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Phenom Surgical, the premier Surgical First Assistant group in the Metropolitan Area, is looking for talented professionals.

Certified Surgical Technician (CST)

Surgical technologists are allied health professionals, who are an integral part of the team of medical practitioners providing surgical care to patients. Surgical technologists work under the supervision of a surgeon to facilitate the safe and effective conduct of invasive surgical procedures, ensuring that the operating room environment is safe, that equipment functions properly, and that the operative procedure is conducted under conditions that maximize patient safety. Surgical technologists possess expertise in the theory and application of sterile and aseptic technique and combine the knowledge of human anatomy, surgical procedures, and implementation tools and technologies to facilitate a physician’s performance of invasive therapeutic and diagnostic procedures.

Education
Surgical technologists graduate from surgical technology programs accredited through ARC/STSA, a collaborative effort of AST and ACS, by CAAHEP. CAAHEP is a recognized accreditation agency of the Council for Higher Education Accreditation (CHEA). In addition, surgical technology programs are located in educational institutions that are institutionally accredited by agencies recognized by the United States
Department of Education (USDE) or The Joint Commission. The ARC/STSA is also a member of the Association of Specialized and Professional Accreditors (ASPA).

Credentials
Certification is conferred by the National Board of Surgical Technology and Surgical Assisting (NBSTSA). Initial certification as a Certified Surgical Technologist (CST) is based upon satisfactory performance on the national certifying examination following completion of an accredited program in surgical technology. CSTs maintain their certification by earning 60 hours of approved continuing education in a four-year period
or by successfully retaking the certifying examination at the conclusion of the four-year period.
The NBSTSA’s CST certification program is accredited by the National Commission for Certifying Agencies (NCCA), the accreditation division of the National Organization for Competency Assurance (NOCA) and is in compliance with NCCA’s Standards for the Accreditation of Certification Programs. NCCA standards and accreditation services are referenced requirements in state and federal legislation pertaining to personnel
certification. NOCA is accredited by the American National Standards Institute (ANSI) as a developer of American National Standards. ANSI accreditation provides third-party validation that NOCA’s standards development process ensures openness and due process.

Scrub Surgical Technologist
The scrub surgical technologist handles the instruments, supplies, and equipment necessary during the surgical procedure. He/she has an understanding of the procedure being performed and anticipates the needs of the surgeon. He/she has the necessary knowledge and ability to ensure quality patient care during the operative procedure and is constantly on vigil for maintenance of the sterile field.
Duties are as follows:
1. Checks supplies and equipment needed for surgical procedure
2. Scrubs, gowns, and gloves
3. Sets up sterile table with instruments, supplies, equipment, and
medications/solutions needed for procedure
4. Performs appropriate counts with circulator prior to the operation and before incision is closed
5. Gowns and gloves surgeon and assistants
6. Helps in draping sterile field
7. Passes instruments, etc., to surgeon during procedure
8. Maintains highest standard of sterile technique during procedure
9. Prepares sterile dressings
10. Cleans and prepares instruments for terminal sterilization
11. Assists other members of team with terminal cleaning of room
12. Assists in prepping room for the next patient

Circulating Surgical Technologist
The surgical technologist assisting in circulating obtains additional instruments, supplies, and equipment necessary while the surgical procedure is in progress. He/she monitors conditions in the operating room and constantly assesses the needs of the patient and
surgical team.
Duties are as follows:
1. Obtains appropriate sterile and unsterile items needed for procedure
2. Opens sterile supplies
3. Checks patient’s chart, identifies patient, verifies surgery to be performed with consent forms, and brings patient to assigned operating room
4. Transfers patient to operating room table
5. Assesses comfort and safety measures and provides verbal and tactile reassurance to the patient
6. Assists anesthesia personnel
7. Positions patient, using appropriate equipment
8. Applies electrosurgical grounding pads, tourniquets, monitors, etc., before procedure begins
9. Prepares the patient’s skin prior to draping by surgical team
10. Performs appropriate counts with scrub person prior to the operation and before incision is closed
11. Anticipates additional supplies needed during the procedure
12. Keeps accurate records throughout the procedure
13. Properly cares for specimens
14. Secures dressings after incision closure
15. Helps transport patient to recovery room
16. Assists in cleaning of room and preparing for next patient
17. Performs urinary catheterization when necessary.

Registered Nurse (RN)

The job of a Registered Nurse involves treating patients, educating patients about their medical conditions, providing advice or emotional support to patients and their family members, recording medical histories, performing diagnostic tests and analyzing results, operating medical equipments, administering medications and treatments, helping patients with rehabilitation and assisting medical doctors with various tasks.

Education/Experience Requirements for the job of a Registered Nurse: A successful candidate can become a registered nurse through a bachelor’s degree in nursing (BSN), an associate’s degree in nursing (AND) or a diploma. Graduates of any of these educational nursing programs can then obtain a NCLEX-RN license to practice as a Registered Nurse (RN). Many employers prefer RNs to have at least 1 year nursing experience and a CPR certification. Specialization and continuing education is available to RNs.

Skills of a Registered Nurse include but are not limited to: Strong problem-solving and decision-making skills, excellent interpersonal skills, good communication skills, and knowledge of practices, trends and principles in nursing. Registered nurses must also be physically fit, caring, responsible, detail-oriented, sympathetic, flexible, possess good work ethic and emotionally mature to cope with human suffering on a daily basis.

