Cardiac First Assist: Acute Care Nurse Practitioner (NP), Physican Assistant (PA) or RN First Assist (RNFA)

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General Summary

* Vein Harvesting Experience Preferred, but not required*

Under the direction and supervision of a licensed Cardiothoracic surgeon, assists in the performance of surgical procedures in Cardiac surgery.  During the intraoperative phase of heart surgery, the first assist practices in collaboration with and at the direction of the attending surgeon or his designee.

This position is hiring for an Acute Care Nurse Practitioner (NP), Physican Assistant (PA) or RN First Assist

1. Principal Responsibilities and Tasks
   
   The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification.  They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

1. 1. Performs tissue handling including making incisions, retracting, dissecting, tying, ligating, stapling, suturing and providing hemostasis.  Performs chest closure, including chest wires when indicated.  Routinely closes the leg and chest soft tissue layers. Assists in transporting the patient from the O.R. to the CTICU/ PACU.
   2. Performs endoscopic or open harvesting of the saphenous vein during coronary artery bypass procedures and preparation of the vein for bypass.
   3. Performs endoscopic or open harvesting of the radial artery during coronary artery bypass procedures and prepares radial artery for bypass.
   4. First or second assisting with cannulation, graft anastomosis, valve placement, decannulation, femoral access catheters (including IABP)  or any other task of open heart procedures.
   5. First or second assists on robotic procedures including port placement.
   6. Physician Assistant or Nurse Practitioner level RNFA performs the pre-op surgical addendum for outpatients on the morning of surgery.
   7. Assists in supervising students of all levels in the appropriate understanding of the Cardiac operating room including evaluation of pre-op tests, sterile technique, anatomy, procedure steps, and introduction to suturing.
   8.  Role models Patient-Centered Care and mentors other in their growth.
   9. Researches and integrates evidence-based findings into practice beyond the unit.
   10. Notifies the attending surgeon or resident regarding any unusual or unexpected events or problems requiring direct physician consultation or intervention while the patient is in the intraoperative phase of care.
   11. Must take call during non-routine working hours to assist attending physicians in urgent and emergency procedures.

1. 1. Education and Experience

      Graduation from a Physician Assistant Training Program approved by the Board of Physician Quality Assurance is required.  Evidence of current certification as a Physician Assistant by the Maryland Board of Physician Quality Assurance.

   2. 1. Certification or eligibility for certification by National Commission for Certifying Physician Assistants is required. Current Basic Cardiac Life Support Certification is required.
      2. Registration by Maryland State Board for Medical Examiners as a Physician Assistant is required.
      3. Copy of a letter of agreement approved by Board of Physician Quality Assurance is required.
      4.  A minimum of 5 years of experience as a Physician Assistant  is suggested      

Or: 

1. 1. Successful completion of a recognized planned program of instruction designed for the Registered Nurse Surgical First Assistant to include:
      1. Didactic instruction of at least 50 hours which includes:
      2. Pre-operative and post-operative assessment, evaluation of physical and laboratory findings, patient pain management and patient and staff teaching.
      3. Intraoperative considerations including anatomy and physiology and surgical interventions as related to each system.
      4. Surgical techniques.
      5. Surgical hazards and appropriate interventions.
      6. Clinical instruction and experience including:
   2. A minimum of 200 hours assisting in major surgical procedures including positioning, prepping and draping, providing exposure, retraction, hemostasis, and surgical instrumentation.
   3. Instruction provided by qualified surgeons participating in the program.
   4. The surgeon preceptor(s) written documentation of the registered nurse’s competency in the intraoperative surgical first assistant role.
   5. A minimum of 5 years of experience as a Registered Nurse First Assist is suggested

All your information will be kept confidential according to EEO guidelines.