By Ron Brewer RNFA, Owner, First Assist Surgical Team LLC: Like many of you, my journey to become a First Assist began when I became
a Certified Surgical Tech and eventually became a nurse working in the
OR. As my training progressed, I decided my ultimate goal was to become
an independent RNFA. That goal was achieved in 2003. Seven years later,
in 2011, I created a company that mimicked and reflected my own success.
I created First Assist Surgical Team and actively sought out my fellow
OR equals to provide a service that benefited both hospitals and surgeons.
Seventeen hospitals and two states later, our formula has proven to be
There are two things that have become evident to me while expanding our
business. 1) Once hospitals and physicians are introduced to the benefits
a qualified First Assist Program brings to their operating room, word
gets around and other physicians and hospitals want to utilize the service
and the demand increases; and 2) The demand is much higher than the supply.
I am on a constant search for quality first assistants to fill this ever
My team includes a top notch group of CRNFA’s, CSFA’s, and
SA-C’s. As a team, we all work together for the one common goal
of providing the consummate First Assist experience to the hospitals and
surgeons who utilize our service. Now, because of our strong commitment
to the team concept, we are continually approached by new hospitals and
physicians seeking to benefit from our services.
When looking for a First Assist, the hospitals and surgeons are looking
for quality of work, professionalism, knowledge, and experience. It is
important to note that at no time has a surgeon or a hospital asked me
to separate my team into certification categories so as to express a preference
for a certain category.
Industry wide, we have become specialists. And as specialists, we have
all gone through the appropriate certifying organizations for recognition
of our expertise. However, in our effort to become specialists, we have
become fragmented by either certification or surgical expertise rather
than realizing we are all ONE in the same; and that is the problem we
face today. With this in mind, it becomes clear we need to work together,
as a collective group, for local, state, and national recognition.
The answer is to make a well-trained and certified Surgical First Assist
the “Standard of Care” in cases where a first assistant is
needed. Currently, the credentials that satisfy this Standard of Care
are CRNFA, CSFA, SA-C, or CSA (also PA’s and NP’s with First
It is crucial that OR staff and others are guided by standards of care
in proper methods so they can provide the best possible care and outcomes
for patients who put the ultimate faith in their caregivers. Standards
of care dictate everything from: dress, time outs, which professionals
should be in the room for certain procedures, etc. It is a Standard of
Care to have an RN circulate, not a tech. It is a Standard of Care to
have a CRNA give anesthesia, not an anesthesia tech. It is a Standard
of Care to have a certified perfusionist run the pump on a heart case,
not the OR nurse.
We must promote a Standard of Care that requires a qualified First Assistant,
not an “extra tech or nurse,” provide first assist services.
Once the trained and certified First Assistant is recognized as the Standard
of Care in the OR, then organizations such as American Hospital Association
and the multiple Doctors Associations will recognize our collective profession
as an entity who should be recognized by our state and federal governments.
The bottom line is this: we have all been so busy getting our certifications,
learning surgeon specific needs, and meeting hospital desires, we forgot
to look out for ourselves and the important part we play in the industry.
First Assists are an individual industry, just like MD’s and PA’s,
and we need and deserve that same acknowledgement.
So I am issuing a challenge to you, companies like mine, and certifying
entities to ban together and demand our service to the industry be recognized,
acknowledged as the Standard of Care and paid fairly by employers and
health insurance companies for our higher level of training, expertise,
and professional liability. It is time for all First Assists, regardless
of certification or specialty, to ask our surgeons and hospital affiliations
to stand with us and support us in the goal of professional recognition.
Until we do this as a collective group, the insurance industry and other
parties will continue to wrongfully minimize our contribution to the surgical
process and patient outcomes. More importantly, First Assists are the
perfect standard bearers to represent and promote our “Standard of Care.” A recognized and thriving First Assist industry is one element
of healthcare that can act as a catalyst to make the OR economically viable
now and into the future. We already know this to be true. Now it is time
to bring this message to the entities that affect us.
Now that you have read and digested the Standard of Care concept I presented
above, I look forward to hearing your thoughts. How we can turn this concept
into a mechanism for change First Assists around the country can use to
make their role as standard bearers more productive and effective? We
look forward to reading your comments with enthusiasm.
Are you interested in becoming a Surgical Assistant? Contact
ACE Surgical Assisting
today to request more information
and to learn more about advancing your career.