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In January 2001, I was granted the opportunity to work in an expanded perioperative nursing role as a Registered Nurse First Assistant (RNFA) at Hamilton Health Sciences (HHS), in Hamilton, Ontario. This role was to be practised under the supervision of Dr. John Wells in the neurosurgical specialty. Officially, I began working in this capacity on March 5, 2001. This position is under corporate evaluation and, at present, its future is undetermined.
Currently, there are seven known RNFAs working in Ontario. The first two were hired at the Trillium Centre, in Mississauga, in November 2000. The Trillium Centre recently recruited two more RNFAs. Soldier's Memorial Hospital, in Orillia, fully sponsored two perioperative nurses to become RNFAs. They began their positions in January 2001, employed full-time by the hospital. I am the fifth RNFA to practise in Ontario.(1)
BACKGROUND
In order to practise as an RNFA in Ontario and be eligible to apply for RNFA-accredited expanded education, one must be an RN licensed with the College of Nurses of Ontario, have at least two years' operating room (OR) experience and have achieved national Perioperative Certification in Canada.
There are several health organizations that sanction this role in Ontario, as well as nationally. In particular, the Ontario Medical Association(2) and the College of Nurses of Ontario(3) endorse the role to be within the scope of nursing practice, if the additional knowledge, skill and decision-making abilities required to function in such a capacity are achieved through a recognized formal first assistant educational program that includes a surgeon-mentored clinical component.
There are two Canadian RNFA programs. One is offered in the French language through a university program at Trois-Rivieres in Quebec, and the other through the British Columbia Institute of Technology (BCIT). The latter is a university-accredited program(4) that consists of: 12 to 16 weeks of distance education, one-week didactive and live laboratory components, and a minimum of 175 hours of surgeon-mentored clinical internship. The BCIT-RNFA program is standardized, recognized and available to all qualified perioperative nurses across Canada. I was fortunate and honoured to complete my internship at the same facility where I practise today.
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What is unique to the RNFA role is that it allows the nurse to provide continuity of...