Job Description

General Summary

Under general supervision of the Division Chief, Thoracic Surgery, assists in the performance of surgical procedures during Open Heart Surgery. During the intraoperative phase of open heart surgery, practices in collaboration with and at the direction of the cardiac surgeons to assist in the performance of the surgical procedures. The RN First Assistant does not concurrently function as a scrub nurse.

This role is aimed for the nurse who is a clinical and professional leader in their practice setting. He/she advances evidence based practices, leads unit governance initiatives, and mentors others to achieve and grow in the role of the professional nurse. As a senior member of the practice partnership in the perioperative setting, serves as a leader, change agent, and coordinator of patient care services within a specific service line. Takes a leadership role in overall design and implementation of a patient centered care delivery system that facilitates achievement of patient outcomes, supports continuity of care and patient flow between care delivery sites, and enhances patient and care giver satisfaction. Monitors the quality and cost effectiveness of nursing practice and governance systems at the unit level. Is accountable patients and families for the processes and outcomes of care during an episode of care. Is accountable to peers for the advancement of group practice and to the manager for the totality of work performance.

Principal Responsibilities and Tasks

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

Clinical Practice/Care Delivery

• Under the direct supervision of a surgeon, assists with the performance of surgical procedures and general patient care in the operating room in accordance with established nursing protocol, policor with established nursing protocol and the policies and procedures. Observable duties may include:

A. Assisting with positioning, prepping and draping of the patient.

B. Tissue handling including making incisions, retracting, dissecting, tying, ligating, stapling, suturing and providing hemostasis.

C. Endoscopic or open harvesting of the saphenous vein during coronary artery bypass procedures and preparation of the vein for bypass.

D. Preparing and loading the vein on an Aortic Connector System for proximal anastamosis.

E. Endoscopic or open harvesting of the radial artery during coronary artery bypass procedures, and preparation of the radial artery for bypass.

F. Setting-up cardiopulmonary bypass pump lines.

G. First or second assisting with cannulation, graft anastamosis, valve placement, decannulation, or any other phase of open heart procedures.

H. Installation of Intraortic Balloon Pump (IABP), femoral arterial lines, radial artery lines and femoral venous lines.

I. Chest tube insertion.

J.. Closure of the leg and chest incisions.

K. Defibrillation (internal or external) of patient as needed.

L. Assisting with emergency procedures and resuscitation as needed.

• Instructs and explains procedures to patients and families prior to surgery to assure an understanding of surgical procedure and ensure compliance with post-operative care.

A. Educates cardiothoracic patients regarding pre- and post-operative health care. Sees primarily adult patients undergoing open heart, lung, esophageal resection, dilatation procedures and repair procedures to the great vessels of the thorax.

• Serves as a clinical expert and professional resource for nurses; mentors and coaches other nurses to advance their developmen
• Advances clinical practice; consistently integrates evidence into practice and uses this as a firm foundation for the practice setting; coaches staff
• Utilizes clinical expertise to teach other nurses informally on the unit in a structured role or through formal teaching in classes

Qualifications

• . Current licensure as a Registered Nurse with the Maryland State Board of Examiners of Nurses. Current certification in Basic Cardiac Life Support is required. Current CNOR certification from the National Certification Board of Perioperative Nursing is required.
• minimum of two years of experience as a Registered Nurse is required.
• Successful completion of a recognized planned program of instruction designed for the Registered Nurse Surgical Assistant to include:

** Didactic instruction of at least 50 hours which includes:**

• Pre-operative and post-operative assessment, evaluation of physical and laboratory findings, patient pain management and patient and staff teaching.
• Intraoperative considerations including anatomy and physiology and surgical interventions as related to each system.
• Surgical techniques.
• Surgical hazards and appropriate interventions.

Clinical instruction and experience including:

• A minimum of 200 hours assisting in major surgical procedures including positioning, prepping and draping, siding in exposure, retraction, hemostasis, surgical instrumentation, etc…

• Instruction provided by qualified surgeons participating in the program.

• The surgeon preceptor(s) written documentation of the registered nurse’s competency in the intraoperative surgical first assistant role.

• Knowledge of surgical anatomy, physiology and operative technique related to the specific operative procedures in which the R.N. assists.

• Knowledge of emergency procedures and demonstrated proficiency in peri-operative nursing practice as both a scrub and circulator.

• Ability to operate electrosurgical cautery machine to cauterize blood vessels.

• Highly effective communication skills are necessary in explaining procedures to patients, preparing written reports for patient medical charts, and providing preliminary results to health care providers.

• Maintenance of 20 contact hours of education/year.

• Member of a professional organization

Additional Information

All your information will be kept confidential according to EEO guidelines.

Compensation:

Pay Range:

Other Compensation (if applicable):

Review the 2024-2025 UMMS Benefits Guide