APRN Required To Have First Assist

I work in a busy level two trauma center's operating room and I am also in school to be an ARNP(finish in 17 months) My faciliting is enacting a rule they say was in a law passed in 2015 requiring ARNP's to have a first assist certification in order to assist in surgery.

Has any heard of this requirement for ARNP's

There is good information here about APRNs in the first assist role: APRNs in the RN First Assistant Role 

At least it gives you an idea of which states went adopted the AORN recommendations or some version thereof, and which had not, as of that date.

Specializes in Neonatal Nurse Practitioner.

My state BON issued an opinion that NPs must have an FA cert to function in that role since NP education doesn't cover that. It also seems that they are starting to crack down (and not approving collaborative agreements) on NPs working outside of their training and population foci. Many facilities are only considering ACNPs for inpatient roles.

Specializes in Surgery.

I'm a NP RNFA. I've had it for about 3 years now and work as a Surgical NP. In my state, Massachusetts, its a requirement for assisiting in the OR. If your job is willing to pay for the training and find you a surgeon preceptor to get your hours, I would see this as an opportunity!

Specializes in Anesthesia, Pain, Emergency Medicine.

Sam,

You get get education and training above your basic education as long has it's in the population/role. So FNPs in the ER are fine. Many rural ERs are staff by solo FNPs. NOTE: Many states don't need a collaborating physician. Here in Montana we are totally independent. There are even board certifications for FNPs to become ENPs. Look at ANCC and AANP-CP or AAENP.

The same with first assisting. Done by NPs all over especially in rural areas. Remember, just because your hospital/state does it one way does not mean all states do it that way.

Specializes in ED, OR, Oncology.

Changes are a coming. We're chock full of FNPs in Wyoming, and they practice anywhere and everywhere, but the State board is looking at following the consensus model. Existing FNPs in non primary care roles will probably be OK, but in the next few years I wouldn't want to be a new FNP looking to do anything but primary care. I live and work in western Wyoming, I'm well aware of current practice in rural healthcare. Just because there are FNPs running solo in rural ERs all over the west, doesn't mean they are trained for it. Many get by fine and are good providers, but many are also new FNPs, with limited RN experience, which means they are flying solo with what? Maybe 600 hours of clinical in the provider role, in a primary care setting? And they are ready to take the lead with the initial stabilization of traumas or critically ill patients? Sure, much of what they actually see is fine for an FNP, but there is a mountain of stuff they aren't ready for- and it isn't their fault- hell, there aren't exactly abundant ACNP programs to choose from in the mountain states. Just because its been that way, doesn't mean that's the way it should be, or how it is going forward.

Specializes in OR, Trauma, OH, Vasc., Ortho, Gen.

I was told it was a national Law. I live in Florida so I am trying to find the statute with no luck.

What work do you do in the OR now?

Specializes in OR, Trauma, OH, Vasc., Ortho, Gen.

well this thread has gotten very interesting. As an end result the hospital backed down and is only requiring FA training for RN's understandably to open and close. The you cant do it as your school didn't train you argument is ludicrous. I am an OR nurse manager something I received no training for in RN school, yet I can scrub and circulate. The same argument would hold true for ER, endo, radiology, cath lab, neuro lab and any other procedural area. It's called OJT and there is only one way to get it.

well this thread has gotten very interesting. As an end result the hospital backed down and is only requiring FA training for RN's understandably to open and close. The you cant do it as your school didn't train you argument is ludicrous. I am an OR nurse manager something I received no training for in RN school, yet I can scrub and circulate. The same argument would hold true for ER, endo, radiology, cath lab, neuro lab and any other procedural area. It's called OJT and there is only one way to get it.

so what you're suggesting is that ojt is appropriate in some cases while others (lowly rns) should be expected to go the extra mile and get certified? Hell why have an RN license in the first place when 70% of the day is passing meds. You can train a monkey on the job for that! Sounds like a bad policy across the board. But it's your hospitals decision... Their liability... And someone else's license at stake. Points made earlier are clear.... No np school makes an np any note capable of being a first assist than an RN.

Specializes in ED, OR, Oncology.

Nobody is saying that on the job training is not what has been done forever, or that it is not in many cases very effective. It is also a big part of being a new nurse- whether that be RN or APRN. My point is that people going to NP school now, or in the future, should be paying attention to the consensus model, and getting training that is suited to where they want to work, or they might very well find themselves getting an expensive post masters certificate to be qualified for the job they wanted all along.

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