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Surgical First Assistant Jobs in Hawaii (NOW HIRING)

The Queen's Health System

Thoracic Surgeon

Honolulu, HI · On-site

$575K/yr

Participates in the first assist program for both Thoracic and Cardiovascular surgery cases. * Makes rounds on Thoracic and Cardiovascular Surgery (TCV) patients in accordance with expectations of ...

Centstone HC

Surgical Technologist

Hilo, HI · On-site

$1 - $2/wk

Surgical Technologist (Operating Room / Scrub Tech) Location: Hilo, Hawaii Pay Rate: $ 1,800 To $ 2 ... Independently scrub and assist during General, Orthopedic, Vascular, Ophthalmic, Urology, ENT ...

Talented Medical Solutions

Surgical Tech (19291)

Kailua, HI · On-site

$28 - $38.50/hr

Certified Nursing Assistant (CNA) certification: Preferred * Certified Surgical Technologist (CST) credential: Required in Hawaii within one year of hire Essential Functions * Prepare surgical cases ...

Shrinerschildrens

Surgical Technician

Honolulu, HI

$32.55 - $48.83/hr

The Surgical Technician will have the opportunity to assist surgeons during operative and invasive procedures, as well as assist in preparation of surgical services to ensure suite setup is ...

Shriners Children's

Surgical Technician

Honolulu, HI · On-site

$32.55 - $48.83/hr

The Surgical Technician will have the opportunity to assist surgeons during operative and invasive procedures, as well as assist in preparation of surgical services to ensure suite setup is ...

3B Healthcare, Inc.

Surgical Tech - OR

Kailua, HI · On-site

Required Certified Nursing Assistant (CNA) certification: Preferred Certified Surgical Technologist (CST) credential: Required in HI within one year of hire Facility Specific License/Certifications:

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Surgical First Assistant information

See Hawaii salary details

$17

$39

$78

How much do surgical first assistant jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for surgical first assistant in Hawaii is $39.12, according to ZipRecruiter salary data. Most workers in this role earn between $31.20 and $43.46 per hour, depending on experience, location, and employer.

What is a surgical first assistant?

A Surgical First Assistant is a trained healthcare professional who assists surgeons during surgical procedures. Their responsibilities include providing exposure, controlling bleeding, suturing incisions, and ensuring the surgical field is maintained. They work closely with surgeons, nurses, and other operating room staff to help ensure surgeries are conducted safely and efficiently. Surgical First Assistants may be registered nurses, physician assistants, or other certified professionals who have completed additional specialized training.

How do you become a surgical first assistant?

You can become a Surgical First Assistant by first getting certified as a Surgical Technologist. You can then pursue the Certified Surgical First Assistant (CSFA) credential to enhance your learning process as well as your professional profile. The minimum education requirement for this job is an associate degree, but some employers will prefer a bachelor’s degree prior to your certification. At your earliest opportunity, you should begin working in a medical environment, such as a hospital or clinic.

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

To thrive as a Surgical First Assistant, you need in-depth knowledge of surgical procedures, anatomy, sterile techniques, and typically a certification such as the Certified Surgical First Assistant (CSFA) or equivalent. Familiarity with surgical instruments, advanced suturing techniques, and operating room technology is essential. Excellent communication, attention to detail, and the ability to anticipate surgeons’ needs are vital soft skills in this role. These skills and qualities ensure patient safety, efficient surgical workflows, and optimal support for surgeons during procedures.

How does a surgical first assistant typically collaborate with surgeons and other members of the surgical team during procedures?

A Surgical First Assistant works closely with the lead surgeon and the entire operating room team to ensure procedures run smoothly and safely. Their responsibilities include anticipating the surgeon’s needs, providing technical support such as tissue retraction, suction, and suturing, and maintaining clear communication throughout the surgery. Collaboration requires adaptability, quick decision-making, and a thorough understanding of surgical protocols. Effective teamwork is vital, as the assistant helps maintain sterile fields, manages instruments, and supports patient safety at every stage of the operation.

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

AspectSurgical First AssistantSurgical Technologist
CredentialsCertified Surgical First Assistant (CSFA), surgical assisting certificationsCertified Surgical Technologist (CST), surgical tech certifications
Work EnvironmentAssist surgeons during procedures, work closely in the operating roomPrepare operating rooms, sterilize instruments, assist in setup
Employer & IndustryHospitals, surgical centers, clinicsHospitals, surgical centers, outpatient facilities
Common Search/ComparisonYesNo

The Surgical First Assistant and Surgical Technologist roles both operate in the operating room environment but differ significantly. Surgical First Assistants actively assist surgeons during procedures, requiring advanced certifications like CSFA. Surgical Technologists prepare the OR and support the surgical team but do not directly assist during surgery. Understanding these differences helps in choosing the right career path or job search focus.

Is a surgical first assistant a good career?

A surgical first assistant is a skilled healthcare professional who supports surgeons during procedures, requiring certification and knowledge of surgical techniques. It offers a stable job outlook with opportunities for specialization and advancement, often involving working in operating rooms with a team. The role provides meaningful work in patient care and typically involves a demanding schedule with high responsibility.

What qualifications do you need to be a surgical first assistant?

To become a surgical first assistant, candidates typically need to have a healthcare background such as a registered nurse, surgical technologist, or physician assistant, along with specialized training in surgical assisting. Certification through organizations like the National Surgical Assistant Association (NSAA) or the American Association of Surgical Assistants (AASA) is often required or preferred. Additionally, strong knowledge of surgical procedures, anatomy, and sterile techniques is essential.

