Despite apprehension over the loss of professional identity, literature supports that the RNSA can be just as effective as a surgeon when operating as a surgical assistant and there have been reductions in surgical times and improvements in surgical site infections (Archie, 1992; Pear & Williamson, 2009; Quick, 2013).
The expanded practice role builds upon existing nursing knowledge and skills and provides the RNSA with the educational experience to practice in the surgical setting.
Continuity of care is ensured by the RNSA being a permanent (not rotating) member of the team with the ability to free the surgeon from some of their tasks and allowing them to focus on more complex clinical problems (Kneebone & Darzi, 2005).
Within the New Zealand context the overall training and piloting of the RNSA role has been positively received by RNSAs, surgeons and managers (Health Workforce New Zealand, 2012a, 2012b).
As a graduate of the inaugural RNSA training programme, the author believes the training improved her academic skills by increasing her research and critical thinking capabilities which in turn positively influenced her leadership skills and confidence to perform within the RNSA role.
The author has been involved in developing proposals to obtain formal recognition and remuneration for the RNSA role within the public and private healthcare sectors utilising the information obtained from her dissertation--" The Registered Nurse working as a Surgical Nurse Assistant and the Impact on the New Zealand Healthcare System.
The RNSA role should not be in competition with that of junior doctors but should enhance the patient journey by providing an efficient service (Bruce, Bruce, & Williams, 2006; Kneebone, Nestel, Chrzanowska, Barnet, & Darzi 2006).
There is emerging evidence that the RNSA is contributing to cost-effectiveness in the operating theatre by reducing theatre time in acute settings, reducing readmissions and length of stay when the patient is readmitted and releasing senior staff to perform other activities (Health Workforce New Zealand, 2012a).
To help promote the RNSA role and reimbursement for undertaking this role, supporting data is required for key stakeholders instead of just opinion (Weeks, 2002).
The expanded RNSA now encompasses the three phases of the perioperative continuum.
The flexibility of the RNSA role offers the greatest benefit allowing it to be adapted to individual service environments (Health Workforce New Zealand, 2012b).
These outcomes positively impact on the RNSA role by enabling flexibility within a multitude of healthcare environments (Health Workforce New Zealand, 2012b).