Registrered Nurse First Assistant (RNFA) in robotic surgery

In 2010, the first Danish RNFA in robotic surgery was educated at the Department of Urology,
Aalborg University Hospital. In 2012, another nurse was educated within the same department.

The purpose of educating nurses in the assisting role of robotic surgery, was a request from the surgeons for continuity and experience in the assisting role of a fixed assistant.

Experience has shown that the expectations have been met.

The two RNFAs …

  • have the expertise in standard procedures of each operation
  • have a detailed knowledge of the advantages and limitations of the robot, operational procedures and instruments (robotic and laparoscopic) and instruments (robotic surgery and laparoscopic) but also various utensils
  • together with the surgeon, preoperatively, going through the patient’s chart and x-ray
  • are one step ahead during the whole process and hereby prevent many challenges
  • are able to trouble-shoot from several angles/views – from a nursing point of view but also seen from  the technical and assistant (medical) point of view
  • handle the instruments in a prompt and precise manner so that theatre time and bleeding are reduced and safety improved
  • act quickly, appropriately and in case of deviations from standard procedures
  • have theoretical and practical skills to act appropriately in case of critical matters
  • work closely together with the surgeon – they know each other’s roles, responsibility and  working methods
  • know how to read the surgeon’s instrument signals –  just like reading body language
  • are very service-minded – always being aware of how to optimize the conditions for the operating surgeon
  • contribute to qualified assistance so that both beginners as well as experienced robotic surgeons can focus more on their own role and to a lesser extent on the assisting role
  • when communicating with the surgeon are aware of the fact that the surgeon and the assistant/other staff do not see the same thing neither on the screen (2D/3D), everything outside the screen or each other
  • are supervising young doctors in the assistant role during their first 5 assistances in robotic surgery
  • are able to help, teach and give support to other nurses – specially trainees and less experienced nurses
  • are able to flex between the work of a nurse and an assistant which gives a certain flexibility in all work flows so that pre-, per-, and postoperative procedures are being speeded up
  • give the possibility to make a surgeon available for other duties
  • are an economic advantage in a department