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First Assistant Jobs in Houston, TX (NOW HIRING)

3/11/2026

Licensed Surgical Assistant

Houston, TX · On-site

Join Our Team as a Surgical First Assistant | Sugar Land & Cypress, Houston, TX Avant First Assistants, LLC is seeking a highly skilled and dedicated Licensed Surgical Assistant to join our dynamic ...

Emerge

Sonic Drive-In 1st Assistant Manager

Deer Park, TX · On-site

$27K - $38K/yr

As a SONIC Drive-In Assistant Manager, you are responsible for assisting the General Manager in managing the daily operations of the restaurant to provide quality food in a clean, safe, and efficient ...

Emerge

Sonic Drive-In 1st Assistant Manager

Houston, TX · On-site

$27K - $38K/yr

As a SONIC Drive-In Assistant Manager, you are responsible for assisting the General Manager in managing the daily operations of the restaurant to provide quality food in a clean, safe, and efficient ...

Emerge

Sonic Drive-In 1st Assistant Manager

Houston, TX · On-site

$27K - $38K/yr

As a SONIC Drive-In Assistant Manager, you are responsible for assisting the General Manager in managing the daily operations of the restaurant to provide quality food in a clean, safe, and efficient ...

Emerge

Sonic Drive-In 1st Assistant Manager

Pasadena, TX · On-site

$27K - $38K/yr

As a SONIC Drive-In Assistant Manager, you are responsible for assisting the General Manager in managing the daily operations of the restaurant to provide quality food in a clean, safe, and efficient ...

Emerge

Sonic Drive-In 1st Assistant Manager

Houston, TX · On-site

$27K - $38K/yr

As a SONIC Drive-In Assistant Manager, you are responsible for assisting the General Manager in managing the daily operations of the restaurant to provide quality food in a clean, safe, and efficient ...

Emerge

Sonic Drive-In 1st Assistant Manager

Pasadena, TX · On-site

$27K - $38K/yr

As a SONIC Drive-In Assistant Manager, you are responsible for assisting the General Manager in managing the daily operations of the restaurant to provide quality food in a clean, safe, and efficient ...

Emerge

Sonic Drive-In 1st Assistant Manager

Tomball, TX · On-site

$27K - $38K/yr

As a SONIC Drive-In Assistant Manager, you are responsible for assisting the General Manager in managing the daily operations of the restaurant to provide quality food in a clean, safe, and efficient ...

Emerge

Sonic Drive-In 1st Assistant Manager

Dayton, TX · On-site

$27K - $38K/yr

As a SONIC Drive-In Assistant Manager, you are responsible for assisting the General Manager in managing the daily operations of the restaurant to provide quality food in a clean, safe, and efficient ...

Emerge

Sonic Drive-In 1st Assistant Manager

Katy, TX · On-site

$27K - $38K/yr

As a SONIC Drive-In Assistant Manager, you are responsible for assisting the General Manager in managing the daily operations of the restaurant to provide quality food in a clean, safe, and efficient ...

Emerge

Sonic Drive-In 1st Assistant Manager

Cypress, TX · On-site

$27K - $38K/yr

As a SONIC Drive-In Assistant Manager, you are responsible for assisting the General Manager in managing the daily operations of the restaurant to provide quality food in a clean, safe, and efficient ...

Emerge

Sonic Drive-In 1st Assistant Manager

Friendswood, TX · On-site

$27K - $38K/yr

As a SONIC Drive-In Assistant Manager, you are responsible for assisting the General Manager in managing the daily operations of the restaurant to provide quality food in a clean, safe, and efficient ...

Emerge

Sonic Drive-In 1st Assistant Manager

Houston, TX · On-site

$27K - $38K/yr

As a SONIC Drive-In Assistant Manager, you are responsible for assisting the General Manager in managing the daily operations of the restaurant to provide quality food in a clean, safe, and efficient ...

Emerge

Sonic Drive-In 1st Assistant Manager

La Porte, TX · On-site

$27K - $38K/yr

As a SONIC Drive-In Assistant Manager, you are responsible for assisting the General Manager in managing the daily operations of the restaurant to provide quality food in a clean, safe, and efficient ...

Emerge

Sonic Drive-In 1st Assistant Manager

Houston, TX · On-site

$27K - $38K/yr

As a SONIC Drive-In Assistant Manager, you are responsible for assisting the General Manager in managing the daily operations of the restaurant to provide quality food in a clean, safe, and efficient ...

