Registered Nurse First Surgical Assistant - Frequently Asked Questions

Why has the training programme been established?

This is the first formal training for nurses in this role to be provided in New Zealand, though nurses commonly act as surgical first assistants in private hospitals in New Zealand and occasionally undertake the role in public hospitals. Training pathways exist for this role in the United Kingdom, United States, Australia and Canada.

Research has confirmed that both nurses and surgeons want a New Zealand training programme and this new programme will allow the role to be formalised and provide a clear career pathway and a transportable qualification. This advanced role qualification is credentialed by the Nursing Council of New Zealand. 

Why has the role been developed?

The surgical first assistant is a key role in theatres, supporting and enabling surgeons to carry out a safe and efficient operation. It is already well established as in the US, UK and Canada. Nurses commonly undertake the dedicated first assistant role in New Zealand private hospitals and occasionally in the public sector.

What advantages will there be in using the role more widely?

Creating a dedicated nurse surgical first assist post will help boost the workforce for elective surgery at a time when surgical capacity is increasing, as we seek to reduce surgery waiting lists. It will provide continuity for surgeons and stability in the theatre workforce.

By offering new career opportunities, it should improve retention of experiences and nurses and it will also free up the time of medical registrars to be utilised in more complex cases.

What does the role involve?

The tasks of surgical first assistant include skin preparation, clamping of vessels and retracting of tissue under the supervision and guidance of the surgeon.

Trainees in the new programme will participate in elective surgical procedures and at a later stage are likely to also be involved in the wider peri-operative role.

Does this replace other staff in theatres?

The role does not replace other staff. The development of the RN surgical first assist role will allow junior medical staff to be freed up to undertake more complex surgical tasks and for the focus to be on their skills development in dedicated surgical training lists.

How will patient safety be ensured?

Patient safety is paramount in all workforce innovations and training will be developed and overseen by senior clinicians. The nurse trainees will work under the supervision of a surgeon, undertake regular clinical assessments and each will have a dedicated surgeon mentor.

How will the success of the role be assessed?

The project is being overseen by a multidisciplinary steering group including senior surgeons and nurses.

The role will be fully evaluated in terms of productivity, quality and safety, surgical team satisfaction and patient outcomes to inform future application in New Zealand.

A second cohort of RNFSA trainees is expected to begin the programme in March 2012.