track to RNFA, possibly NP

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    I just started working in the OR coming from bedside orthopedic so glad I made the change! I'm planning to be certified CNOR and I did get accepted to F.N.P. program prior to getting my OR position.
    1) Can F.N.P. be surgical NP or I would have to go for my ACNP instead?
    2) What is the track on working my way "up"? I know I would do cnor first. NP or rnfa next?
    3) Do OR use C.N.S.?

    4) How long is the schooling for RNFA? Part time that is...

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  2. 8 Comments...

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    Finishing up an FNP program in May. I have been in the OR for the past 11 years, CNOR certified for the past 8 years. I had a couple of interviews with ortho docs. Started looking into state BON and asking questions about scope of practice of FNP with ortho, long story short. With AORNs new standards regarding RNFA and most states are adopting theses standards, it is very difficult to understand why AORN seems to be taking the OR nursing profession backwards. These standards for certification are more stringent then the FNP certification not to consider the cost and amount of CEUs needed to keep RNFA compared to FNP and the RNFA is not even considered an advance practice degree. I have dropped my membership in AORN and have encouraged all my fellow OR nurses to not renew their status with this organization.
    Sorry get back to your question. Congrats on the acceptance to FNP program. The only difference to AORN between RN and APRN is the APRN does not have to have to CNOR, to sit for the exam, but as an APRN you will need to meet all the other requirements.
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    The previous poster pretty much answered your question. After you finish your NP program, and take your certification, then you can enroll in an RNFA program. Find a job first in whatever area you're interested, and get your employer to pay for the cost of the program, and everything else needed. You don't need to be a CNOR to complete the program since you would be an advanced practice nurse, but if you ever wanted to become a CRNFA, then you would need to be a CNOR. Good Luck!
  5. 0
    Quote from kguill975
    The previous poster pretty much answered your question. After you finish your NP program, and take your certification, then you can enroll in an RNFA program. Find a job first in whatever area you're interested, and get your employer to pay for the cost of the program, and everything else needed. You don't need to be a CNOR to complete the program since you would be an advanced practice nurse, but if you ever wanted to become a CRNFA, then you would need to be a CNOR. Good Luck!
    Forgot to answer the rest of your questions, no need to pursue the RNFA part until you've found a job. As an APN, you'll only need to assist on cases within your specialty, while RNFAs have to get a mix in different specialties. Also, you'll be on the payroll while getting your cases done for RNFA, because you'll still get paid for rounding on pts and seeing pts in the clinic. Lastly, I completed the NIFA program in 6 months. There are over 20 modules that you have to complete in a year. They're long and painful, but necessary to complete the program. Also, you'll log 120 hours assisting your surgeon in whatever specialty you choose to practice in (the fun part). You'll get your RNFA certificate, and then you'll be legit. As far as I know, Texas (where I live) is the only state that requires a NP to complete a RNFA program. Other states accept your advanced practice status as acceptable to become a first assist without enrolling in a RNFA program.
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    In upstate NY it doesn't require an advanced degree to get Rnfa...so I feel like is it worth going for my NP..? Most hospitals uses surgical physician assistance and hardly any surgical nps.

    Iam also wondering inorder to work as a surgical NP can I do it with a Fnp? Or do I really have to go for a Acnp?
  7. 0
    Quote from elle604
    In upstate NY it doesn't require an advanced degree to get Rnfa...so I feel like is it worth going for my NP..? Most hospitals uses surgical physician assistance and hardly any surgical nps.

    Iam also wondering inorder to work as a surgical NP can I do it with a Fnp? Or do I really have to go for a Acnp?
    The advantage to becoming an advanced practice nurse is based on what you can do outside of the OR. While all RNFAs can bill insurance for first assisting, they can't bill for anything else. As an ACNP, I can place a line and bill for it, first assist on a surgery and bill for it, round on pts on the unit and bill for it. The biggie is that I can bill Medicaid and Medicare for all of those things too, neither of which will reimburse RNFAs. I know FNPs who are first assists, but since they didn't complete an ACNP program, their state board doesn't allow them to place invasive lines, and there are some restrictions placed on caring pts in the ICU, but other than that, there's no reason why you can't complete a FNP program and become a first assist.
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    bbfnp...Professional territorialism-RN conservatism politics of the OR specialty is my possible assessment. This may not be unique to nursing, as MD specialties tell that this exists with them too. I am interested in ortho nursing myself at the APN level, and sense that the above rigidity-setting back could be occurring, and yes would be regressing surgical nursing. I would acknowledge patient on the table is always a risk, for postop infection, and mortality so I would still tip my hat to any seasoned staff CNOR nurse who as earned her/his right to work table side there. If concern for CNOR staff nursing opportunities-job security is present-there should still be plenty of work for us all given the graying of our USA. Ortho by itself is predicted to have 6 fold increase in joint repair cases. My colleagues say I'm great with my patients & are supportive of my interest in APN ortho nursing, so am headed down a similiar path. I was lucky to find this forum, thanks to my colleagues who inputted. Good luck with your ortho endeavour
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    elle604...that's a good question, depends on what your goals are. Per my post to bbnfp, some NP's including myself are interested in ortho. As for me, my specific interest is ortho sports med, so to treat age range like teenage sports and etc. in ortho makes sense to do FNP w/ some type of surgical qualification to assist a surgeon. If you are interested solely in working as staff in OR hospital side, I would guess you would only need RNFA.
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    Thanks for the responses. I was afraid that my Fnp program doesn't have surgical clinicals. I'm guessing its mainly on the floors. But with my OR experience I'm sure I can network with a surgeon and get them to precept me. I do like the idea of having the option in working with assisting in pediatric surgeries. I also know the NPs do periop assessment and clear patients before they go into surgery but I like to know if they are fnp or acnp. I think I'm going to go for my fnp and if things change I hope it wouldn't be too hard to get post grad acnp. What worries me is that I don't have critical care background so I may struggle with that


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