Any NPs here who are Surgical Nurses as well ??

  1. Hello,

    I am a new RN who is pursuing BSN starting next month. My long term plan is to become a Doctor of Nursing Practice (DNP), specialize in Urology, and include surgery. My dilemma is that I do not know what would be the best educational plan after the BSN. How does CNOR and RNFA fit in all this? Do I pursue CNOR and/or RNFA before or after DNP?

    Thanks !!
  2. Visit Devon Rex profile page

    About Devon Rex, BSN, RN

    Joined: Jun '11; Posts: 499; Likes: 249
    Registered Nurse; from US
    Specialty: 5 year(s) of experience in Rehab, Ortho-Spine, Med-Surg, & Psych


  3. by   subee
    What would a urology NP do in an OR? The RN circulates while the scrub tech handles the instruments. Both are employees of the hospital. NP's are seeing the patients in the office and clinic while surgeons are in the OR.
  4. by   JOJOba
    I have heard of NPs doing solo minor surgeries, but that is a done on a hospital-by-hospital basis per their policy. Think the majority surgical NPs are assists to MDs. Maybe someone from either of these postings can help.

    Surgical NP:Part time NP program with full time new carrer
    Surgical NP. Experience in OR in "children's hopital?"
    Last edit by JOJOba on Jul 24, '13
  5. by   greygooseuria
    Devon, it depends on the hospital, but NPs I went to school with (from an FNP program) got jobs as new grads in uro surg and neuro surg. One had been an OR nurse for years, the other an Card/ICU nurse for years. One is already a CNOR so she can get her RNFA easily and the other is going to be trained and get her RNFA; both practices (in different states) expect them to do first assist in the OR so yes, it's definitely possible. Most jobs, however, will train you to get your RNFA and if you're an NP, you don't need your CNOR to do so. It's all up to you.
  6. by   BostonRN13
    I'm a newly graduated FNP. My RN job is as an OR nurse scrubbing/circulating, I'm CNOR but not RNFA. The other poster is right, its institution-dependant what the NPs role is. At my job the Urology NP is strictly in the clinic while in ENT and Plastics, PAs are used to help assist. My plan is to apply for Surgical PA jobs at my hospital with the background of having OR experience. Knowing the computer system and the MDs should be attractive for employers if you're interested in becoming a surgical NP, just realize this is not the "norm" as PA usually operate. It would be smart to have OR experience if you truly are interested in that route..
  7. by   Devon Rex
    @ subee ...
    There are several surgical procedures related to urology and with the newer DNP degree I thought maybe some of the minor urological procedures would/might fall under their scope of practice. Perhaps my mind is getting to far ahead, but that is why I'm asking these questions.

    @ JOJOba, greygooseuria, & Thirteengirl ...
    Thanks for your input as well!

    Last edit by Devon Rex on Jul 24, '13
  8. by   nomadcrna
    Yes, you can first assist as a NP. You would most likely be hired by the surgeon not the hospital. Urologist ARE surgeons as well.
    I've never seen a first assist NP or PA working with a urologist though. If they have a bigger case, I've seen them utilize another physician. Most likely urology just does not do enough of the bigger cases to justify having a permanent first assist.

    I've seen NP first assists with ortho, general and neuro surgery though.

    The hospital will give you privileges in most states when you work with a surgeon. You would being doing first assisting and inpatient/clinic work as well.
    I do minor surgeries all the time in both the clinic and ER. I&D abscess and skin boo boos being the most common.
    Again, in the states I have practiced in (9). There is no need to have RNFA or CNOR. You are a NP now, not a regular RN. Those certs mean very little to nothing. Federal law allows NPs (and PAs) to bill as first assist. They do NOT need any other cert. Your mileage may vary from state to state though. There are a couple that are pretty restrictive.
  9. by   kguill975
    Absolutely, Urologists use Surgical Nps and PAs. You'll need advanced robotic training, though. It would benefit you to take a first assist course, to get that training. Of course, it can be taught, but I think taking the course will give you confidence in basic assisting, which will help you in attempting advanced cases. Good Luck to you.