Advanced Practice Nursing in the OR

GadgetRN71, ASN, RN · Mar 25, 2009

There are other options for nurses in the OR..

You can become a CRNFA- Certified Registered Nurse First Assist. They can close patients etc under the supervision of the surgeon. Some places have Nurse Practioners who do this as well. And some have PA's do it.

beanal · Mar 30, 2009

I use to be a CRNFA before they had this official certification. It was so much fun and in my opinion is much better than being a PA as you just get to operate all day

long. It was a blast and so exciting! One day you will be assisting with a craniotomy and the next day you will be assisting with a abdominal aortic aneurysm. There is nothing boring about this job as it is always changing.

core0 · Apr 1, 2009

Hi there everyone!
I am a student nurse graduating next year, and I have a strong interest in OR nursing since I observed there a few months ago. What advanced practice degrees are there to go into if I want to be in the operating room?
Is there only Nurse Anesthesia?

Most ORs have CNS which is more of an educational role. NPs, PAs and CNMs are the only providers that Medicare pays to assist in the OR. Depending on the setting you may work for the hospital or the physician group. Non physician providers the OR is only part of the practice. The value for the physician comes from managing the patient on the floor and in the office. There are a number of studies in the PA world that show in orthopedics for example, OR fees are only 1/3 of the value that a PA brings to a practice.

There are some PA and NP first assist groups where the NPs and PAs assist various surgeons as needed. It can be lucrative but relies heavily on the relationship the providers have with the surgeons.

David Carpenter, PA-C

core0 · Apr 1, 2009

I use to be a CRNFA before they had this official certification. It was so much fun and in my opinion is much better than being a PA as you just get to operate all day
long. It was a blast and so exciting! One day you will be assisting with a craniotomy and the next day you will be assisting with a abdominal aortic aneurysm. There is nothing boring about this job as it is always changing.

I felt exactly the opposite. I worked as a tech and assisted some. I hated not knowing anything about the patient, never knowing how they did or what happened to them. Now I work in a surgical service that is primarily medicine with an occasional trip to the OR at 3AM. I know all about the patients and how they do. I only do about 50 cases a year and that's plenty.

David Carpenter, PA-C

Heogog53 · Apr 17, 2009

In small hospitals, some docs hire private scrubs, who act as assistant during the case, may suture and tie under the doc's direct supervision, take histories, remove sutures, staples, etc.

In some larger hospitals, RNFAs are assigned to a particular service, such as CT.

In a large university setting, there are PA's who come into the OR and those who don't.

It all depends on the facility and the state nurse practice act.

So advanced practice in the OR as a nurse can be as an SA(just like a PA only just for surgery), very occasionally as an NP, more likely as a CRNFA or as a CRNA.