APNP vs PA in surgery?

BSN2FNP1 · Jun 23, 2017

Search for this PA, NP, or RNFA in the OR?

pretty recent discussion of this

Advanced Practice Columnist / Guide · Jun 23, 2017

I find that it's both location and specialty-dependent. In our institution, PA's assist in Cardiothoracic Surgery and Orthopedic Surgery. The Trauma service across the city with surgeons who are part of our institution has a team of NP's some with RNFA credential who assist in the OR. An NP friend works in Trauma Surgery at a county hospital (rural) where NP's work with surgeons and assist in the OR. From a training standpoint, you will likely get more OR exposure in a PA program than an NP program because PA programs have general surgery rotations built in.

Alicia777, MSN, NP · Jun 27, 2017

I'm a NP-RNFA. My role is very similar to that of a PA. I see patients in ER, consent, write H&P, first assist in OR, discharge plan or admit, observe in-house, occasionally consult for my specialty and write daily progress notes and discharge home.

I started as an OR nurse. I love the OR and knew I wanted to continue in the OR but in an advanced role. It is state-dependent on whether or not you need your RNFA but is required here. I think these jobs are open equally to both PAs and NPs, but you as an NP will have to create training and mentoring for yourself. This is unlike PA school where OR training is built-in.

Good luck!

Alexxoxox, BSN · Jun 27, 2017

I'm a NP-RNFA. My role is very similar to that of a PA. I see patients in ER, consent, write H&P, first assist in OR, discharge plan or admit, observe in-house, occasionally consult for my specialty and write daily progress notes and discharge home.
I started as an OR nurse. I love the OR and knew I wanted to continue in the OR but in an advanced role. It is state-dependent on whether or not you need your RNFA but is required here. I think these jobs are open equally to both PAs and NPs, but you as an NP will have to create training and mentoring for yourself. This is unlike PA school where OR training is built-in.
Good luck!

Thank you! What specialty do you work in?

BSN2FNP1 · Jun 27, 2017

This is great information! Thanks for your contribution to this thread. I work in the OR as well and have a similar goal to what you're doing. I have a few questions: what specialty do you work in and what specialty did you work in as an RN, how long were you a nurse before pursuing your education, what advanced degree do you hold FNP vs ACNP, how were your job prospects after graduation, how was your transition from RN to ACNP in the OR?

thanks so much

Alicia777, MSN, NP · Jun 29, 2017

This is great information! Thanks for your contribution to this thread. I work in the OR as well and have a similar goal to what you're doing. I have a few questions: what specialty do you work in and what specialty did you work in as an RN, how long were you a nurse before pursuing your education, what advanced degree do you hold FNP vs ACNP, how were your job prospects after graduation, how was your transition from RN to ACNP in the OR?
thanks so much

I posted this a while ago....

Hi there!

I've received quite a few PMs recently regarding how I became a surgical NP. Which specialty is the best route and in general what my typical day looks like so I thought I'd post something.

I started as an Med/surg nurse and then a travel nurse in cardiac step-downs but OR nursing always intrigued me. So I became an OR nurse and was there for about 10 years. My hospital had an excellent reimbursement program and a friend of mine had started NP school and I decided I didn't want to be a lifer lol so I decided to start chipping away at an NP program too.

I always envisioned myself doing something procedural based with it. I didn't really see myself as a primary care NP so that was always my goal-although none of my training in NP school was in inpatient surgery. I decided to go with an FNP program figuring that that would be the broadest education. At that time the Acute NP programs were just becoming more popular-still I feel like FNP works well.

It took me quite a bit of work to get my first surgical NP job. I hounded my first boss with emails when I saw position posted and when I finally got an interview I really played up my OR nursing experience.

My training was all hands-on. They were generous enough to pay for my RNFA program-RN first assist program which is required in my state for all NPs to practice in the operating room. It Required about 200 hours of precepting from a surgeon and it took me roughly 5 months together these hours. By no means did I feel skilled at the end of those hours but I felt competent enough for small cases/closures.

I've been at it for about two years now and have since changed hospitals. I do not take call, work weekends or holidays. I typically round by myself and chat with the doctors either on the phone or via text. I assist in the OR almost every day and I love it. I feel like I'm getting a lot better. I occasionally see patients in the ER, consult and consent for procedures. I dictate on consults after speaking with the surgeon and discharge plans. I oversee patients in the day surgery unit and write prescriptions and orders for them as well.

I'm thrilled with my move. I feel like I've been able to spend a lot more quality time with my family and I even still moonlight at my old hospital for 'play money'!

I definitely recommend the specialty although it is difficult to get your first job and your foot in the door as we all know we are not typically trained this way so it helps to know people or to have the luxury of waiting for the perfect job.

BSN2FNP1 · Jun 29, 2017

Thanks for you great response! It sounds similar to my nursing background med/surg then OR. I absolutely love general surgery and robotics! I love the cases I love the pace I love my surgeons, but I want to pursue an advanced education and until the last year or so I wasn't sure what roles were out there for someone with similar goals as I do. I just honestly feel so torn between AG-ACNP and FNP, but you do provide some great information. I wish there was a single certification out there that would let me take care of adults and children, but on an acute basis. I can't imagine working in a primary care office and the entirety of my nursing experience is hospital based. What type of OR nursing did you do previously? What type of OR work do you do now? What are your favorite parts of your job now? Do you get to perform any procedures independently at the office or hospital like I&D, CVC placement, chest tube placement? No call anymore?! Good for you! That's amazing! General surgery is such a big part of my life. I can't imagine leaving it behind when I'm done with school. What type of orientation did you MD give you when you started? Was the MD that hired you also the one who gave you your hours to get your RNFA?