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Rn First Assistant Jobs in Tennessee (NOW HIRING)

TNAA TotalMed RN

Travel OR RN - $2,147 per week

Powell, TN · On-site

$2.1K/wk

The right RN should have 1-2 years recent acute care experience as a circulating nurse, and/or scrub nurse, and potentially RN first assistant. Read below for more requirements. As an OR Travel Nurse ...

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Rn First Assistant information

See Tennessee salary details

$32.2K

$96.9K

$167.9K

How much do rn first assistant jobs pay per year?

As of Sep 7, 2026, the average yearly pay for rn first assistant in Tennessee is $96,939.00, according to ZipRecruiter salary data. Most workers in this role earn between $70,800.00 and $117,500.00 per year, depending on experience, location, and employer.

What is an RN First Assistant?

RN First Assistants (Registered Nurse First Assistants) are specialized registered nurses who work alongside surgeons and surgical teams during operations. They play a critical role in patient care by assisting with surgical procedures, providing direct patient care before, during, and after surgery, and helping to ensure the best possible outcomes. RNFAs are trained in advanced surgical techniques, such as suturing, controlling bleeding, and handling tissues, and they must have additional education and certification beyond standard registered nurse credentials.

What are the key skills and qualifications needed to thrive as an RN First Assistant?

To thrive as an RN First Assistant, you need advanced clinical knowledge in perioperative nursing, surgical procedures, and patient assessment, typically supported by RN licensure, perioperative experience, and CNOR or RNFA certification. Familiarity with surgical instruments, sterile technique, and electronic health records is essential for this role. Strong communication, critical thinking, and teamwork skills help you collaborate effectively with surgical teams and respond quickly in high-pressure situations. These skills and qualifications are crucial for ensuring patient safety, reducing complications, and supporting optimal surgical outcomes.

What are the most common challenges faced by an RN First Assistant in the operating room?

As an RN First Assistant, one of the most common challenges is balancing direct surgical responsibilities with maintaining patient safety and effective communication within a fast-paced environment. You'll often need to anticipate the needs of the surgical team and adapt quickly to unexpected situations during procedures. Collaboration with surgeons, anesthesiologists, and other OR staff is crucial, and handling stressful or high-pressure moments with composure is a key part of the role. Continuous learning and staying updated with surgical techniques also help in overcoming these challenges.

What is the difference between Rn First Assistant vs Surgical Technologist?

AspectRn First AssistantSurgical Technologist
CredentialsRegistered Nurse license, First Assistant certificationCertified Surgical Technologist (CST) or Tech certification
Work EnvironmentHospitals, surgical centers, operating roomsOperating rooms, surgical suites, hospitals
Role FocusAssists surgeons during procedures, provides intraoperative supportPrepares operating rooms, sterilizes instruments, assists during surgery

While both roles support surgical teams, Rn First Assistants have advanced nursing credentials and directly assist surgeons during procedures, whereas Surgical Technologists prepare the surgical environment and assist indirectly. Rn First Assistants typically require more advanced certifications and have a broader scope of intraoperative responsibilities.

Is it worth it to become an RN First Assistant?

Becoming an RN First Assistant allows registered nurses to perform advanced surgical assisting duties, often leading to higher compensation and expanded responsibilities. It requires additional training, certification, and experience in surgical settings, making it a valuable career advancement for RNs interested in perioperative care.

What are popular job titles related to Rn First Assistant jobs in Tennessee?

For Rn First Assistant jobs in Tennessee, the most frequently searched job titles are:

What job categories do people searching Rn First Assistant jobs in Tennessee look for?

The top searched job categories for Rn First Assistant jobs in Tennessee are:

What cities in Tennessee are hiring for Rn First Assistant jobs?

Cities in Tennessee with the most Rn First Assistant job openings:

Rn First Assistant jobs near you
Infographic showing various Rn First Assistant job openings in Tennessee as of August 2026, with employment types broken down into 1% As Needed, 74% Full Time, 19% Part Time, and 6% Contract. Highlights an 84% Physical, 1% Hybrid, and 15% Remote job distribution, with an average salary of $96,939 per year, or $46.6 per hour.

