Registered Nurse First Assistant | RN (RNFA)

Registered Nurse First Assist (RNFA)

Saint Louis, Missouri

Days | Full-Time | $44 – $72 per hour

Compensation based on experience and qualifications

Position Overview

We are seeking an experienced Registered Nurse First Assist (RNFA) to join a high-performing surgical team in a large acute care hospital setting. This full-time position offers the opportunity to work 10 or 12 hour shifts, with a 6:30 AM start time, supporting a wide range of cases including general surgery, orthopedics, robotics, gynecology, and vascular.

About the Facility

This leading regional hospital provides a full continuum of medical and surgical services—including cardiac, oncology, women’s health, gastrointestinal, orthopedic, stroke, and rehabilitation care. The hospital has earned national recognition for nursing excellence, patient outcomes, and clinical innovation, including Magnet® designation — a distinction held by fewer than 10% of hospitals nationwide. The Surgical Services Department includes 20+ operating rooms, with three dedicated heart team rooms and advanced robotic surgical technology.

Role Purpose

The RNFA plays an expanded perioperative role by serving as a first assistant to surgeons during operative procedures. Working collaboratively with the surgical team, the RNFA provides direct intraoperative patient care and supports the preoperative and postoperative continuum.

Key Responsibilities

• Deliver intraoperative patient care as a first assistant to the surgeon in collaboration with the surgical team.
• Perform focused preoperative nursing assessments related to the planned procedure and develop corresponding nursing diagnoses and goals.
• Plan, implement, and evaluate individualized care plans throughout the perioperative process.
• Administer medications and monitor patient responses, modifying plans as necessary.
• Evaluate patient progress and document outcomes in accordance with quality standards.
• Contribute to the efficiency, safety, and effectiveness of the surgical department.
• Participate in professional development and continuing education to maintain current practice standards.
• Mentor peers and collaborate across disciplines to enhance team performance.
• Incorporate evidence-based practices and maintain ethical decision-making in all care activities.

Minimum Qualifications

Education:

• Bachelor’s Degree in Nursing (BSN)

Experience:

• 2–5 years of perioperative or surgical nursing experience

Licensure/Certification:

• Current RN license (state of Missouri or compact state)
• CNOR certification

Preferred Qualifications

Experience:

• 5–10 years of perioperative or RNFA experience

Certification:

• Certified First Assistant (CFA or CRNFA)

Benefits Overview

• Comprehensive medical, dental, and vision coverage (eligible first of the month following hire)
• Employer-paid disability insurance
• 401(k) with employer match and automatic contribution
• Tuition assistance and professional development programs
• Paid Time Off (PTO) combining vacation, holidays, and sick time
• Adoption assistance and additional voluntary benefits

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