First Assistants in Surgery

Traditionally, a qualified surgeon or a resident in an approved surgical training program assumed the role of first assistant to the surgeon in the operating room (OR). Assigning a surgeon or resident to this function was considered necessary as a means of protecting the safety and welfare of the surgical patient. Due to the limitations placed on the number of hours medical residents can work and, to a lesser extent, the increased risk of malpractice lawsuits in certain areas of the country, staff shortages currently exist in surgical specialties. To meet the need for staff, nonphysician first assistants such as physician assistants (PAs), registered nurse first assistants (RNFAs), and various surgical technologists have emerged as a viable option for OR staff managers.

Risk managers should ensure that these practitioners are well qualified, working within an accepted scope of practice that has been approved by the facility's board of directors through appropriate credentialing mechanisms, and in full compliance with state regulations and accepted standards of practice.

This Risk Analysis reviews the following:

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