RN First Assist

Nashville General Hospital

Nashville, TN • On-site

Full-time

Posted 19 days ago

Nashville General Hospital rating

7.7

Company rating: 7.7 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

227th of 1,065 rated hospitals

Job description

Description
Title and Definition
Essential Responsibilities
  • Responsible to the patient and the surgical team to assist, educate and otherwise facilitate an optimal outcome for the patient
  • Participate in preoperative assessment and planning for surgical patients specific to RNFA activities (eg, anatomical exposure, wound closure) in collaboration with perioperative team members.
  • Develop an individualized perioperative patient plan of care.
  • Implement the plan of care by:
  • Assist with positioning, prepping and draping of the patient or perform there independently, if so directed by the surgeon.
  • Protecting the patient from injury caused by extraneous objects and chemical, electrical, laser, mechanical, and thermal sources;
  • Participating in accounting procedures to protect the patient from unintended retained surgical items;
  • Performing interventions necessary to ensure that the patient's procedure is performed on the correct site, side, and level;
  • Delays surgical procedure if any discrepancy among parties, patient history and physical, consents, or scheduled procedure occurs.
  • Assisting with management of the patient's specimens as necessary;
  • Communicating the patient's current status to relevant parties throughout the continuum of care;
  • Administering medications safely and correctly;
  • Performing interventions to maintain the patient's wound and tissue perfusion at or above baseline levels;
  • Performing interventions to maintain the status of the patient's genitourinary, gastrointestinal, musculoskeletal, endocrine, respiratory, cardiovascular, and neurological systems and fluid, electrolyte, and acid-base balances at or above baseline levels;
  • Performing interventions to ensure the patient is at or returned to normothermia at the conclusion of the immediate postoperative period;
  • Performing interventions to protect the patient from surgical site infection;
  • Assessing the knowledge level of the patient or designated support person;
  • Demonstrates the ability to operate specialized equipment intra-operatively; i. e. stapling instrumentation, laparoscopic tools and equipment, orthopedic drills, and instrumentation, lasers, etc. per established procedures.
  • Providing education regarding the expected psychosocial response, nutritional management, medication management, pain management, wound management, and expected responses to the operative or invasive procedure;
  • Acts as a resource person for the operating room staff.

Essential Responsibilities:
  • Acts as a resource person for the operating room staff.
  • Involve the patient or designated support person actively in decisions affecting his or her perioperative care and the rehabilitation process;
  • Protecting the patients' rights, dignity, and privacy;
  • Providing age-specific, culturally competent, ethical care within legal standards of practice; and
  • Providing consistent and comparable care regardless of the setting.
  • Function as an RN first assistant during operative and other invasive procedures by:
  • Providing exposure through correct use of instruments, retractors, suction, and sponging techniques;
  • Placing and holding surgical retractors and demonstrating stamina for sustained retraction
  • Retaining manually controlled retractors in the position set by the surgeon with regard to surrounding tissue.
  • Anticipating retraction needs with knowledge of the surgeon's preferences and anatomic structures
  • Packing sponges or laparotomy pads into body cavities to hold tissues and organs out of the operative field
  • Managing all instruments in the operative field to prevent obstruction of the surgeon's view.
  • Considers anatomical and physiological implications when selecting, placing, and moving retractors to provide surgical site exposure and reduce tissue injury.
  • Suctions surgical site as necessary to remove smoke, blood, and fluids from the site to improve visualization and decrease biohazard exposure.
  • Provide hemostasis by:
  • Applying electrocautery tip to clamps or vessels in a safe and knowledgeable manner as directed by the surgeon.
  • Sponging and utilizing pressure as necessary.
  • Utilizing suction techniques.
  • Applying clamps on superficial vessels and the tying off, electrocoagulation of them as directed by the surgeon.
  • Placing suture ligatures in the muscle, subcutaneous, and skin layers.
  • Placing hemoclips on bleeders as directed by the surgeon.
  • Perform knot tying by:
  • Choosing suturing material and techniques (eg, knot tying, ligation of vessels, wound closure) based on physician preference, density of tissue, support for suture line, potential tissue necrosis, need to evert skin edges, and cosmetic effect.
  • Having knowledge of the basic techniques.
  • Tying knots firmly to avoid slipping.
  • Avoiding undue friction to prevent fraying of suture.
  • Carrying knot down to the tissue
  • Approximating tissue rather than pulling tightly to prevent necrosis.

