Becoming an RNFA....Steps that I should take?

canesdukegirl, BSN, RN · Nov 16, 2011

Yep, you pretty much have it correct.

The most ideal program for new grads with an interest in OR nursing is a nurse residency program. This program typically lasts for a year. I have seen both ADNs and BSNs enter these programs. Don't be disappointed if you cannot get into a residency program-they are competitive. Apply for open OR positions that you see. Some will take you on as a new grad and train you, some will tell you that they want experience. APPLY ANYWAY. They can only tell you no, and you have lost nothing but the time it takes to fill out the application.

Then when you have 2 years of experience, you are eligible to take the CNOR exam. You do have to be a member of AORN. I think the cost of yearly membership is around $125. You don't HAVE to attend classes, but I have seen 'mini-seminars' that will help you to prepare for the CNOR exam. I just read the AORN standards/guidelines and passed the exam. It IS a difficult exam, and it is expensive. If I remember correctly, the exam itself costs $250. Most institutions will reimburse you for the exam cost when you pass.

You can then enter the RNFA program of your choosing. Most RNFA programs don't REQUIRE that you have your CNOR when you enter the program, but DO stipulate that you must complete the exam within a year of your RNFA certification.

I thought really long and hard about whether or not to pursue an RNFA cert. I was gung-ho about it for several years, and then witnessed nurse after nurse after nurse return to OR staff positions simply because there wasn't a market for RNFAs. It is very expensive to complete an RNFA program-the most inexpensive program that I saw was around 6 grand. The process seemed a bit tedious to me, as you had to get a surgeon to agree to supervise you while you completed your clinicals...and if you are working, those hours DO NOT count. You have to do it on your own time.

I think it is a great idea if you feel that there is job security after you spend that amount of time and money on the certification. You are young and just starting your nursing career. I am not. It wasn't in my best interest to choose this route because I reside in an area that is surrounded by university hospitals...who don't employ RNFAs.

I am still unclear regarding the meat and potatoes of billing. I know that RNFAs can bill Medicare/Medicaid. I am actually allergic to reimbursement paperwork, which works well for me because the tedious (and confusing) aspect of reimbursement makes my OCD go into overdrive.

There are a myriad of pros and cons that you must seriously consider while embarking on the path that you desire.

My advice to you is to get through school with the determination to land a job in the OR when you graduate. However, I must add that it is absolutely KEY to remember that EVERY SINGLE CLINICAL is important, every class is important, and all of it will mold you into a well rounded nurse, even if you feel that your clinical/class focus is irrelevant to your end goal.

Once you get into the OR, get your feet wet and start focusing on becoming proficient in the OR. This usually takes about a year.

Take notes during your journey and re-read them when you finish your first year in the OR. You might have a different perspective, or you might be more determined than ever to pursue your goal.

I wish you the best of luck in school. Keep in mind that everything you do and everything you experience will only make you more educated, more aware and provide you with a different view. Your road will be a difficult one, but with the perseverance and determination that you have, you will overcome each roadblock.

Editorial Team / Admin · Nov 16, 2011

Canes, just one small correction. It is not a requirement to be an AORN member to take the CNOR exam, although there is a discount of $100 if I remember correctly. OP, CCI is responsible for the certification exams for both CNOR & CRNFA. The website is cc-institute.org and specifics for the steps to certification can be found here: http://www.cc-institute.org/cnor/steps-to-certification

AaronsMommyxx · Nov 16, 2011

Thank you! I want to be an RNFA because I always wanted to be a surgeon but being a single mommy, I do not have the resources to go to school for 11-17 years with no job opportunities in-between like Nursing has. I just want to be able to handle tissue and cut/suture. However, if I don't have the resources either to become an RNFA I will be just as happy being a scrub nurse. Anything in the OR will make me happy :) Currently I am a CNA.

Editorial Team / Admin · Nov 16, 2011

Have you also looked into being a surgical technologist? They too can become certified first assist (CFA). You also may want to research hospitals in your area. Many hospitals these days utilize STs to scrub and RNs only circulate. The only nurses who scrub where I work either were STs before becoming RNs or work on the heart team. That's also the experience for most of those I work with who came from other hospitals, but it could also just be my area and the fact that we have 3 schools for STs. Just another consideration to throw out there.

msn2010 · Nov 24, 2011

FYI... I know a OR nurse who is also NP and RNFA. He has 3 part-time jobs and he is happy. He couldn't find one that was NP/RNFA so he can act as a 'PA'. It is due to billing and pay scale difference and things. although he loves all 3 of his jobs, he thinks it is a joke to keep up with his 3 license/certificate.

There are not much of demand for RNFAs in my region. One of my mentor, who is a RNFA, informed me that since RNFAs can't be bill, it goes under MDs service and get paid hourly.

Are you already a RN or working as a CST? If you are not a RN, a CST might be one of the option as poet mentioned.

LoopsRN2 · Nov 24, 2011

Hi everyone!!
I have a HUGE interest in being a RNFA. But I'm not sure of the steps I'm supposed to take to get there. Right now I'm only taking my prerequisites for nursing school, but I am determined.
Does it go somewhat along the steps of.... Go to Nursing school (ADN or BSN??),
Land an internship/residency in the OR,
Take CNOR classes after 2 years exp.,
Take a FA Program after several more years experience. ??
I just want to know how I should go about doing this and what degree I need, what residency I should try to land, further education needed, etc.
Thanks in advance!!:)

I have worked as a certified surgical first assistant in various specialties since 1998, and I would consider a few things before launching into this field now; How many cases are performed that will be reimbursable in your area? RNFA/CSA/CSFA are having an increase in difficulties getting reimbursed for their services. I work in a more rural area, with a high medicare/medicaid population (greater than 75%) and in order to make living by self billing I believe I once read that the market needed to be less than 65% medicare/medicaid so I never went that route. I have also heard that humana is also a concern starting in 2012. I work for a hospital and take 180-240 hours of call every 2 weeks, and I never know what my hours will be day to day. There is a push to use non-certified, cheaper staff for smaller cases now (the staff's only cert being CPR, the OR receptionist now closing skin, etc) to save costs. I will eventually be moving to a circulating position in order to obtain benefits, as I don't even have PTO :rolleyes: My over all goal was to eventually obtain my RNfA but I won't ever recoup my investment in my area If I lived in a more urban area, I would be able to recover my investment. Good luck

hcolbe42 · Oct 27, 2016

Hey everyone,

My manager just spoke to be about becoming an RNFA. If I was "interested" they would set up all the schooling and allow me to do my 2,000 hours in the OR while still working full-time for the next year. I have 2 years of cardiac/med-surg experience and just recently started with ENT. I'm not sure why they thought of me but I'm glad they did because I've never looked into it before? I see that some of you posted you need OR experience, is that to sit for your RNFA? I would only have 2,000 hours which is roughly a year. Would I still qualify? They also suggested they I would use a program they provided and attend a week long hands on training experience in NY. Any RNFA's out there? Do you love your job? What all do you do? And is the salary any better? Also can you start working on your RNFA classes, while being enrolled in a BSN program or do you have to be graduated first? I have 8 classes left before I graduate in the spring of 2017. Thanks in advance.

kaekd · Feb 26, 2018

how is it? are you now currently working as an RNFA?