AGACDNP Career Trajectory

[AF2BSN]

Background:
Former military medic/flight medic, current working LPN, and senior in a BSN program.

Today:
I met with the chair of an AGACDNP program at the University of Michigan-Ann Arbor last winter and I'm thinking about beginning my application when it opens up this Fall. I have a passion for trauma, acute care, and surgical intervention. Is it a pipe dream to think that I could be a trauma or cardiothoracic assist with this certification? I'm not particularly thrilled with the idea of being a "hospitalist" running around utilized as a first/second year resident, per say. I'd would much rather do surgical workup, assist in procedures, and follow-up post intervention. I know the obvious answer would be, "Did you ask the program chair this question?". However, my thoughts have evolved and my initial conversation was centered around application and program content.

Any advice? Thank you in advance!

[ArmaniX, MSN, APRN]

No direct knowledge in the “how.” One of my preceptors (Burn service) would see patients in the unit/floor, have outpatient clinic across the street, eat, then go to the OR and assist with debridements, STSG, etc.

I believe she had first assist certification, I believe this is a requirement. But again, not very knowledgeable in that particular area.

[AF2BSN]

2 minutes ago, ArmaniX said:

No direct knowledge in the “how.” One of my preceptors (Burn service) would see patients in the unit/floor, have outpatient clinic across the street, eat, then go to the OR and assist with debridements, STSG, etc.

I believe she had first assist certification, I believe this is a requirement. But again, not very knowledgeable in that particular area.

Thanks for the response! I've looked into a NFA program at a local-ish CC-- I believe it's 9 months long. I guess I was hoping my didactic work and clinical rotations could be steered towards that direction. It seems like a lot of NPs fall into it through a combination of experience, certification, and timing. Maybe I should just shake the tree at a few local hospitals for a mentor? My BSN instructors and clinical coordinator are like deer in headlights when it comes to this topic.

[ArmaniX, MSN, APRN]

I looked into it briefly years ago. I felt like once an NP you could sit for the test without taking a 9mo course or OR experience. But I might be delusional.

[Corey Narry, MSN, RN, NP]

You could totally First-assist as an NP and many NP's already do that. The question would be what your preparation is for that role so that a surgeon would hire you. NP programs tend to be short on clinical hours so expecting to learn skills such as harvesting saphenous vein grafts or assisting a Trauma Surgeon in an NP program is quite a stretch in my opinion. There may also be limitations on what NP students are allowed to do especially in the OR depending on the institution.

A lot of the NP's I know who also First-assist had RNFA training in addition to their NP training or were already First-assisting as RN's prior to attending NP school. You may find that unicorn of a surgeon who will take a chance on a newbie NP with no First-assist experience and say that they will train you. Alternatively, that unicorn surgeon may be around now and be willing to serve as a preceptor for one of your NP clinicals. Good luck finding him or her though.

Also be aware that some surgical specialties see both adults and kids (Ortho, Neurosurgery come to mind). In those specialties, you may be limited by an Adult AGACNP cert.

[Corey Narry, MSN, RN, NP]

BTW, since you will be going to Ann Arbor, you can find out if this program admits NP's...it's basically a residency program for PA's to train in Cardiothoracic Surgery.

http://www.stjoesannarbor.org/physicianassistantresidencyprogram

[FullGlass, BSN, MSN, NP]

You might want to consider working as an RN in the OR for awhile, before pursuing a DNP. While doing that, you could get the First Assist certification and your employer would likely pay for it.

Some hospitals have special hiring programs for OR RNs only. At Johns Hopkins, there is a special recruitment program for them, separate from the other RNs. The RNs must commit to work at least 2 years (I think) in the OR, and they will be given intense training.

[AF2BSN]

On 8/7/2019 at 3:36 PM, juan de la cruz said:

BTW, since you will be going to Ann Arbor, you can find out if this program admits NP's...it's basically a residency program for PA's to train in Cardiothoracic Surgery.

http://www.stjoesannarbor.org/physicianassistantresidencyprogram

Thanks for your response and follow-up! I'll definitely check it out.

On 8/7/2019 at 5:33 PM, FullGlass said:

You might want to consider working as an RN in the OR for awhile, before pursuing a DNP. While doing that, you could get the First Assist certification and your employer would likely pay for it.

Some hospitals have special hiring programs for OR RNs only. At Johns Hopkins, there is a special recruitment program for them, separate from the other RNs. The RNs must commit to work at least 2 years (I think) in the OR, and they will be given intense training.

I've considered that. I'll likely be working at least part-time while going to school (like I have the entire time in undergrad). I appreciate the feedback!

[AF2BSN]

Just an update: I was accepted into University of Michigan's AGAC-DNP program. With everything going on at the moment, we're still waiting to hear additional information. I did find there was a semi-local First-Assist program at a community college. The requirements for attendance look daunting, to say the least. As previously mentioned, having OR experience and your CNOR is necessary.

I was offered a job in a Level I ED when I graduate this April. I mentioned OR as one of my top picks in my interview, but OR jobs seem elusive (or maybe offered to internal candidates?). I'll keep looking and update this thread on the off chance there is another weirdo like me.