Essential Responsibilities:
  • Approximating tissue rather than pulling tightly to prevent necrosis.
  • Correctly approximating tissue layers under the direction of the surgeon
  • Demonstrates proficiency in skin stapling techniques by assessing blood supply of tissues to be stapled, inspection of staple line, and applying skin staples correctly.
  • Handling and dissecting tissues in collaboration with the surgeon;
  • Clamp and sever tissue
  • Grasp and fixate with screws, staples and other devices
  • Perform specialized tissue handling, dissection, or cutting techniques under the direction of the operating surgeon
  • Clamping blood vessels, coagulating bleeding points, and ligating vessels in collaboration with the surgeon;
  • Suturing muscle, fascia, subcutaneous, and skin in collaboration with the surgeon.
  • Placing drains as directed by the surgeon
  • Assist with applying casts, plaster splints or other devices as indicated
  • Serve as an educator, mentor, consultant, and resource to peers, colleagues, and others in relation to RNFA activities
  • Transfer care as applicable.
  • Delegate tasks according to TN Nurse Practice Act and job descriptions.
  • Document nursing care accurately, completely, and legibly.
  • Collaborate effectively with other disciplines as applicable.
  • Ability to be self-directed in accomplishing the coordination and decision making responsibilities of this position, and be resourceful in problem solving.

Employee Relations:
  • Listen attentively and responsively to information provided.
  • Comprehend information, anticipate information needs of others. Keep others informed in a complete and accurate manner.
  • Supply information requested by nursing personnel, patients, visitors, hospital departments, outside agencies and various health care institutions, using established policy and procedure.
  • Establish and maintain effective working relationships with fellow employees, administrative staff and the general public.
  • Communicates changes in the patient's situation to members of the healthcare team as intervention progresses to determine a need for new treatments or a change in existing treatments.

Customer Satisfaction:
  • Takes appropriate action to address customer concerns and complaints
  • Implements innovative approaches to meet the needs of patients and families
  • Responsible for assessing, planning, implementing and coordinating patient care throughout the perioperative continumum
  • Ability to correlate clinical data with patient's medical and nursing care
  • Ability to handle difficult situations involving patients, physicians, or others in a professional manner
  • Supports perioperative patients' health care rights by involving individuals in their own care.

Quality and Regulatory Standards:
  • Reports illegal, incompetent, or impaired practices
  • Assumes a leadership role in the provision of quality nursing care for patients receiving care
  • Know the accurate standards of clinical competency for the safe care of the unit's patients
  • Understand key quality and safety improvement measures
  • Assist with safety survey scores and actios to improve
  • Remains informed of innovative clinical trends through benchmarking and evidence-based practice
  • Actively participates in preparation of regulatory agency reviews.

Financial Responsibility:
  • Assist in assuring operational cost, equipment and supply cost stay within the unit's budget
  • Collaborates with the surgeon and other members of the health care team to promote efficient use of time, supplies, equipment, and personnel.

Education:
  • Seeks opportunities and experiences to increase skills and maintain competency necessary to practice as an RNFA
  • Assist with orientation, training and developing of employees within the department as necessary
  • Identifies, initiates, and collaborates to provide needed educational programs
  • Ensures compliance with educational requirements through scheduling, planning, and support.
  • Demonstrates current evidence-based practice
  • Recognized as an expert clinician and a leader within area of specialty
  • Maintains current licensure necessary for job requirements
  • Complete annual performance evaluation for self and employees and implement plans of correction when needed
  • Maintain required competencies for self
  • Pursue professional growth and participates in a professional organization.

Professional Requirements:
  • Influences multidisciplinary relationships by enhancing collaborative processes, "corporate culture," institutional values, and professionalism.
  • Practices first assisting in accordance with professional standards, state and federal laws and regulations, and accreditation standards.
  • Adhere to dress code, appearance is neat and clean.
  • Complete annual education requirements.
  • Maintain patient confidentiality at all times
  • Ability to maintain confidentiality of all medical, financial, and legal information
  • Report to work on time and as scheduled.
  • Wear identification while on duty.
  • Maintain regulatory requirements, including all state, federal and local regulations.
  • Represent the organization in a positive and professional manner at all times.
  • Comply with all organizational policies and standards regarding ethical business practices.
  • Participate in performance improvement and continuous quality improvement activities.
  • Attend regular staff meetings and in-services.
  • Follow through on commitments; accepts responsibility for personal actions; and adapt to change.
  • OR on call is Required at times.

Experience:
  • Healthcare/Medical - Nurse: Registered Nurse- Preferred
  • Two years perioperative RN or RNFA experience- Required

Additional Certification & Licensures details
  • Current and valid Registered Nurse licensure, RN First Assistant licensure in TN (CRNFA preferred but not required), Certified Nurse of the Operating Room (CNOR)
  • BLS Required by hire date
  • ACLS and CPI Required within 90 days of hire date

We are an E-Verify employer.
For more information, please click on the following links:
E-Verify Participation Poster: English Spanish
E-Verify Right to Work Poster: English Spanish

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