hemostasis, closure and other intraoperative technical functions that help the surgeon carry out a safe operation under the direction and supervision of the surgeon and in accordance with hospital policy and procedures. Plays a hands-on role in surgical procedures by controlling bleeding, suturing incisions and wounds and intervening if complications arise.

PRINCIPAL DUTIES AND RESPONSIBILITIES (*Essential Functions)

1. Administers medications within the scope of practice and the hospital’s policies and procedures.
2. Assesses, evaluates, interprets and documents the patient’s physical and mental status.
3. Communicates the patient’s status with other health care disciplines.
4. Coordinates and develops the patient’s plan of care with all health care disciplines.
5. Performs and assists with medical and nursing procedures.
6. Provides pertinent health care education to patients and patient’s family.
7. *Positioning the patient:- Points of pressure shall be padded; elbows, heels knees, eyes, face and axillary region.                                         - Circulation shall not be impaired.- Nerve damage shall be guarded against.                                                                                            - The temperature of the patient should be discussed with the anesthesia personnel and methods employed to maintain the desired temperature range.                                                                   
8. The RN First Assistant shall be familiar with common positions related to the surgical procedure and will be able to use the equipment necessary to provide the Competencies that will include the following:                  - Fracture tables; Head stabilizers; Body stabilizers; C-arm extensions; Any other equipment needed.
9. Upon completion of the procedure, the patient shall be evaluated for any possible damage from positioning which will include assessment of the skin. The abnormal condition shall be reported to the surgeon and treatment and documentation shall be carried out.
10. Providing visualization of the operative side by the following: Appropriate placement and securing of retractors with or without padding; Packing with sponges; Digital manipulation of tissue; Suctioning, irrigating or sponging; Manipulation of suture materials (i.e., loops, tags, running sutures); Proper use of body mechanics to prevent obstruction of the surgeon’s view.
11. Utilizing appropriate techniques to assist with hemostasis:                    - Permanent: Clamping and/or cauterizing vessels or tissue; Tying and/or ligating clamped vessels or tissue; Applying hemostatic clips; Placing local hemostatic agents                                                          - Temporary: Applying tourniquets and demonstrating awareness of the indications/contraindications for use with knowledge of side effects of extended use; Applying vessel loops; Applying non-crushing clamps; Applying direct digital pressure; Participating in volume replacement in auto-transfusion techniques as appropriate; Placement of needles for x-ray on spine cases as directed by the surgeon; Insertion of implants; i.e., screws, plates as directed by the surgeon; Use of power equipment under the direction of the surgeon. 
12. Utilizing appropriate techniques to assist with closure of body planes: Utilizing running or interrupted sutures with absorbable or non-absorbable material of wound layers, including muscle and fascia; Utilizing sub-cuticular closure technique with or without adhesive skin closure strips; Closing skin with method per surgeon’s directive (suture, staples, etc.); Postoperative subcutaneous injection of local anesthetic per surgeon’s directive; Placement of trocars during laparoscopic procedures under the direction of the surgeon; Suturing of large vessels; Postoperative subcutaneous injection of local anesthetic per surgeon’s directive. 
13. Selecting and applying appropriate wound dressings, including the following: Liquid or spray occlusive materials; Absorbent material affixed with tape or circumferential wrapping; Immobilizing dressing (soft or rigid); Place tourniquet or extremity as directed by surgeon; Providing assistance in placing and securing drainage systems to tissue; Radial and saphenous vein harvest, including skin incision, per surgeon’s directive; Participating in resuscitation of patient during cardiac arrest or other life-threatening events in the operating room; Assist the surgeon in dissecting common femoral artery and bifurcate per surgeon’s directive. 
14. Documents on the Operating Room Record his/her first assistant role in the operative procedure under the designated category of “assistant.”   
15. Respects the right of the patient to privacy. Recognizes and respects the dignity of the patient during treatments/examinations. 
16. Upholds the wishes of the patient to be alone with self and family if not medically contraindicated. Limits discussion of health status of patient to only those involved in direct patient care. Supports and respects the decision of the patient and family regarding interventions of other treatment modalities. 
17. Supervise a team of nurses and act as a liaison between staff nurses, other supervisors, and hospital administration. Develops and posts appropriate work, staff, and break/lunch schedules. Schedules staff meetings. Trains, motivates, and conducts performance evaluations on team.
18. Anticipates physician needs and complies with hospital policy for receiving doctor’s orders, including verbal and phone. Implements the Plan of Care and follows orders as developed by the Provider. Evaluates nursing interventions on medical records.
19. Complies with policy regarding risk management and handling Medical Emergencies. Insures standards of patient care through QA monitors.
20. Works on assigned projects under the direction of the department supervisor in keeping productivity costs within certain standards. Directly orders the necessary supplies. Utilizes a lean approach for case cart management. Works with staff to ensure they have access to the necessary supplies and equipment needed for procedures.
21. Effectively problem-solves for self and other personnel on shift.
22. Communicates problems involving personnel, medical staff, patients, families and the general public to the appropriate management personnel.
23. Performs other duties as needed and/or assigned. 

JOB SPECIFICATIONS (Minimum Requirements)

KNOWLEDGE, SKILLS, AND ABILITIES

Certification as a Registered Nurse First Assistant

Thorough knowledge of a variety of medical equipment.

Excellent oral and written communication skills and critical thinking skills.

Ability to administer medications per policy and procedure.

Ability to follow the National Patient Safety Goals.

Ability to interpret lab and diagnostic results as it relates to patients status.

Ability to communicate with all disciplines using SBAR.

Ability to multi task.

Demonstrates courteous, kind and a caring, compassionate, positive attitude and support to the organization.

Strong leadership and organization skills.

An ability to communicate in a calm, empathetic, and assertive way.

EDUCATION

All post high school education must have been obtained from a recognized College or University.  Additional education or related experience may be substituted for requirements on a year for year basis should the substitution not conflict with State or Board certification/license requirements.

• Associate's Degree in Nursing Required
• Bachelor's Degree in Nursing Preferred

EXPERIENCE

• 5 years First Assist-Surgical Technology Required
• 5 years Team Lead Required

LICENSE/CERTIFICATION

• IN Licensed Registered Nurse Required
• Certified RNFA Required
• BLS Certification Required
• ACLS Certification Required

STANDARDS OF BEHAVIOR

Meets the Standards of Behavior as outlined in Personnel Policy and Procedure #1, Employee Relations Code.

CONFIDENTIALITY/HIPAA/CORPORATE COMPLIANCE

Demonstrates knowledge of procedures for protecting and maintaining security, confidentiality and integrity of employee, patient, family, organizational and other medical information. Understands and supports the commitment of Methodist Hospitals in adhering to federal, state and local laws, rules and regulations governing ethical business practices for healthcare providers.

DISCLAIMER - The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. The statements are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required.