Nurse Types / RNFA
Registered Nurse First Assistants (RNFA) have exciting careers. They serve as a right-hand man (or woman) to surgeons. Their jobs are an extension of the traditional operating room nurse. From delicate brain surgeries and knee replacements to emergency surgery to repair internal and external trauma, an RNFA is in every stage of the action. They assist with medical corrections and interventions needed to help people live better, healthier lives.
In this article we will explore:
- What does an RNFA do?
- How do I become an RNFA?
- Where do RNFAs work?
- What are the job and salary outlooks for RNFAs?
What does an RNFA do?
The primary role of a registered nurse first assistant is to monitor patients’ vital signs during surgical procedures. If complications arise, the RNFA must spring into action, helping the surgeon and other medical personnel stabilize the patient.
Some of the other common tasks for RNFAs include:
- Preparing patients for surgery
- Providing patient care and support before and after surgery
- Administering medications before and after surgery
- Preparing all surgical tools and supplies needed for performing surgical procedures
- Practicing surgical procedures that include controlling bleeding, draping, handling tissue, and suturing incisions
- Performing CPR or other life-saving measures when necessary
- Educating patients and families about surgery after-care
- Conducting post-operative assessments
These are just a few of the duties for RNFAs. Some employers may require additional responsibilities. Be sure to ask about all expectations before accepting an RNFA job.

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How do I become a RNFA?
The first step in becoming a registered nurse first assistant is to complete an accredited nursing program. Then, you must pass the NCLEX-RN to earn your RN licensure. That is not the end of the journey. To become a certified RNFA, nurses must meet two other criteria before they are eligible to work alongside surgeons and other medical staff in the operating room.
- RNFAs need at least two years of perioperative nursing experience
- RNFAs must hold Certified Nurse Operating Room (CNOR) credentials. The Association of perioperative Registered Nurses (AORN) oversees all RNFA credentialing programs.
You cannot work as an RNFA without CNOR credentials. Skipping this step will invalidate you as a candidate for RNFA nursing positions.
Where do RNFAs work?
Hospitals and ambulatory surgery centers are an obvious choice for registered nurse first assistants. They also can practice their craft in other healthcare settings like obstetrical delivery rooms, critical access hospitals, dentists’ offices, plastic surgery centers, and ophthalmologists’ offices.
What are the job and salary outlooks for RNFAs?
The U.S. Bureau of Labor Statistics (BLS) does not provide salary figures for nursing specializations but rather lumps all classifications of RNs into the same category. RNFAs earn an average salary of $90,631, according to data from Incredible Health.
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Some states pay more than others for the privilege of having RNFAs on staff in hospitals, ambulatory surgery centers, and other healthcare facilities where surgeries are routinely performed. Among the top five states offering the best annual compensation for RNFAs are California, Hawaii, Massachusetts, Oregon, and Washington, D.C. RNFA jobs come with some amazing benefits. Health insurance, retirement options, and tuition reimbursement are among the many perks you can expect from employers.