Surgical Assistant vs. Surgical Technologist

The operating room is a dynamic environment where every team member plays a critical role in ensuring patient safety and successful surgical outcomes. In California, the terminology and roles can differ slightly from those in other states. While surgical assistants are recognized in many parts of the country, California requires individuals who perform advanced surgical support duties to hold a Registered Nurse First Assistant (RNFA) credential. This article will explore the similarities and differences between surgical technologists and RNFAs, helping you understand the unique requirements and opportunities in California.

Understanding the Roles

Surgical Technologist: The Backbone of Surgical Preparation

Surgical technologists, also known as operating room technicians or scrub techs, are primarily responsible for the preparation and maintenance of the surgical environment. They ensure that surgical instruments are sterilized, organized, and readily available. Their duties typically include:

  • Setting up the operating room with surgical instruments and equipment.
  • Sterilizing tools and ensuring a sterile environment.
  • Assisting the surgical team in donning gowns and gloves.
  • Handing instruments and supplies to the surgeon during procedures.
  • Managing surgical specimens and maintaining accurate counts of instruments and supplies.

Surgical technologists act as the “right hand” of the surgeon when it comes to tools and equipment, playing a crucial role in maintaining the efficiency and safety of the operation.

Registered Nurse First Assistant (RNFA): The Surgeon’s Partner

RNFAs take on more advanced responsibilities, acting as a direct extension of the surgeon during procedures. RNFAs are registered nurses who have completed additional education and training in surgical assisting. Their tasks may include:

  • Helping with patient positioning before surgery.
  • Retracting tissues to give the surgeon better visibility.
  • Controlling bleeding and managing wound exposure.
  • Closing surgical sites with sutures or staples.
  • Applying bandages or dressings post-surgery.

While RNFAs may perform some overlapping duties with surgical technologists, their role is more hands-on during the procedure, requiring a deeper understanding of surgical techniques and anatomy.

A surgical team in the middle of an operation

Education and Training

Educational Path for Surgical Technologists

A nursing instructor pointing to an anatomy model in front of two students
To become a surgical technologist, individuals typically complete a diploma, certificate, or associate degree program, which can take 12 to 24 months to complete. These programs focus on foundational topics such as:
  • Anatomy and physiology.
  • Medical terminology.
  • Sterilization techniques.
  • Surgical procedures and instrumentation.

Graduates often pursue certification, such as the Certified Surgical Technologist (CST) credential, to enhance their employability. Many surgical technologist programs, like those offered by CNI College, provide hands-on training in simulated or real operating room settings to prepare students for the demands of the job.

Educational Path for RNFAs

The path to becoming an RNFA is more advanced. It starts with becoming a registered nurse (RN), which requires earning an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN) and passing the NCLEX-RN exam. After gaining experience as an RN, individuals must complete an RNFA program, which includes training in:
  • Advanced surgical techniques.
  • Suturing and wound management.
  • Patient positioning and care during surgery.
  • In-depth surgical anatomy and physiology.

RNFA programs often require hands-on clinical practice to ensure competency in the operating room. Certification through the Competency and Credentialing Institute (CCI) as a Certified RNFA (CRNFA) is a common next step.

Similarities Between the Careers

  1. Work Environment
    • Both surgical technologists and RNFAs work in operating rooms, assisting surgeons and ensuring smooth surgical procedures. They are essential to the success of surgeries and patient safety.
  2. Team Collaboration
    • Both roles require excellent communication and teamwork skills, as they interact closely with surgeons, nurses, and other members of the surgical team.
  3. Certifications
    • Both careers benefit from certification, which not only validates skills but also improves job prospects and earning potential.

Key Differences

  1. Scope of Responsibilities
    • RNFAs have a more advanced and hands-on role during surgery compared to surgical technologists. They are involved in tasks like retracting tissues, suturing, and assisting with hemostasis, whereas technologists focus on preparing instruments and maintaining the sterile field.
  2. Educational Requirements
    • Becoming an RNFA requires significantly more education and training, beginning with a nursing degree and culminating in specialized surgical assisting credentials. Surgical technologists can enter the field more quickly with an associate degree.
  3. Earning Potential
    • Due to their advanced responsibilities and education, RNFAs typically earn higher salaries than surgical technologists. According to the U.S. Bureau of Labor Statistics (BLS), RNFAs can earn significantly more, depending on their location and experience.

Choosing Your Path

Why Become a Surgical Technologist?

If you’re looking to enter the healthcare field quickly and are passionate about supporting surgical teams, a career as a surgical technologist is a great choice. With relatively short training programs and strong demand for skilled professionals, it’s a rewarding and accessible path. 

Why Become an RNFA?

If you’re already a registered nurse or plan to pursue nursing, becoming an RNFA allows you to play a more advanced role in the operating room. While the educational path is longer, the responsibilities and earning potential are greater, making it an appealing option for those committed to a surgical career.

Hand holding a compass with a lake in the background

RNFA or Surgical Technologist?

Both surgical technologists and RNFAs are indispensable members of the surgical team, each playing a unique role in ensuring successful outcomes for patients. While their duties and educational requirements differ, both paths offer opportunities to make a meaningful impact in the healthcare field. 

If you’re considering a career in the operating room, CNI College offers comprehensive programs to help you get started. Explore our programs today and take the first step toward a rewarding career in surgical care!