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RN First Assistants or RFNAs for short are nursing professionals who function in an expanded role or as an Advanced Practice Registered Nurse (APRN) assisting during surgery. Those working as RNFAs are highly skilled and qualified to provide perioperative, intraoperative, and postoperative care for patients undergoing surgical procedures. RN First Assistants must have acquired the right knowledge, judgment, and skills in order to expand their role in the Operating Room. Intraoperatively, RNFAs practice under the guidance of a surgeon and do not function as scrub nurses.

To become a Certified Registered Nurse First Assistant (CRNFA) it is required that individuals validate their competency as a perioperative nurse by working closely with a surgeon in an expanded nursing role. Certifications can be earned through organizations like the Competency & Credentialing Institute (CCI). Based on current data, the average salary of an RNFA is $68,450 a year and the profession is expected to grow 16% over the next decade.