The Second Set of Hands Saving Lives

Facing surgery can be an unsettling experience for patients. They and their loved ones put their trust in the care and skill of the surgical team, which includes many who work behind the scenes to make sure vulnerable patients receive toplevel care. A surgical first assistant is a key member of that surgical team.

“A surgical assistant is like a second set of hands and eyes for the surgeon,” said Allison Henning ’16, a certified surgical first assistant (CSA) at Mayo Clinic, specializing in general, colorectal and transplant surgery. Allison Henning ’16 is a certified surgical first assistant at Mayo Clinic specializing in general, colorectal and transplant surgery.

“We have advanced knowledge of surgical anatomy and procedural steps,” she explained. “CSAs are in charge of positioning and prepping the patient for the specific procedure. We start with the resident or fellow by making an incision, locating relevant anatomy with retraction, and getting everything ready for the surgeon. During, we anticipate the surgeon’s needs and the best way to help them. When you work with a specific surgeon, you learn their preferences and how they want things done. We are also responsible for closing incisions and applying surgical dressings at the end of the procedure.” 

To train excellent surgical first assistants for this vital role, the Mayo Clinic School of Health Sciences offers a 12-month Surgical First Assistant (SFA) program, one of only 14 in the nation. This accredited certificate-training program is limited to only 20 students in each session; they work intensely to gain experience in the lab, the classroom and the operating room. Normally, the program begins in January and runs a full year. Now, however, a new collaboration offers an accelerated one-year SFA Capstone Experience for University of Minnesota Rochester (UMR) students, which allows them to begin the certificate program just before graduation, and accrue credits towards their Capstone and undergraduate degree.

Three UMR alumni who have continued their training in Mayo Clinic’s cutting-edge SFA program shared their experience, including the joys and challenges of becoming that second set of hands providing the best possible care to patients in their most vulnerable moments. 

Allison Henning ’16

Certified Surgical Assistant at Mayo Clinic

Allison Henning chose UMR for her undergraduate degree because she liked that the entire program was geared towards health science.

“I knew I wanted to do something in health care, and having all my classes relate to that made things much more interesting. I also really valued the small class sizes and the opportunity to develop relationships with professors and other students. I didn’t want to attend a university where I was just another number. I felt like everyone at UMR cared about my journey and wanted to help me succeed.”

She was initially set on going to medical school, but gradually discovered it wasn’t what she truly wanted. “My connections with my classmates and professors helped me realize that it was okay to change my mind and not always know what my next step would be. The support I received from my friends, professors and success coaches helped me find a career path I had never considered before. Without them, I’m not sure where I would have ended up.”

Initially, Henning thought the SFA program would be a stepping stone, but it ended up being a career that she really enjoys. “I am able to be directly hands-on during surgery. I get to help do the fun part of the case without any of the crazy hours, endless charting, stress and responsibilities outside of the operating room (OR) that the surgical residents have.”

Henning’s UMR experience prepared her to work on team projects in the SFA program. “Other UMR grads and I were way ahead of the curve when it came to group projects and presentations compared to our SFA classmates. I was able to handle the workload thanks to the high standards we were held to during our undergrad coursework.”

As a CSA at Mayo Clinic, Henning specializes in open, laparoscopic and robotic abdominal surgeries. She works primarily with one surgeon focused on colon cancer and other chronic conditions such as ulcerative colitis, Crohn’s disease and diverticulitis. On days when her surgeon isn’t operating, she works with various other surgeons within the general surgery, colorectal and transplant departments. This involves more big, open cases, sometimes combined with multiple specialties and sometimes minimally invasive laparoscopic and robotic surgeries. “I really enjoy the variety of cases and the fact that I get to do something different each day.”

“The surgeons rely on us to help teach the residents and students. Many residents and surgeons have told us that having a strong surgical assistant who knows the case makes a huge difference for them. The supervising surgeons are able to be in two ORs at the same time. They can stagger their surgeries knowing they have a strong team working safely to get everything ready for the critical portion where they need to be present. At the same time, the second OR is starting to close and get ready for the next surgery. They put a lot of trust in CSAs to make sure things run smoothly and safely, and to notify them of any issues.” This allows more patients to get the lifesaving procedures they need, she said.

“I like knowing that I played a part in helping patients. At Mayo Clinic, we see a lot of patients who have been turned away from other hospitals or have already had a surgery that was unsuccessful. Sometimes, we are a patient’s last hope, and being able to help them in their time of need is very rewarding. We may be behind the scenes, but the work we do is an integral piece of their care.”

Nick Baker ’14

Certified Surgical Assistant at Mayo Clinic 

For Nick Baker ’14, declaring a major right out of high school was not easy as he had many interests but nothing specific he could confidently say he wanted as a career. 

“Choosing UMR with their Bachelor of Science in Health Sciences (BSHS) degree gave me an area of study to focus on, without deciding on a career path before I was ready,” he said. 

