Am I setting myself for failure wanting to be an RNFA?

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Specializes in Nursing Student.

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Hello, I just got into nursing school and am pretty dead set on the OR. It was only reaffirmed when I got to shadow a surgeon, he let me be uncomfortably close (like 1 step from the sterile table, which they move around vs using a mayo and 1 step from him close at one point, but I basically was behind him the entire time), and it was the most incredible thing ever. 

I really want to be a first assist, his FA highly suggested I change to CST school, while the surgeon and CRNA disagreed, and said that hospitals are so short staffed, if I got a new grad OR nurse position and said I wanted to scrub only they’d probably let me due to being desperate for people. 

I’m fully aware that to become an RNFA you have to work 2000 hours in the OR, get your CNOR and go to FA school. I’m in an ADN program, and I’m worried I’m going to have issues finding new grad OR nurse jobs to get my foot in the door and start those 2000 hours while I work on bridging to BSN to take the CNOR exam. 

A more logistical note. Nursing school is 2 years and the CST program is 1 and cost far less than the nursing program. I am definitely going to incur debt getting my RN, while I wouldn’t for my CST. I know CST’s make far less than RN’s though. So is RN then still needing my BSN still the better investment? I basically see CST as get what I want ASAP and nursing as a slower route with more investment. 

Just need reassurance and suggestions. I’m tempted to just apply to the local CST program while in nursing school to put the option on the table. 

I also hear RNFAs compete with PA’s/NP’s and CSFA, so will it be difficult to find a job and get experience? 

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Specializes in OR, Nursing Professional Development.

What you will find is that many hospitals have different staffing models, and there is no one size fits all. Mine started with a mix of RNFAs and CSFAs, but due to the cost and more surgeons hiring NPs and PAs, the powers that be elected to allow the RNFAs to decrease by attrition (as they left, they weren't replaced). We do still hire CSFAs, paying for our own staff to attend a program and complete their clinical hours while on the job. However, we are not a teaching institution and therefore do not have residents (outside of one specialty) or medical students. I would highly advise researching the facilities in your area and seeing what the staffing models are and who is used in the first assistant role.

As for RN vs CST, well, should you decide at any point you wish to leave the OR setting, you're quite stuck as a CST, but will have much more flexibility as an RN.

New grads in the OR? Several facilities are in the "you have a pulse and a license how soon can you start" staffing crunch in my area. My facility has over 60 vacant positions just in the OR, with over double that in periop as a whole.

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Specializes in Nursing Student.
On 11/14/2021 at 11:26 AM, Rose_Queen said:

 I would highly advise researching the facilities in your area and seeing what the staffing models are and who is used in the first assistant role.

I’m actually a transplant to the area I’m in currently due to inability to get into nursing school where I’m from (California). I am not real dead set on staying one particular place and not opposed to relocation, as long as the place doesn’t have snow tbh. 

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Specializes in OMFS, Dentistry.
23 hours ago, Rose_Queen said:

What you will find is that many hospitals have different staffing models, and there is no one size fits all. Mine started with a mix of RNFAs and CSFAs, but due to the cost and more surgeons hiring NPs and PAs, the powers that be elected to allow the RNFAs to decrease by attrition (as they left, they weren't replaced). We do still hire CSFAs, paying for our own staff to attend a program and complete their clinical hours while on the job. However, we are not a teaching institution and therefore do not have residents (outside of one specialty) or medical students. I would highly advise researching the facilities in your area and seeing what the staffing models are and who is used in the first assistant role.

As for RN vs CST, well, should you decide at any point you wish to leave the OR setting, you're quite stuck as a CST, but will have much more flexibility as an RN.

New grads in the OR? Several facilities are in the "you have a pulse and a license how soon can you start" staffing crunch in my area. My facility has over 60 vacant positions just in the OR, with over double that in periop as a whole.

Rose_Queen: "you have a pulse and a license how soon can you start" staffing crunch in my area - Please PM me your area! That sounds right up my alley!

