Registered Nurse First Assistant - Duke Health Cary

RN First Assistant (RNFA)

Duke Health Cary Surgery Center | Cary, NC

Help Build the Future of Ambulatory Surgery

Duke Health is seeking an experienced Registered Nurse First Assistant (RNFA) to join the founding clinical team of the new Duke Health Cary Surgery Center, a state-of-the-art ambulatory surgery center scheduled to open in 2027.

This is a rare opportunity to be part of a new surgical facility from the beginning, helping shape the culture, workflows, and patient experience while delivering exceptional surgical care in a highly collaborative environment.

The Duke Health Cary Surgery Center will feature six operating and procedure rooms, including advanced robotic surgery capabilities with two da Vinci surgical systems. The center will provide outpatient surgical services across multiple specialties, including:

• Urology
• Plastic Surgery
• Breast Oncology
• General Surgery
• Gynecology
• ENT
• Pediatric Urology
• Pediatric ENT
• Orthopedic Surgery

Why Join the Founding Team?

As a member of the inaugural perioperative team, you will:

• Help establish a culture of excellence, innovation, and teamwork
• Work with cutting-edge surgical technology, including robotic-assisted procedures
• Contribute to process design and continuous improvement initiatives
• Collaborate with highly skilled surgeons and perioperative professionals
• Deliver exceptional patient-centered care in a modern outpatient environment
• Play a key role in launching one of the region's most advanced ambulatory surgery centers

Position Summary

The Registered Nurse First Assistant (RNFA) provides comprehensive perioperative patient care through the preoperative, intraoperative, and postoperative phases of surgery. Working collaboratively with surgeons and the perioperative team, the RNFA serves as the qualified first assistant during surgical procedures, helping optimize patient outcomes, surgical efficiency, and workflow effectiveness.

This role supports surgical services across multiple specialties and serves patients of all ages while promoting quality, safety, and excellence in surgical care.

Key Responsibilities

Preoperative Care

• Conduct patient assessments and evaluations
• Collaborate with surgeons and care teams to develop plans of care
• Prepare and document preoperative orders in accordance with established protocols
• Coordinate care and communicate with multidisciplinary team members

Intraoperative First Assisting

• Serve as the qualified first assistant to the operating surgeon
• Provide surgical exposure, hemostasis, tissue handling, and wound closure
• Utilize surgical instruments, equipment, and technology safely and effectively
• Support procedural efficiency and patient safety throughout the surgical procedure

Postoperative Care

• Collaborate with providers during the immediate postoperative period
• Assist with postoperative documentation and orders following established protocols
• Participate in patient rounds and discharge planning activities
• Support continuity of care and positive patient outcomes

The RNFA functions as the surgical first assistant and does not concurrently perform the role of scrub nurse during procedures.

What We're Looking For

Successful candidates will:

• Have at least two years of ambulatory, outpatient, or perioperative surgical experience
• Thrive in a fast-paced, highly collaborative surgical environment
• Demonstrate accountability, professionalism, and reliability
• Embrace flexibility and cross-functional teamwork
• Support innovation, continuous improvement, and operational excellence
• Enjoy building new programs and contributing to organizational growth
• Be passionate about delivering exceptional patient care

Our Culture

At Duke Health Cary Surgery Center, we are building a team that:

• Puts patients first in every decision
• Works collaboratively across the perioperative continuum
• Embraces innovation and advanced technology
• Supports flexibility and operational excellence
• Values continuous learning and professional growth
• Promotes respect, inclusion, accountability, and psychological safety
• Takes ownership of quality, safety, and patient experience outcomes

Minimum Qualifications

Education

• Bachelor of Science in Nursing (BSN) required
• Master of Science in Nursing (MSN) preferred
• Graduate of an accredited school of nursing
• Completion of an accredited RNFA program that includes both didactic and supervised clinical practice and is based on the AORN Core Curriculum for the RNFA

Experience

• Minimum of three years of perioperative nursing experience required
• Previous operating room experience with both circulating and scrub responsibilities strongly preferred

Licensure & Certifications

• Current RN license in North Carolina or compact state licensure
• Basic Life Support (BLS) certification required
• CNOR certification required
• Current RNFA certification, or ability to obtain within two years of employment

Planned Start Dates

• February 8, 2027
• February 22, 2027

First patient procedures anticipated in April 2027.

Be Part of Something Extraordinary

If you are an experienced RNFA who is excited by the opportunity to help launch a new surgical center, collaborate with exceptional colleagues, and shape the future of outpatient surgical care, we invite you to apply and join Duke Health Cary Surgery Center.