RN First Assistant

RN First Assistant Online Program

Lorain County Community College/Division of Allied Health and Nursing

Continuing Education for Health Professionals

Program Overview
The online RNFA program is for perioperative and advanced practice nurses who will assume the expanded role of the first assistant in the operating room.  The focus of the program is development of extensive knowledge of surgical anatomy and surgical procedures in a variety of surgical specialties.  Skill development includes intraoperative techniques of anatomy identification, providing exposure, providing hemostasis, knot tying and suturing, positioning and prepping.  The intraoperative role of the first assistant is emphasized. 

This program meets the standards of the Association of Operating Room Nurses and its revised Core Curriculum for the RN First Assistant, 3rd Edition.  The Competency and Credentialing Institute (CCI) accepts this course in preparing the Registered Nurse as first assistant in surgery.

The RN First Assistant Program consists of two credit nursing courses, NURS 297 and NURS 298.  Together these courses will include care of the patient experiencing general, gynecological, urological, head and neck, ENT, orthopedic, neurosurgical, plastic and reconstructive, vascular, thoracic and cardiac surgery, as required by the Competency and Credentialing Institute (CCI).  One course will be offered on-line fall and spring semesters.    Lorain County Community College uses the ANGEL system for on-line courses, which is extremely easy to use.   The professor is available on a full time basis at the college. 

NURS 297

NURS 298

On-line format only

On-line format only

 Fall or Spring semester

Fall or Spring semester

5 credit hours

5 credit hours

Skill development lab required.  Students will be provided a suturing packet and DVD.  An assigned project is required.

No lab

Clinical hours 45 (hours above 45 may be transferred to the next semester, as long as the student continues in the sequence in the same academic year)

Clinical hours 90 (hours may be tallied from NURS 297 – see NURS 297)

Topics include: role of the RN first assistant, nursing process, skill development and the following surgical specialties: general, gynecological, urological, head and neck, ENT

Topics include the following surgical specialties:  orthopedic, neurosurgical, plastic and reconstructive, vascular, thoracic and cardiac surgery

Laboratory requirements
Skill development will occur at the start of NURS 297.  Skills include:  tissue handling, visualization, suctioning, retracting, providing hemostasis, use of surgical instruments, knot tying and suturing, positioning and prepping.  Students will be provided a suturing DVD and suturing project

Clinical requirements
A total of 135 clinical hours as a first assistant in surgery are required.  The hours are flexible and must be arranged at participant’s hospital of employment.  Students are encouraged to first assist in a variety of specialties, but students may develop all of their skills in the surgical service in which they are employed. 

A letter from your hospital’s Director of Surgical Services and at least one surgeon or first assistant, agreeing to allow you to obtain clinical hours as a first assistant, is required prior to registration.  This letter must be on hospital letterhead stationery.  Please note the sample letter below:

This letter will serve as permission for ____________ to obtain required clinical hours for the RN First Assistant Program at Lorain County Community College.  Sign and date, include professional title, address, phone number and e-mail.

I, Dr. __________ or __________ RNFA, PA(C) or CFA, agree to support __________ as he/she pursues clinical practice required for the RN First Assistant Program at Lorain County Community College.  Sign and date, include professional title, address, phone number and e-mail.

Both of these statements and signatures may be included in one letter.

Upon receipt of all of these items, students may register and a formal LCCC and hospital agreement will be sent.


Rothrock, J., Alexander’s Care of the Patient in Surgery, 13th Ed. , 2007.  
  Mosby: St. Louis (available at the LCCC bookstore)

Rothrock, J., and Seifert, P., Assisting in Surgery: Patient Centered Care, 1st Edition (Sept. 2009) (available from Competency and Credentialing Institute.)

Participants are encouraged to check their hospital’s tuition reimbursement benefit.  As these are credit courses, tuition reimbursement policies usually apply.  You may take these courses in one academic year (fall and spring semesters) which is two different calendar years.  This may allow you to maximize your benefit.  The fee for RN First Assistant I is $1900 for Ohio residents and $2,525 for out of state residents.  The same fee applies to RN First Assistant II.  

Current licensure as a Registered Nurse in your home state is required.  A copy of your nursing license is required.   

CNOR certification (prior to registration) is required for perioperative nurse participants.  A copy of your certificate is required.  However, those who are CNOR eligible, with a reservation to take the CNOR exam, may take this course.  Accreditation rules state that if the participant does not become certified while in the program, a certificate at the end of the program may not be awarded.  If you are not CNOR certified, please call the Competency and Credentialing Institute at 1-888-257-2667 with questions regarding the CNOR exam and qualifications. 

Advanced Practice Nurses are not required to have the CNOR certification.  A copy of your certification as a Nurse Practitioner or Clinical Nurse Specialist is required.

Canadian nurses who are certified, CPN(C), are not required to have the CNOR.  A copy of your certification is required.

Prospective students are advised that first assisting requires a significant expansion of the perioperative nurse’s knowledge of surgical anatomy, surgical procedures and intraoperative technique.  It requires a complete commitment to the educational process and demands of the first assistant role.  As one’s role expands so does the level of maturity and responsibility required to assure safety in patient care delivery.  Perioperative nurses are encouraged to consider the demands of their personal lives and weigh their personal ability to commit to this rigorous academic challenge before applying.  

A minimum number of students are necessary for this program to continue each semester. 

Contact: Michelle Michener (HS 223)
Lorain County Community College
1-800-995-5222, ext. 4165

Faculty and Program Personnel 

Patricia K. Sedlak, CST, RN, BSN, CNOR, RNFA, MEd.
Associate Professor and Director
Surgical Technology, Surgical Assistant
and RN First Assistant Programs

Division of Allied Health & Nursing
Lorain County Community College HS 223
1005 North Abbe RoadElyria, OH 44035


1-800-995-5222, ext. 7159

440-366-7159 direct

440-366-4116 fax


Michelle Michener
Staff Associate
Continuing Education for Health Professionals

Division of Allied Health & Nursing
Lorain County Community College HS 223
1005 North Abbe Road
Elyria, OH 44035


1-800-995-5222, ext. 4165

440-366-4115 (fax)


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