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Discussion

Can an FNP work in surgery?

Hi y’all !

I'm an OR nurse and I’m looking to go back to school. My ultimate goal is to work in surgery - assisting in procedures, rounding and seeing patients in clinic. But I’m not sure if FNPs are allowed to do that ? I’m not sure if it’s out of the scope of practice.
Unfortunately, the OR is not considered acute care so most schools will only accept me for the FNP program.
so my two options are :

1. Transfer to an ICU and get the experience for a year and two and then apply to school for the AGACNP
2. start an FNP program and see what options are out there when I graduate.

help me out here !!

Featured Replies

Ask potential employers what they prefer as this will vary by hospital system and surgeon

  • Admin

I have worked with a handful of OR nurses who went on to become FNPs and function in the role of a first assistant in the OR in addition to their duties on the inpatient unit and in the office. All are employed by the physician office and not the hospital itself. Non-academic center so no med students and residents are limited to family practice.

I am an FNP working for a surgical service. I do not have my RNFA so I do not assist in the OR. I love my job.

  • I am currently in a post-graduate certificate program for FNPs who want to be AGACNPs. In 2012 the AACN put out a consensus statement regarding the scope of practice of APRNs. It's hard to argue with the main premise, that the population you practice with should match your certification and your certification should match your education.
  • At this time, hospitals in my area are no longer hiring FNPs to work in acute care settings, and surgery is considered an acute care setting. However, they aren't firing the ones who are already here, like me. But when an FNP leaves they're replaced with an AGACNP or a PA.
  • In my state, FNPs can no longer be supervised by a surgeon or physician working in acute care, so no new grad FNPs could be hired to a surgical service anyway.

Check with your state's board of nursing-- but every year that passes more and more states start following the consensus statement guidelines. It may depend on where you live, but you'd likely find it difficult to work with a surgical service as an FNP.

I do know some FNPs who work for outpatient offices for urology or hematology, with the idea being that patients seen in the office are stable patients being seen for a chronic condition. Could an FNP with an RNFA then go to the hospital with a surgeon and assist? Based on the reply above it certainly looks like that is the case in some places, but you would need to be prepared for the landscape to change even while you're in school. When I was hired 6 years ago for a surgical service, most of the NPs on that service were FNPs. Some have moved to other jobs, some have gone to get their AGACNP certification. I'm one of the few left, and as I said, no more will be hired for surgical services from here on out.

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