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Nurse Practitioner First Assist information

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$41.5K

$130.3K

$200K

How much do nurse practitioner first assist jobs pay per year?

As of Sep 10, 2026, the average yearly pay for nurse practitioner first assist in the United States is $130,295.00, according to ZipRecruiter salary data. Most workers in this role earn between $108,000.00 and $150,000.00 per year, depending on experience, location, and employer.

What is a nurse practitioner first assist?

A Nurse Practitioner First Assist (NPFA) is an advanced practice registered nurse who is specially trained to assist surgeons during surgical procedures. In addition to their standard nurse practitioner responsibilities, they provide direct patient care in the operating room, such as suturing, controlling bleeding, and handling tissues. NPFAs work closely with the surgical team to ensure patient safety and optimal outcomes throughout the perioperative period. They require specialized education, certification, and clinical experience in surgical assisting.

What are some common challenges nurse practitioner first assists face when working in surgical teams?

Nurse Practitioner First Assists often encounter challenges such as adapting to the fast-paced nature of the operating room, maintaining clear communication with surgeons and other team members, and staying current with evolving surgical techniques and protocols. Balancing patient care responsibilities before, during, and after surgery can also be demanding. Successful Nurse Practitioner First Assists proactively seek feedback and participate in ongoing education to continuously improve their skills and ensure patient safety.

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

To thrive as a Nurse Practitioner First Assist, you need advanced clinical knowledge, surgical assisting expertise, and an active NP license with additional First Assist certification. Familiarity with surgical instruments, electronic health records (EHRs), and perioperative protocols is typically required. Excellent communication, teamwork, and adaptability are crucial soft skills for collaborating with surgical teams and supporting patient care. These competencies ensure safe, efficient surgical procedures and positive patient outcomes in high-pressure environments.

What is the difference between Nurse Practitioner First Assist vs Physician Assistant?

AspectNurse Practitioner First AssistPhysician Assistant
CredentialsMaster's or Doctoral degree in nursing, certification as First AssistMaster's degree in health sciences, certification as PA
Work EnvironmentOperating rooms, surgical teams, hospitalsHospitals, clinics, surgical settings
Roles & ResponsibilitiesAssist during surgeries, patient care pre/post-opPerform exams, diagnose, assist in surgeries
Industry UsageCommon in surgical teams, hospitalsBroadly in healthcare, including surgical support

Both Nurse Practitioner First Assist and Physician Assistant roles involve patient care and surgical support, but the First Assist specializes in assisting during surgeries with specific nursing credentials, while PAs have a broader scope in diagnosis and treatment across various settings.

What cities are hiring for Nurse Practitioner First Assist jobs?

Cities with the most Nurse Practitioner First Assist job openings:

What states have the most Nurse Practitioner First Assist jobs?

States with the most job openings for Nurse Practitioner First Assist jobs include:

What are popular job titles related to Nurse Practitioner First Assist jobs?

For Nurse Practitioner First Assist jobs, the most frequently searched job titles are:

Nurse Practitioner First Assist jobs near you
Infographic showing various Nurse Practitioner First Assist job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 74% Full Time, 21% Part Time, and 4% Contract. Highlights an 88% Physical, 1% Hybrid, and 11% Remote job distribution, with an average salary of $130,295 per year, or $62.6 per hour.

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

The Woodlands, TX

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

Full-time

Re-posted 27 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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