Emerge

Sonic Drive-In 1st Assistant Manager

Houston, TX · On-site

$27K - $38K/yr

As a SONIC Drive-In Assistant Manager, you are responsible for assisting the General Manager in managing the daily operations of the restaurant to provide quality food in a clean, safe, and efficient ...

Emerge

Sonic Drive-In 1st Assistant Manager

Houston, TX · On-site

$27K - $38K/yr

As a SONIC Drive-In Assistant Manager, you are responsible for assisting the General Manager in managing the daily operations of the restaurant to provide quality food in a clean, safe, and efficient ...

Emerge

Sonic Drive-In 1st Assistant Manager

Houston, TX · On-site

$27K - $38K/yr

As a SONIC Drive-In Assistant Manager, you are responsible for assisting the General Manager in managing the daily operations of the restaurant to provide quality food in a clean, safe, and efficient ...

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Showing results 21-40

All JobsFirst JobsFirst Assistant JobsFirst Assistant Jobs in Houston, TX

First Assistant information

See Houston, TX salary details

$31K

$127.4K

$182.9K

How much do first assistant jobs pay per year?

As of Sep 12, 2026, the average yearly pay for first assistant in Houston, TX is $127,442.00, according to ZipRecruiter salary data. Most workers in this role earn between $38,700.00 and $172,400.00 per year, depending on experience, location, and employer.

What is a first assistant?

First Assistants, often referred to as First Assistant Directors (First ADs) in film and television production, are responsible for coordinating all production activities on set. They assist the director by managing the shooting schedule, ensuring that cast and crew are prepared, and facilitating communication between departments. Their role is essential in keeping the production running smoothly, safely, and on time. First Assistants also help enforce safety protocols and can be involved in overseeing rehearsals and blocking scenes. Overall, they play a key organizational and leadership role in any production.

What are the key skills and qualifications needed to thrive as a first assistant, and why are they important?

To thrive as a First Assistant, you need a comprehensive understanding of surgical procedures, aseptic techniques, and anatomy, usually backed by a relevant certification such as Certified Surgical First Assistant (CSFA) or equivalent clinical training. Familiarity with surgical instruments, operating room protocols, and electronic medical records is typically required. Strong attention to detail, effective communication, and the ability to work well under pressure are essential soft skills. These competencies ensure optimal surgical outcomes, enhance patient safety, and support seamless teamwork in the operating room.

What are some common challenges first assistants face when supporting high-level executives or teams?

First Assistants often juggle multiple priorities, such as managing complex calendars, responding to urgent requests, and coordinating logistics for meetings or events. One common challenge is maintaining clear communication and anticipating the needs of executives, which requires strong organizational skills and discretion. Additionally, First Assistants may need to adapt quickly to changing schedules or last-minute tasks, making flexibility and problem-solving essential. Building good relationships with both internal teams and external contacts also helps ensure smooth workflow and successful collaboration.

What is the difference between First Assistant vs Second Assistant?

AspectFirst AssistantSecond Assistant
CredentialsTypically requires medical or legal certifications, depending on industrySimilar credentials, often with less experience required
Work EnvironmentHigh-pressure settings, assisting lead professionalsSupport role, often in administrative or support settings
Employer & Industry UsageUsed in legal, medical, or film industries as a primary support roleSupporting role, often subordinate to First Assistant
Common Search & ComparisonOften compared for responsibilities and qualificationsLess frequently searched in comparison to First Assistant

The First Assistant typically holds more responsibilities, requires specific certifications, and works closely with lead professionals in high-pressure environments. The Second Assistant generally provides support and performs delegated tasks, often with less experience or certification requirements. Understanding these differences helps clarify career progression and role expectations within the industry.

How do I become a first assistant?

To become a first assistant, typically you need relevant experience in the field, strong communication and organizational skills, and often a background in the specific industry or environment. Some roles may require specific certifications or training, depending on the industry standards. Gaining practical experience through internships or entry-level positions can also be beneficial.

How much do first assistants make?

First assistants in Florida typically earn between $30,000 and $60,000 annually, depending on experience, location, and the industry they work in. They often require strong organizational skills and proficiency with office tools to perform their duties effectively.

What are the most commonly searched types of First jobs in Houston, TX?

The most popular types of First jobs in Houston, TX are:

What cities near Houston, TX are hiring for First Assistant jobs?