Specific work elements of the job as a Registered Nurse include but are not limited to: Administering medication based on doctor prescriptions; recording patient’s symptoms and progress; supervising junior-level nurses; providing care to children or elderly; conducting physical examination to patients; assisting doctors in diagnosing illnesses; checking blood pressure; conducting ECG tests, x-rays or other laboratory tests; and advising patients about healthy lifestyles and post-surgery care, among others. Some registered nurses specialize in a particular organ, disease or treatment, so their tasks may vary widely depending on specialization.

Certified Surgical First Assistant (CSFA)

As defined by the American College of Surgeons, the surgical assistant provides aid in exposure, hemostasis, closure, and other intraoperative technical functions that help the surgeon carry out a safe operation with optimal results for the patient. In addition to intraoperative duties, the surgical assistant also performs preoperative and postoperative duties to better facilitate proper patient care. The surgical assistant to the surgeon during the operation does so under the direction and supervision of that surgeon and in accordance with hospital policy and appropriate laws and regulations.

In general, surgical assistants have the following responsibilities:
• Determine specific equipment needed per procedure
• Review permit to confirm procedure and special needs
• Select and place of x-rays for reference
• Assist in moving and positioning of patient
• Insert and remove Foley urinary bladder catheter
• Place pneumatic tourniquet
• Confirm procedure with surgeon
• Drape patient within surgeon’s guidelines
• Provide retraction of tissue and organs for optimal visualization with regard to tissue type and appropriate retraction instrument and/or technique
• Assist in maintaining hemostasis by direct pressure, use and application of appropriate surgical instrument for the task, placement of ties, placement of suture ligatures, application of chemical hemostatic agents, or other measures as directed by the surgeon
• Use electrocautery mono and bi-polar
• Clamp, ligate, and cut tissue per surgeon’s directive
• Harvest saphenous vein, including skin incision, per surgeon’s directive
• Dissect common femoral artery and bifurcate per surgeon’s directive
• Maintain integrity of sterile field
• Close all wound layers (facia, subcutaneous and skin) as per surgeon’s directive
• Insert drainage tubes per surgeon’s directive
• Select and apply wound dressings
• Assist with resuscitation of patient during cardiac arrest or other life-threatening events in the operating room
• Perform any other duties or procedures incident to the surgical procedure deemed necessary and as directed by the surgeon

Register Nurse First Assistant (RNFA)

The Registered Nurse First Assistant (RNFA) is a registered nurse with specialized education. The development of specific technical skills enables the RNFA to assist the surgeon with specific intraoperative procedures that are beyond the scope of practice for registered nurses without RNFA education and training. The RNFA may provide direct care to patients using the nursing process preoperatively, intraoperatively and postoperatively. Intraoperatively, the RNFA functions interdependently with the surgeon and applies knowledge, skill, and judgment necessary to assist the surgeon in performing a safe operation that yields optimal results for the patient.

Cauterizing blood vessels involves the application of energy and is a controlled act. This may be performed by the RNFA as a Delegated Controlled Act: Cauterizing.

ROLE RESPONSIBILITIES:

Preoperative Role:

In collaboration with the health team members in preoperative stage RNFAs will assist with transportation of patients to operating room, moving a patients to operating table and assist with preparation for operative procedure.

Intraoperative Role:

1. Collaborates with other health team members to develop, coordinate and implement a perioperative plan of care unique to individual patient needs.

2. Maintains dignity of the patient while assuming the responsibility of patient advocate.

3. Skillfully applies principles of asepsis and infection control.

4. Has excellent knowledge of surgical anatomy, physiology and operative technique specific to cardiovascular procedures to work in collaboration with the surgeon.

5. Recognizes safety hazards and initiates appropriate preventative and/or corrective actions to ensure a safe environment for the patient and surgical team throughout the perioperative experience.

6. Preparation and administration of medications perioperatively, as directed by the surgeon and anaesthesiologist.

7. Provides exposure through appropriate use of instruments, retractors, suctioning and sponging techniques.

8. Handles and dissects tissues in collaboration with the surgeon.

9. Clamping blood vessels, coagulating bleeding points, ligating vessels and other procedures in collaboration with the surgeon to achieve haemostasis.

10. Sutures muscle, fascia, subcutaneous and skin tissue in collaboration with the surgeon.

11. Places drains as surgically indicated.

12. Assists with cannulation and decanulation procedures.

13. Evaluates the outcomes of nursing care and ensures continuity of care by communicating pertinent patient information to CSICU staff.

Postoperative Role:

In collaboration with the interdisciplinary team may follow selected cardiac surgery patients postoperatively to evaluate the outcomes of perioperative nursing care e.g. positioning, wound healing surveillance etc.

QUALIFICATIONS:

1. Licensed as a Registered Nurse.

2. Graduate of a recognized RNFA program.

3. Certified in perioperative nursing – CPN (C).

4. Current ACLS certification.

5. Have excellent interpersonal and communication skills that enhance team functioning in the operating room. Maintains professional manner at all times, demonstrating flexibility, sound judgment and adaptability in decision-making, problem solving and team building to function as an effective team member.

6. Has demonstrated leadership skills that enhance team functioning in an emergency situation.

7. Participates in continuing education programs to maintain and enhance clinical competencies related to both perioperative nursing and RNFA practice. Maintains ongoing certification as a CRNFA, if applicable.

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