Can the NP assist in surgery?

Specialties NP Nursing Q/A

Hi, I'm new to this forum and wanted to know if the NP can assist in surgery (similar to how the PA can assist in surgery). If so, which specialty NP track should I choose? I'm considering becoming an RNFA, but I was wondering what types of jobs are available for the RNFA with an advanced practice degree. Thanks, and sorry if my questions have already been answered somewhere on this forum.

Can an RNFA cert help a WHNP who wants to be involved in gynecological surgeries and c-sections? How common is this?

Specializes in CT ICU, OR, Orthopedic.
\ said:
Can an RNFA cert help a WHNP who wants to be involved in gynecological surgeries and c-sections? How common is this?

Most RNFA programs require prior surgical scrub experience, like experience working as a scrub nurse. If you can find someone to train you to scrub, then an RNFA/NP CERTAINLY CAN assist in surgery. The problem, though, is getting the experience. In my case, I have about 15 years of scrub experience, so this will not be an issue. But if you don't have that background, getting the required RNFA clinical time will be tough. The RNFA programs are geared toward scrub nurses or NPs with scrub experience. Good luck!!

Specializes in FNP, ONP.

Just met a FNP who assists with a lot of spinal surgery. He positions the patient after induction, opens the incision, and prepares everything for the neurosurgeon. Then the NS comes in and does the actual laminectomy, then talks to the family and heads to the following procedure. The NP closes the incision and writes the post-op orders. They can do twice as many procedures a day this way. It is all about the best and highest application of training and education. Everybody wins.

I never saw much of this because I worked almost exclusively in academic med centers, and who needs to pay an NP 100K a year to do this when you can pay a resident 40? I am only recently becoming aware of the enormous role NPs are assuming in non-academic centers and now, too, even in academic centers now, that resident hours are being cut drastically.

There is a world of opportunity out there, and it seems you can do just about anything you want to as an NP if you seek suitable environments.

I know this thread is old, but can I ask if surgical NPs make more than an FNP with the same amount of time practicing? Or do they make about the same? I ask because I want to be a surgical NP ? just curious!

Specializes in Nephrology, Cardiology, ER, ICU.

Here is an article you might be interested in:
https://allnurses.com/advanced-practice-practitioners-in-the-t686306/

Another thing to consider is multiple surgical residencies for PAs and NPs. Almost unanimously, these residencies require the NP to be acute care certified - not family.

Specializes in critical care.

Perhaps this thread will be of interest: 
https://allnurses.com/surgical-first-assist-NP-t306457/

Specializes in Level II Trauma Center ICU.

UAB has a combined Acute Care NP/RNFA program. I think you are required to have OR experience, though.

alisabeth said:

I chose to specialize in neurosurgery as a registered nurse in the operating room. When I went back for my master's and doctorate, I had my advanced clinical rotations in neurosurgery and neurology.

Yes, I do have a lot of certifications and have attended a lot of courses for my specialization. These are not required but are something I enjoy doing.

I'm sure it varies by state, but in Florida, before you even begin practicing as a nurse practitioner. You and the physician you work with must provide BON with specific details of what you will be doing in your position and specialty. They have to approve this before you can begin working. So I do not have to be worried about being "thrown under the bus" to the BON. They have already approved every clinical skill/procedure/first assisting I do in my position. The surgeon also must sign this letter that he supervises everything I do and is responsible for me. This is Florida-specific.

As I stated in my previous post, the RNFA is something I will probably work towards in the future. Yes, I know it does look more favorable to have your RNFA when you are in surgery.

For now, I practice per my state laws and hospital regulations, which do not require you to have your RNFA.

So did you have surgical training as part of your NP Program? Were you scrubbing/assisting in your NP clinical rotations?

Alisabeth said:

Yes, nurse practitioners can first assist in surgery. I am a Family Nurse Practitioner, and I specialize in neurosurgery. I was an operating room nurse for several years and knew how to scrub and assist. I do not have my RNFA, which I will probably work towards in the future. Some hospitals where you will either work or have privileges require you to have your RNFA. I am at an HCA hospital, and they do not.

Hello, Alisabeth; thanks for replying! Your reply has been the most helpful for me so far!

If you don't mind, please tell me your duties as the FNP assisting neurosurgery. What procedures do you do while helping? I'm a bit confused, but how did you learn how to help since you have not completed an RNFA program (if you can't tell already, do I know anything about NP school and what they instruct regarding surgery)? And what do you do as the FNP specializing in neurosurgery outside the operating room (such as before and after surgery)? I am so interested in your profession, and I am burning to know more!

Again, thanks for being so great, Alisabeth!

Hi,

I know this topic has been here for a long time, but does anyone have any updated information regarding an APRN's role as a first assistant in the OR? I practice in FL and have been in this role since 2015. Do I require RNFA certification? Thank you.

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