Cities near Houston, TX with the most First Assistant job openings:

First Assistant jobs near you
Infographic showing various First Assistant job openings in Houston, TX as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 18% Part Time, and 5% Contract. Highlights an 87% Physical, 1% Hybrid, and 12% Remote job distribution, with an average salary of $127,442 per year, or $61.3 per hour.

Nurse Practitioner First Assist - Acute Care - Nights/Weekends/ Days - CV Surgery (The Woodlands)

The Woodlands, TX • On-site

Houston Methodist Physician Organization
See more jobs at Houston Methodist Physician Organizationexternal

Full-time

Re-posted 29 days ago

Job description

At Houston Methodist, the Nurse Practitioner (NP) First Assist AC position is responsible for functioning as an advanced practice practitioner maintaining and promoting the health of the patient requiring care. The NP First Assist AC position will assist the physician in the global management of patient care in all peri-operative settings; the primary role is to assist licensed physicians in patient surgery. This end-to-end involvement enables this position to provide unparalleled continuity of patient care. The NP First Assist AC position will work in both inpatient and outpatient settings and perform according to the nurse practice act of the State of Texas, and as part of a treatment team. In addition, this position examines, diagnoses and decides treatment for patients, including analyzing and interpreting x-rays and lab results, writes prescriptions, takes patients' histories and orders various forms of therapy. The NP First Assist AC position provides education to patients about preventative care and prescribed treatments. This position will take call as required or as outlined by their supervising physician, manager or lead and should be in the OR a minimum of 30%. The NP First Assist AC position effects direct patient care according to the Houston Methodist Professional Practice Model Nursing Practice and Professional Performance policies and procedures
Employees in this job code are assigned to nights and/or weekend shifts intermittent with day shifts as part of their regular schedule.
FLSA STATUS
Exempt
QUALIFICATIONS
EDUCATION
  • Master’s degree or higher from an accredited school of Nursing and graduate from an accredited Nurse Practitioners program

EXPERIENCE
  • Two years of registered nurse, advanced practice or nurse practitioner clinical experience
  • One year of surgical experience

LICENSES AND CERTIFICATIONS
Required
  • RN - Registered Nurse - Texas State Licensure - Texas Board of Nursing_PSV Compact Licensure – Must obtain permanent Texas license within 60 days (if establishing Texas residency) and
  • ARPN Acute Care state license and
  • Magnet ANCC-recognized Acute Care practitioner certification and
  • CRNFA - Certified Registered Nurse First Assistant (CCI) - Cardiovascular Credentialing International_PSV and
  • BLS - Basic Life Support or Instructor (AHA) - American Heart Association and
  • ACLS - Advanced Cardiac Life Support or Instructor (AHA) - American Heart Association and
  • AP - Prescriptive Authority - Texas Board of Nursing - Texas Department of Licensing and Regulation_PSV and
  • DEA - Narcotics License (DEA) - Drug Enforcement Administration_PSV

SKILLS AND ABILITIES
  • Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through ongoing skills, competency assessments, and performance evaluations
  • Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security
  • Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles
  • Uses therapeutic communication to establish a relationship with patients, families and interprofessional team to collaborate on the plan of care
  • Strong assessment, organizational and problem-solving skill as evidenced by capacity to prioritize multiple tasks and role components
  • Ability to function independently and exercise judgment in interactions with physicians, interprofessional care team and patients and their families
  • Demonstrates proficient time management skills
  • Uses critical thinking skills and clinical judgment to work autonomously as defined by the Nurse Practice Act

ESSENTIAL FUNCTIONS
PEOPLE ESSENTIAL FUNCTIONS
  • Provides leadership as a clinical resource, interprofessional consultant and patient advocate. Identifies staff development opportunities for professional growth of colleagues and provides coaching to meet identified goals.
  • Collaborates to foster healthy relationships in the work environment. Facilitates the promotion of teamwork. Acts as a role model and coaches staff in effective verbal, non-verbal and written communication. Serves as preceptor for Nurse Practitioner students and medical resident(s), as applicable.
  • Fosters staff engagement by demonstrating active listening, requesting and acknowledging feedback, making equitable decisions, providing rationale when appropriate and supporting organizational goals. Anticipates the needs of the staff members and proactively offers assistance. Role models interprofessional communication and assists with staff stress management as needed. Improves department score for turnover/retention/employee satisfaction.