Where do surgical first assistants make the most money?

Surgical first assistants tend to earn higher salaries in regions with a higher cost of living and greater demand for specialized healthcare services. Typically, urban areas and regions with large hospitals or medical centers offer the highest compensation, especially for those with advanced certifications and experience. Salary can also vary based on the healthcare facility and geographic demand for surgical services.
More about Surgical First Assistant jobs

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For Surgical First Assistant jobs in Hawaii, the most frequently searched job titles are:

What job categories do people searching Surgical First Assistant jobs in Hawaii look for?

The top searched job categories for Surgical First Assistant jobs in Hawaii are:

What cities in Hawaii are hiring for Surgical First Assistant jobs?

Cities in Hawaii with the most Surgical First Assistant job openings:

Surgical First Assistant jobs near you
Infographic showing various Surgical First Assistant job openings in Hawaii as of August 2026, with employment types broken down into 4% As Needed, 67% Full Time, and 29% Contract. Highlights an 100% In-person job distribution, with an average salary of $81,367 per year, or $39.1 per hour.

RN, Surgery, First Assistant, Full Time, Day Shift

Adventist Health

Kailua, HI • On-site

$65.75 - $90.19/hr

Full-time, Other

Re-posted 29 days ago

Key responsibilities

  • Organizes and facilitates patient care in the Operating Room (OR).

  • Assists with surgical procedures by handling tissues, clamping blood vessels, suturing, and placing drains in collaboration with the surgeon.

  • Performs circulating and scrubbing duties, including confirming surgical site, maintaining sterile environment, and documenting relevant patient data.

Adventist Health rating

7.7

Company rating: 7.7 out of 10

Based on 246 frontline employees who took The Breakroom Quiz

165th of 898 rated healthcare providers

Job description


RN Castle Benefits:
  • Evening Shift Differential: $2/hour
  • Night Shift Differential: $6/hour
  • Weekend Shift Differential: $1/hour
  • No Parking Fees

Located in Kailua, Adventist Health Castle has been one of the area's leading healthcare providers since 1963. We are comprised of a 160-bed hospital, eight medical offices, home care services, urgent cares and a vast scope of services located throughout O'ahu. In 2017, Adventist Health Castle was recognized with the Malcolm Baldrige National Quality Award, the nation's highest presidential honor for performance excellence. O'ahu is known for its ideal climate, diverse culture and picturesque landscape. The allure of Castle's laid-back lifestyle is complimented by its close-knit and proud community.
Job Summary:
Organizes and facilitates the patient while in the Operating Room (OR). Coordinates the overall care of patient between surgeon, anesthesiologist and room staff. Functions as a first assistant during surgical incision, excision, and repair of pathology throughout the perioperative period on procedures for which privileges have been granted. Participates in preoperative assessment and planning for selected surgical patients in collaboration with the healthcare team members in the preoperative location. Regularly demonstrates subject matter expertise regarding medication, treatment and patient care standards.
Job Requirements:
Education and Work Experience:
  • Completion of an RNFA program that meets AORN standards: Required
  • Two years' perioperative nursing experience: Preferred

Licenses/Certifications:
  • Registered Nurse (RN) licensure in the state of practice: Required
  • Certified Registered Nurse First Assistant (CRNFA) certification in the state of practice: Preferred
  • Cardiopulmonary Resuscitation (CPR) certification or Basic Life Support (BLS) certification from approved vendor per AH policy: Required
  • Certified Nurse Operating Room (CNOR) certification: Required
  • Pediatric Emergency Assessment, Recognition and Status (PEARS)/Pediatric Advanced Life Support (PALS) certification from approved vendor per AH policy: Preferred
  • Association of perioperative Registered Nurses (AORN) membership: Preferred

Facility Specific License/Certifications:
  • Basic Life Support (BLS) certification from approved vendor per AH policy: Required

Essential Functions:
  • Performs circulating and scrubbing duties. Verbally confirms surgical site/side before induction of anesthesia. Accurately performs all sponge, needle, sharp and instrument counts at appropriate time and according to department policy. Handles and dissects tissues in collaboration with the surgeon. Clamps blood vessels, coagulates bleeding points, ligates vessels, and performs other procedures in collaboration with the surgeon. Sutures muscle, fascia, subcutaneous, and skin tissue in collaboration with the surgeon. Places drains as surgically indicated. Assists with cannulation and decannulation procedures, if indicated.
  • Assists with transferring the patient to and from the operating room, positioning, prepping and draping. Provides patient with safe and aseptic environment by applying the principles of aseptic technique. Takes corrective action to rectify breaks in aseptic technique. Inspects sterile items before opening and maintains sterility of items during delivery to sterile field. Obtains and interprets patient data to determine appropriate diagnostic and therapeutic procedures, as needed. Develops and implements action plan for practice changes to enhance patient outcomes.
  • Maintains appropriate traffic patterns and personnel around the sterile field. Applies appropriate methods and parameters of sterilization/disinfection. Observes for general cleanliness of the Operating Room and takes appropriate action to amend, as necessary. Prepares instruments according to physician preference and scheduled procedure. Utilizes specific knowledge and skills in a surgical environment to assist the surgeon. Works under minimal supervision.
  • Documents relevant data, including but not limited to nursing diagnoses, patient's plan of care, intervention and response, and discharge plan. Mentors, develops, inspires, educates and leads staff members in patient care setting. Enhances efficiency and cost effectiveness by identifying opportunities to decrease costs, as applicable to the job.
  • Performs other job-related duties as assigned.

Organizational Requirements:
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.
About Us
Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Founded on Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.

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