Registered Nurse First Assist

Veterans Health Administration • Saint Louis, MO

1d • Onsite

About The Position

The First Assist Registered Nurse (RN) is a proficient nurse who demonstrates proficiency in decision-making and using the nursing process for complex situations that affect performance outcomes at the point of care. Practice is enhanced through the development of collegial relationships. Demonstrates collaboration by using the group process to solve problems. The focus is on leadership in strategically planning long-term goals for the microsystem (unit, team, or workgroup) that impacts operations or resources. They demonstrate critical thinking with efficiency and accuracy in assessing and managing situations. First Assist RN's, function in an expanded perioperative nursing role. When performing delegated medical functions, First Assist RNs are practitioners who are agents of the supervising physician(s)/independent licensed practitioner(s) who are responsible for the First Assist RN's actions within the agreed upon scope of practice. The supervising physician/independent licensed provider is to direct and review the work and practice on a continuous basis to ensure that appropriate directions are given and understood, and appropriate care is rendered. The First Assist RN must have acquired the necessary knowledge, judgment, and skills specific to the expanded role of First Assist RN clinical practice.

Requirements

• U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
• All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment.
• Applicants who refuse to be tested will be denied employment with VA.
• Selective Service Registration is required for males born after 12/31/1959.
• Subject to background/security investigation.
• Selected applicants will be required to complete an online onboarding process.
• Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents).
• Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
• Must pass pre-employment physical evaluation/examination.
• Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
• You may be required to serve a probationary period.
• Complete all application requirements detailed in the "Required Documents" section of this announcement.
• English Language Proficiency. In accordance with 38 U.S.C. 7403(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English.
• Graduate of a school of professional nursing approved by the appropriate 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 ); OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. Upon achievement of a State license, the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program. (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 to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program. Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware ( ICD ).
• 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.
• Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements, but do not possess the required licensure, may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.)
• Must be able to meet the physical demands of the position, including prolonged standing, walking, lifting, bending, and wearing PPE when required.
• Carrying/lifting 45 pounds and over
• Walking and/or standing for eight hours at a time
• Kneeling and repeated bending throughout shift

Nice To Haves

• 2-3 years of experience as a Registered Nurse First Assist in hospital setting.
• Demonstrates proficiency and accountability in all aspects of assigned patient care under direct supervision, progressing with skill development and independent practice as appropriate to experience.
• Participates in and complies with Employee Health requirements, including PMDB (Prevention and Management of Disruptive Behavior) training.
• May be assigned to different assignments, tours, or roles as operational and patient care needs dictate.
• Protects patient privacy and PHI in accordance with federal regulations and facility policy, including electronic/computer security standards.
• Supports the culture of safety and reports potential and actual safety events, near-misses, and system issues.

Responsibilities

• Delivers fundamental, knowledge-based perioperative nursing care to assigned patients, developing technical skills based on age-specific components and patient needs.
• Assesses, plans, implements, and evaluates nursing care for patients in the perioperative setting, with a focus on education, safety, satisfaction, and self-management throughout the surgical continuum.
• Applies professional nursing practice as an RNFA, including all validated competencies and functions delegated by the supervising surgeon.
• Assisting in patient positioning and prepping/draping of the surgical site
• Providing exposure through tissue manipulation, using surgical instruments, suctioning, and retraction
• Controlling bleeding and providing hemostasis using standard and advanced technologies (e.g., electrosurgical units, ligatures, suture, topical agents, argon beam, bipolar/ultrasonic devices)
• Suturing and stapling of tissue, and closure of surgical wounds and application of dressings including wound vac therapy
• Making skin incisions, creating laparoscopic access (stab wounds/trocars) as allowed by the State Board of Nursing
• Placing and securing drains, inserting and removing surgical instrumentation (including robotics)
• Application and removal of casts and splints
• Harvesting veins and arteries for bypass conduit as delegated
• Administration of local anesthetic under surgeon direction
• Cleansing surgical site (superficial, subcutaneous, muscle/fascia, bone, abdominal/pelvic cavities)
• Removal of surgical drains (chest tubes, orthopedic/joint drains)
• Other intraoperative, preoperative, and postoperative RNFA tasks as permitted by certification and defined by hospital policy.

Benefits

• Competitive salary, regular salary increases, potential for performance awards
• 50 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year)
• Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA
• Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement)
• 1 full and unrestricted license from any US State or territory

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree