Surgical first assistants provide assistance to the surgeon during operations, with more complex work and direct participation in the surgery than surgical technologists have. A registered nurse first assistant provides expertise in patient assessment and care management in addition to the technical assisting duties. The average registered nurse first assistant salary is significantly higher than that of a typical staff nurse.
The registered nurse first assistant position is an extended role of the operating room staff nurse. In contrast to the typical surgical first assistant, the registered nurse first assistant is involved from preoperative through postoperative patient management as well as during surgery. The median annual salary for a registered nurse first assistant is $80,000 in 2011, finds Salary.com. The middle 50 percent of these nurses on the earnings scale have annual pay rates of $72,350 to $86,760. The top 10 percent are earning $92,920 and higher per year, and only the bottom 10 percent have annual salaries below $65,400. In contrast, the median annual salary for an operating room registered nurse is $68,870, and for a registered nurse employed as a typical staff nurse $65,460.
In some high-paying metropolitan areas, the top 10 percent of registered nurse first assistants earn more than $100,000 per year. These include Washington, D.C., where the median annual pay rate for these health care professionals is $87,140; in Seattle, Washington, with a median annual salary of $89,000; in Honolulu, Hawaii, at $89,250; in Atlantic City, New Jersey, and Boston, Massachusetts, at $90,100; and in San Jose, California, at $96,910. The top 25 percent of registered nurse first assistants in San Jose earn more than $105,000 per year, and the top 10 percent more than $112,500 per year.
In contrast, some smaller cities and cities in less urbanized areas have significantly lower median salaries for registered nurse first assistants. In Elko, Nevada, for example, these nurses earn a median annual salary of $54,530 per year, and in Aberdeen, South Dakota, $54,920. Registered nurse first assistants in Salina, Kansas, earn a median annual salary of $67,560; in Great Falls, Montana, $70,400; in Amarillo, Texas, $71,430; and in Pine Bluff, Arkansas, $71,760.
The job search website Indeed.com lists about 300 job openings for registered nurse first assistants throughout the country in February 2011. These job postings indicate that employers provide substantial benefit packages to registered nurse first assistants. Employers may offer a variety of health, dental, vision and life insurance options; short-term and long-term disability coverage; a health care flexible spending account; the option to buy insurance coverage for same-sex domestic partners; adoption assistance; an employee assistance program; health and fitness programs; and paid time off for vacation, personal days and illness. One organization offers a time-off program in which employees can return accumulated hours for cash or can donate the hours to another employee who needs them for an emergency situation.