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Duke Health Cary

Opening in Spring 2027, the next phase of this 85-acre, mixed use walkable Duke Health Cary campus will add emergency services, inpatient care, surgical services, imaging, specialty care, and infusion services, creating more than 230 career opportunities. Joining Duke Health Cary offers the opportunity to build something new, grow your career, and support our mission of advancing health across the communities we serve.

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.

Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

Essential Physical Job Functions:

Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.

Duke University

Registered Nurse First Assistant - Duke Health Cary

About the Job

Requirements

Responsibilities

Desired Qualifications