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Registered Nurse First Assistants (RNFAs) are assigned to the Operating Room Service under the Operative Care Division and are directly accountable to the Operating Room Manager. RNFAs are functioning in an expanded perioperative nursing role and must have acquired the necessary knowledge, judgement, and skills specific to the expanded role of RNFA clinical practice. Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Education: Graduate of a school of professional nursing approved by the appropriate State-accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE). In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration will meet the requirement of graduation from an approved school of professional nursing. OR The completion of coursework equivalent to a nursing degree in a MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing. Students should submit the certificate of professional nursing to sit for the NCLEX to the VA along with a copy of the MSN transcript. (Reference VA Handbook 5005, Appendix G6) OR In cases of graduates of foreign schools of professional nursing, possession of a current, full, active and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing. License: Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia. Language: Must be proficient in written and spoken English. Grade Determinations: The following criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade: Nurse I Level I - An Associate Degree (ADN) or Diploma in Nursing, with no additional nursing practice/experience required. Nurse I Level II - An ADN or Diploma in Nursing and approximately 1 year of nursing practice/experience; OR an ADN or Diploma in Nursing and a bachelor's degree in a related field with no additional nursing practice/experience; OR a Bachelor's of Science in Nursing (BSN) with no additional nursing practice/experience. Nurse I Level III - An ADN or Diploma in Nursing and approximately 2-3 years of nursing practice/experience; OR an ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 1-2 years of nursing practice/experience; OR a BSN with approximately 1-2 years of nursing practice/experience; OR a Master's degree in nursing (MSN) or related field with a BSN and no additional nursing practice/experience. Nurse II - A BSN with approximately 2-3 years of nursing practice/experience; OR ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 2-3 year's of nursing practice/experience; OR a Master's degree in nursing or related field with a BSN and approximately 1-2 year's of nursing practice/experience; OR a Doctoral degree in nursing or meets basic requirements for appointment and has doctoral degree in a related field with no additional nursing practice/experience required. Nurse III - Master's degree in nursing or related field with BSN and approximately 2-3 year's of nursing practice/experience; OR a Doctoral degree and approximately 2-3 year's of nursing practice/experience. Reference: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-6 Nurse Qualification Standard. This can be found in the local Human Resources Office. Preferred Experience: 4 years of operating room RN experience with 2 years in RNFA role. Physical Requirements: Moderate lifting and carrying (15-44 pounds); straight pulling (1 hour); Pushing (1-2 hours); Reaching above shoulder; Use of fingers; Both hands required; Walking (3 hours); Standing (4-6 hours); Repeated bending (2 hours), Both legs required; Ability for rapid mental and muscular coordinating simultaneously; Near vision correctable to 13" to 16" to Jaeger 1 to 4; Far vision correctable in one eye to 20/20 and to 20/40 in the other; Depth perception; Ability to distinguish shades of colors; Hearing (aid may be permitted); Able to walk without assistive devices; Mental and emotional stability required. Environmental factors: Working closely with others. ["Registered Nurse First Assistants (RNFAs) intra-operatively practice at the direction of the attending surgeon. The RNFA has the duty to verify the standardized procedures in effect before performing the functions of a surgical first assistant. Specific practice settings includes the perioperative arena. The practice of each RNFA is based on knowledge, experience, and research and has a direct impact on patient outcomes in the assigned area and for the facility. When not performing in the First Assistant role, the RNFA may provide care in the Operating Room Registered Nurse (OR RN) role. The OR RN provides professional nursing care to assigned operating room patients throughout the perioperative period and collaborates with the interdisciplinary team to strategize, implement and evaluate an individualized plan of care for each patient. Patient populations include, but are not limited to: ENT, General Surgery, Cardiothoracic Surgery, Liver Transplantation, GU, GI, Neurological, Vascular and Orthopedic procedures.Other duties and responsibilities of the RNFA include but are not limited to the following: Positioning the patient, preparing and draping the surgical site. Administering local anesthetic(s). Providing exposure and retraction. Providing hemostasis utilizing electrosurgical cautery (ESU), suture ligation, hemostatic agents and argon beam. Using and handling of surgical instrumentation. Tissue handling, dissection, suturing, and stapling. Making the skin incision or stab wound for laparoscopic surgery or drains and placement of trocar (based on State Board of Nursing) for laparoscopic access. Inserting, re-positioning and removal of Robotic instrumentation. Securing drains. Closing wounds and changing dressing, including wound vac therapy. Applying and removing casts and splints. Harvesting vein and arteries for bypass conduit. Cleansing surgical area, including superficial, subcutaneous, muscle and fascia, bone and abdominal and pelvic cavities. Removing surgical drains under the direction of the attending surgeon. Performing focused preoperative nursing assessments. Communicating and collaborating with other health care providers regarding the patient plan of care. Participating in postoperative rounds. Assisting with patient discharge planning and identifying appropriate community resources. Work Schedule: Monday-Friday, 7:00 am to 5:30 pm (8 or 10 hours shifts available); variable per Service needs; position will take call.\nTelework: Not available\nVirtual: This is not a virtual position.\nRelocation/Recruitment Incentives: Not authorized\nPermanent Change of Station (PCS): Not authorized\nFinancial Disclosure Report: Not required"]