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The Registered Nurse First Assistant (RNFA)

About the RNFA Program

The Registered Nurse First Assistant (RNFA) is a perioperative registered nurse (RN) or an Advanced Practice Registered Nurse (APRN) who functions in an expanded role as a surgical first assistant. The RNFA works in collaboration with the surgeon and other health care team members to achieve optimal patient outcomes; utilizes the necessary knowledge, judgment, and skills specific to the expanded role of RNFA clinical practice; and practices intraoperatively at the direction of the surgeon” (AORN, 2015).

The RNFA role is recognized within the scope of nursing practice by the nurse practice acts in all 50 states and may vary depending on patient populations, the environment in which the RNFA practices, services provided, availability of fiscal resources including reimbursement policies, and institutional credentialing regulations. (AORN, 2015). 

RNFA Details

All students will enter the RNFA program in the Fall.

  • Three courses (Total 9 credit hours)
      • Course 1 offered on-line: Fall
      • Course 2 offered on-line: Spring
      • Course 3 clinical practicum offered: Spring and Summer
  • One week (40 hours) on-campus simulation workshops offered during Course 1
  • 180 clinical hours of perioperative practicum in Course 3 precepted by Board-Certified Surgeons in your area of residence
Admission Eligibility

Who Should Apply?  

  • Applicants must have: (1) current RN license, (2) BCLS, ACLS (preferred), (3) minimum cumulative GPA of 3.0 AND (4) one of the following:  
      • BSN or RN enrolled in BSN accredited program (CNOR/CNOR eligible)
      • MSN/DNP/PhD with APRN certification
      • BSN/MSN/DNP/PhD seeking APRN and/or CNOR certification

How To Earn RNFA Certificate of Completion?

  • Must achieve:  (1) successful completion of 3 RNFA courses, AND (2) CNOR or APRN certification (eligible) (students who complete the 3 RNFA courses but have not earned CNOR or APRN certification at time of completion of RNFA program will be issued a certificate of completion upon proof of CNOR or APRN certification)


How To Earn RNFA Certification?

  • Must have RNFA Program certificate of completion AND proof of completion of 2,000 RNFA practice hours. Individual states have different requirements to become eligible to practice as a RNFA. Contact your state Board of Nursing to learn about specific requirements.

Please refer to the residency requirements for Certificate program taken from our admissions page: Graduate certificate applicants with APN license should contact the Office of Student Affairs at 901-448-6139 or for questions on state authorization. RNFA applicants without APN licensure (those currently CNOR eligible and enrolled in an RN to BSN program) must reside in the tri-state area (TN, MS, AR) during their enrollment. Clinical must be completed in TN, MS, or AR. Students accepted into certificate programs are not eligible for federal financial aid.

See complete admission requirements
on Nursing CAS at

RNFA Program Outcomes

The graduate of the RNFA program will be able to:

  1. Explore potential surgical hazards and safety measures to prevent injury including patient and occupational related hazards.
  2. Explain the design and use of key surgical instruments used for surgical procedures.
  3. Demonstrate knowledge of common surgical procedures incorporating an understanding of anatomy, physiology and pathophysiology.
  4. Demonstrate proper sequence of procedures, assisting behaviors, operative technique and knowledge of potential complications related to the surgical procedure.
  5. Exhibit proper handling and knowledge of surgical instruments and medical devices, providing surgical site exposure, handling tissue, cutting tissue, providing hemostasis, suturing, and wound management.
  6. Develop a continuous and applicable nursing assessment, plan of care and patient evaluation throughout the perioperative period in collaboration with other health care providers.
  7. Document intraoperative patient management in the surgical first-assisting clinical experience.
  8. Document postoperative patient management such as participation in postoperative rounds and assisting with discharge planning including identification of appropriate community resources intraoperative clinical experiences precepted by Board-Certified Surgeons.


Last Published: Dec 4, 2017