SERVICE ESSENTIAL FUNCTIONS
  • Conducts appropriate, timely patient care under physician supervision, for a defined patient population(s), focusing on identified expected unit/optimal outcomes, individualized to the patient. Prioritizes care based on the patient’s needs, abilities and preferences.
  • Coordinates patient care between healthcare providers. Attends and participates in interprofessional rounds, as appropriate.
  • Collaborates with the interprofessional healthcare team members to manage/coordinate patient care. Provides first-assist and/or second-assist surgical services as needed.
  • Responds and is available timely to patient questions/issues that arise as triaged by clinical staff and provides assistance for emergencies, as needed. Advocates on patient/family’s behalf to identify and resolve clinical and ethical concerns.

QUALITY/SAFETY ESSENTIAL FUNCTIONS
  • Provides safe and effective care by leading and initiating outcome, quality and safety improvement activities in alignment with organizational goals. Provides highly developed assessments, clinical, documentations, leadership and analytical skills; integrates and contributes to professional practice standards, policies, procedures, protocols and leads improvements in patient safety-related processes.
  • Functions as a quality care provider, coordinating, maintaining and promoting the health of the patient. Assist the interprofessional healthcare team in the development and implementation of protocols to ensure patient safety. Affects direct patient care according to the nurse practice act of the State of Texas and the Houston Methodist Professional Practice Model Nursing Practice and Professional Performance.
  • Conducts health assessments (initial, ongoing, discharge, as appropriate). Identifies normal/abnormal health characteristics, develops plan of care, initiates appropriate interventions and evaluates care outcomes on defined patient population(s).
  • Performs invasive, diagnostic, surgical or therapeutic procedures necessary for defined patient population(s) based on licensure and credentialed privileges.

FINANCE ESSENTIAL FUNCTIONS
  • Implements department strategies to achieve financial target and mentors others to do the same through timely documentation of care, decreasing length of stay, optimizing efficiency and other areas according to department specifications.
  • Contributes to department plans for resource utilization and capital needs to meet department financial target. Projects awareness and understanding of resource allocation based on patient needs and staff experience, knowledge and skills and mentors others to do the same.

GROWTH/INNOVATION ESSENTIAL FUNCTIONS
  • Promotes quality health care through integration of current research into practice and participation in research/evidence-based activities. Leads and identifies opportunities for practice changes and performance improvement.
  • Provides education of information/knowledge in professional activities such as research, presentations and publications. Expands individual nursing knowledge and coaches staff to grow in knowledge, abilities, skills and attitudes. Serves as clinical resource. Ensures own career discussions occur with appropriate management. Completes and updates the My Development Plan on an ongoing basis.

SUPPLEMENTAL REQUIREMENTS
    WORK ATTIRE
    • Uniform: No
    • Scrubs: Yes
    • Business professional: Yes
    • Other (department approved): Yes

    ON-CALL*
    *Note that employees may be required to be on-call during emergencies (ie. Disaster, Severe Weather Events, etc) regardless of selection below.
    • On Call* Yes

    TRAVEL**
    **Travel specifications may vary by department**
    • May require travel within the Houston Metropolitan area Yes
    • May require travel outside Houston Metropolitan area No
QUALIFICATIONS
EDUCATION
  • Master’s degree or higher from an accredited school of Nursing and graduate from an accredited Nurse Practitioners program

EXPERIENCE
  • Two years of registered nurse, advanced practice or nurse practitioner clinical experience
  • One year of surgical experience

LICENSES AND CERTIFICATIONS
Required
  • RN - Registered Nurse - Texas State Licensure - Texas Board of Nursing_PSV Compact Licensure – Must obtain permanent Texas license within 60 days (if establishing Texas residency) and
  • ARPN Acute Care state license and
  • Magnet ANCC-recognized Acute Care practitioner certification and
  • CRNFA - Certified Registered Nurse First Assistant (CCI) - Cardiovascular Credentialing International_PSV and
  • BLS - Basic Life Support or Instructor (AHA) - American Heart Association and
  • ACLS - Advanced Cardiac Life Support or Instructor (AHA) - American Heart Association and
  • AP - Prescriptive Authority - Texas Board of Nursing - Texas Department of Licensing and Regulation_PSV and
  • DEA - Narcotics License (DEA) - Drug Enforcement Administration_PSV

Company Profile:

Houston Methodist Specialty Physician Group is an integral part of Houston Methodist’s overall strategy to become one of the nation’s leading academic medical centers. Established as a nonprofit corporation certified by the Texas State Board of Medical Examiners, the Specialty Physician Group enables physicians to maintain autonomy with respect to clinical practice while growing their practice within an academic environment.

Houston Methodist is an Equal Opportunity Employer.

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