He discovered the SFA program was the route for him when he watched a friend and fellow UMR graduate go through the program. “The BSHS degree was the perfect academic base and the SFA program’s relatively short path to start working sealed the deal for me,” he said. “It gives a solid base for new hires, so their transition into the OR is seamless.”

Clinicals were the toughest part of the program for Baker, but they were also the most critical. The challenge for him was applying the book knowledge from class to real patients and procedures. “Realizing there were experienced preceptors there to share their hard earned knowledge with me and gathering their good habits helped get me through clinicals,” he said.

He has been a CSA at Mayo Clinic for the past eight years. His first four years focused on assisting in the OR, and for the last four years he has served as one of the leads for the surgical assistants at Saint Marys campus. 

“The biggest impact UMR had on my work today is the focus on group work and the communication a good team requires,” he said.

Baker is often surprised how little is known about CSAs. “Surgical assisting is a hidden gem in allied health careers. Every surgical operation needs the patient positioned, extra hands assisting the surgeon and sutures thrown for closure.”

Currently, in a lead role, he works the evening shift and coordinates the transition to relieve day staff while bringing in the evening shift. He organizes between 40–50 CSAs across more than six surgical departments. When making assignments he considers best fit by department and tries to make efficient choices that reduce overtime. “Happy, wellbalanced staff get the best results for patients,” he said. 

That’s a value Baker practices in his own life. “I’m lucky enough to have a job where work stuff stays at work. 

When I am home, I can give all my attention to my four kids (Mona, Cal, Gus and one on the way) and my wife Elsa, also a UMR grad. The kids aren’t school age yet, so the evening work schedule works for us in this stage of life.” Outside Mayo Clinic, he has been a long-time member at Detour Athletics and Mario Roberto’s Jiu Jitsu Academy. 

While his current role gives him less direct patient contact, Baker still prioritizes patient care while he manages fellow CSAs. “Knowing that I helped organize a better work-life balance for my coworkers, in turn helping patients, means a lot to me.”

Alec James ’23

Current Student in the Surgical First Assistant Program

“UMR had my name written all over it,” said Alec James ’23. “It offered me the medical education background that I was looking for so that no matter where I decided I wanted to go after undergrad, I was ready and able.” 

He recalled fondly classes that enthralled him with their relevancy. “These lessons weren’t your stereotypical class lecture, but ones that utilized real-life scenarios and examples and made the learning not only enjoyable, but easier to understand. This largely contributed to my ability to take in concepts so well. I was also able to take more elective classes towards the end of my time at UMR; one that particularly stood out was a medicinal plants course. It brought a new perspective of medicine into my education.”

While James originally aspired to be a doctor, he ultimately realized his values didn’t align with that career. “I switched to the physician assistant pathway and based my time at UMR around this career goal. I then came to realize that the duties of a physician assistant were not what I had in mind for my career as I wanted to be on the surgical/ procedural side of medical treatment.” 

After some research and hard decisions, he applied to the SFA program. 

“Speaking with the director of the program was one of the best decisions that I could have made prior to joining. She provided me with further details, gave me insight on how my personal values aligned with the program and provided a staff-student relationship.”

Now, as a student in the SFA program, he’s on the right path. “I aspire to help those that are unable to physically help themselves. That is the motivation that has gotten me to where I am today. Now, I am doing exactly what I have lived by and I couldn’t be happier with this decision. My role in the care of each individual patient may be similar, but the little nuances are what make each patient situation unique and allow me to fulfill my role to the highest degree by providing the best patient care that I can.”

James also enjoys educating people about the role of the CSA in the OR. “It’s always a pleasure to explain what I get to do on a day-to day basis. The field of surgery is vast and wide and I get to be involved in so many life changing surgical procedures for my patients.”

In clinical rotations, James now spends each day with a preceptor who teaches their method of working in each specialty and the inner workings of the operating room.

As he grows more comfortable, James implements these new methods and his base skill set into practice. “It has been described as ‘creating your own toolbox’ with the many tools that you are being handed, and it couldn’t be more true. 

With each case, I am utilizing my knowledge of suctioning, retracting, maintaining hemostasis and providing visualization to assist the surgeon.” He finds each day is an intense handson learning experience and builds his toolbox with every procedure.

“As the Surgical Assistant, it is my responsibility to make sure the vulnerabilities of the patient are handled with delicacy, decency and utmost respect. A great example of this is positioning a patient for a procedure. Matters that we may find unimportant in our awake life are completely different for a sleeping patient. Things such as an overextended arm, inadequate padding or even a cord being laid incorrectly are all detrimental to the patient’s health and recovery. It is vital that I take these things into account and learn to do them properly so that my patients come out of surgery with the best possible outcome.” 

Read more stories from the Fall 2024 Alumni Magazine: The Kettle.