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Specializes in ICU, Trauma, CCT,Emergency, Flight, OR Nursing.

Once you are a CST (if that is the path you choose) you will be regretting it , and that you didn't pursue your nursing qualification . All the CSTs I know and those I work with are either in the process of becoming RN's or have intentions of doing that. In some states, such as California , surgeons do not use CSFA's at all and they are not permitted to practice as such, whereas RNs can function in the RNFA role. Get your RN then embark on your career journey. Read these posts carefully as there are many who give very accurate accounts of their lives in the OR. Many hospitals now ,including Magnet hospitals are hiring ADN RNs and new grads as the shortage is that bad. Put in the work and then enjoy the rewards once you get your RN license. Best of luck on your journey.

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Specializes in Nursing Student.
10 hours ago, RickyRescueRN said:

Once you are a CST (if that is the path you choose) you will be regretting it , and that you didn't pursue your nursing qualification . All the CSTs I know and those I work with are either in the process of becoming RN's or have intentions of doing that. In some states, such as California , surgeons do not use CSFA's at all and they are not permitted to practice as such, whereas RNs can function in the RNFA role. Get your RN then embark on your career journey. Read these posts carefully as there are many who give very accurate accounts of their lives in the OR. Many hospitals now ,including Magnet hospitals are hiring ADN RNs and new grads as the shortage is that bad. Put in the work and then enjoy the rewards once you get your RN license. Best of luck on your journey.

Thank you so much for the reassurance! I was fully aware that CA doesn’t use CSFA, which was one con of doing CST to CSFA, as I’m highly considering moving back to California when done with school. A hospital administrator friend said that even if I don’t have a BSN, having a bachelors in another field and an ADN may put me one leg up over someone with just an ADN when looking for new grad OR positions. Is this true? 

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You could do either (CST or RN) and find a pathway to becoming an FA.  As an OR travel RN, I have circulated and scrubbed all over the US.  My experience has been that while CST and RN FAs were somewhat common in the midwest, I have never encountered them in large hospitals in other parts of the country.  

 

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Specializes in Nursing Student.
On 11/21/2021 at 9:03 PM, morelostthanfound said:

You could do either (CST or RN) and find a pathway to becoming an FA.  As an OR travel RN, I have circulated and scrubbed all over the US.  My experience has been that while CST and RN FAs were somewhat common in the midwest, I have never encountered them in large hospitals in other parts of the country.  

 

As in they used PA’s, medical students, and NPs? 

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Yes, that seems to be the current trend.  I shouldn't have said 'never' before in my previous comment but they in my experience, they are quite rare in other areas of the country (especially CST FAs).

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Specializes in Nursing Student.
On 11/29/2021 at 8:05 AM, morelostthanfound said:

Yes, that seems to be the current trend.  I shouldn't have said 'never' before in my previous comment but they in my experience, they are quite rare in other areas of the country (especially CST FAs).

Where I am they prefer CSFA, that’s actually my worry, going for RNFA. Like the place I shadowed the only nurses were the pre-op and post-op nurses, the circulator and maybe the anesthesia was a CRNA and not an anesthesiologist. 
 

Guess the logic is why pay a NP, RNFA or PA when you can use a CSFA? 
 

I’m definitely willing to move, I’m not dead set on staying where I am, I am highly considering moving back to California, and I heard they only use RNFA or higher and not CSFA. 

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Stick with your RN goals. I work with a few RN's who were CST's but it took them a long time to make the transition. Not sure if their original goal was to become a nurse. Having your RN will open far more doors for you than the CST as others have noted.

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Specializes in General Surgery Assist.

Hi, I would not suggest CST, when your done with your ADN position, go back right away for BSN and try to get your foot in the door as circulator or RN scrub nurse so you can start getting your hours in the OR. Take CNOR as soon as you are eligible. I am doing RNFA program at NIFA right now.  

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