AUGUST 2020 • Volume 14, No. 8

From the Editor

How are you doing, as we head toward fall in this unusual year?

So many folks are deliberating next steps in their careers right now. Whether you are considering a change or hewing to the same path you’ve been on, you may be interested in NIFA’s latest offering. We have just introduced a series of “Afterhour Webinars” presenting over 8 hours per month of live, interactive seminars on different RNFA topics to help students excel in the highly competitive role of RN First Assistant (see below).

Our surgical topic is total knee arthroplasty (TKA), or total knee replacement, a commonly performed orthopedic procedure and one NIFA covers in its RNFA trainings. According to the American Academy of Orthopaedic Surgeons, more than 790,000 TKAs are performed annually in the United States. It is most often a treatment for osteoarthritis or other types of arthritis, and of course is used in some cases of injury as well. Between wear and tear on aging baby boomers’ bodies, rates of obesity, and people’s desire and drive to stay active later in life than their parents and grandparents did, the volume of TKA surgeries is expected to continue to increase steadily for at least the next 30 years. In this issue we provide some resources about the procedure.

Our Student in the Spotlight is Amy Qualls, BSN, RN, CST, CNOR, of Ft. Worth, TX.

Scroll down for jobs we’ve collected for you, and NIFA’s favorite links.

Thanks, and take care.

Julie Lancaster, Editor

NIFA News: Afterhour Webinars!

We are delighted to announce a brand new interactive program: NIFA Afterhour Webinars. Designed as a special add-on for current students in NIFA’s RNFA program, we are opening it up to you, the readers of this newsletter. Call 800-922-7747 to register.

Over the next 12 months in this series of live, interactive online seminars, leading RNFAs and related professionals will answer your questions and discuss matters of interest to practicing and aspiring RNFAs. Some topics coming up:

  • Sept. 8 – Kimberly Jones, MSN-Ed., RN, CNOR, RNFA, Director of Education, College Division, NIFA, on navigating an online RNFA course, testing/remediation, case logs, documentation, grade reports, and more.
  • Sept. 9 – Carrissa Homme, PhD, and Kellie Anderson, both from the CCI (Competency and Credentialing Institute), along with Julia Johnson, Executive Director, NASC (National Assistant at Surgery Certification), on questions related to RNFA certification.
  • Sept. 14 – Dean Parsons, RN, BSN, CNOR, RNAS-C, Director of NIFA’s SutureStar™ Workshops, on skills-related questions, such as identifying the skills of the nation’s top RNFAs and determining how to best expand one’s expertise.

And a special invitation for readers of this RNFA eNews:

The above schedule covers just the next two weeks for NIFA students and graduates! Keep checking back at this link as new programs are added each month.

Knee Replacement Surgery

Early knee joint replacement efforts took place as far back as 1860, when German surgeon Themistocles Gluck experimented with surgically implanting hinge joints made of ivory. Since the first total knee replacement in 1968, there has been a great deal of work on developing prostheses that have used a variety of mechanisms, as well as materials ranging from pig’s bladder and nylon to polyethylene, ceramics and metal.

A few years ago the medical equipment manufacturer Stryker introduced its MAKO robot (previously available to perform hip replacements and partial knee replacements) to perform total knee replacements. We couldn’t find statistics showing how prevalent robotic-assisted knee surgeries have become, but the equipment seems to be in great demand by hospitals.

Recent news reports on hospitals using MAKO robotic arms for knee replacements:

*  Adirondack Health, Saranac Lake, NY Read more . . .
*  Charlotte Hospital, Charlotte, NC Read more . . .


Video of a knee replacement using the MAKO robotic arm. From Panorama Orthopedics and Spine Center, Denver, CO. 
Watch video . . .

From St. Luke’s Hospital, UnityPoint Health, Cedar Rapids, with the help of KCRG-TV9: Live knee replacement video (non-robotic).  
Watch video . . .

Orthopedic surgeons with Orthopedics & Sports Medicine, BayCare Clinic, Manitowoc, WI, narrate a total knee replacement procedure (non-robotic), then discuss issues that typically follow knee replacement surgery.  
Watch video . .

Student Spotlight: Amy Qualls


Student Status  
Current student

City & State  
Fort Worth, TX

Current Position  
I am currently an RN in the operating room where I started as a CST 12 years ago. I still scrub cases as well as
circulate, and I love doing both! Surgery is where I’m meant to be.

Where did you get your RN degree?    
I received my Associates in Nursing at Tarrant County College in 2013 and moved on to get my Bachelor’s in Nursing from Texas Tech University in 2016.

How did you come to choose perioperative nursing?  
I worked as a surgical technologist for five and a half years before becoming an RN in the operating room.

What is the scariest moment you’ve ever seen at the table?  
The scariest moment happened while I was still a CST and helping with a cardiac procedure. Right after using the sternal saw, the surgeon lifted the sternum, which was stuck to the heart, causing it to rip a hole in the ventricle. (The surgeon did repair the hole and the patient made it out of surgery.) After that case, I felt that if I could get through that, I could get through any procedure.

What is one technique or RNFA trick you’ve learned from NIFA that you will use for life?  
Not just burying the knot, but sewing the last strand under and out the incision so that the knot is purposefully pulled under the incision.

How do you feel having your RNFA will impact your life/career?  
I have always enjoyed surgery and assisting surgeons in any way I can, so this will allow me to utilize my skills in helping more.

Jobs Front

Click here for the RNFA job postings we’ve collected for you this month.

NIFA – Office Hours

Monday-Thursday, 8:00am – 4:00pm
Friday, 8:00am – 3:00pm

Practice Resources

Here are several of the most-in-demand sites for our students, prospective students and grads:

MD Edge Surgery News: Specialty News and Commentaries, Videos and More
RNFA Scope of Practice by State (PDF)
ACS List of Cases that Require an Assistant at Surgery, 2018 (PDF)
Perioperative Nurse Links (state nursing boards & professional associations)
APRN Nurse Links

Disclaimer: The views expressed in this newsletter are strictly those of their respective authors and do not necessarily represent the views of NIFA. NIFA does not give any express or implied warranty as to the accuracy of statements made by our contributors and does not accept any liability for error or omission. It is the responsibility of all perioperative personnel to work within and adhere to their facility bylaws and individual scope of practice.

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