can NP work in OR

nomadcrna, DNP, CRNA, NP · May 24, 2011

YOu have two types of advanced practice nurses in the OR, CRNAs and NPs.

The CRNA does anesthesia, chronic pain management procedures.

The FNP is a first assist, usually working for a surgeon. They assist with the surgeries as well as see patients in the clinic, pre and post op. They also manage pt. who may be admitted postop.

iPink, BSN, RN · May 25, 2011

I had no idea an FNP could work as a First Assist. I'm currently in a BSN program and had my first experience in an Endo rotation. I really enjoyed the surgery and now has got me thinking about the possibilities of OR in the future, but thought my goal of being an FNP would be dashed if I wanted to work in the OR.

sourapril · May 25, 2011

How's their working hours? Long like surgeons?

nomadcrna, DNP, CRNA, NP · May 25, 2011

The hard part is getting the experience to get hired. An ortho surgeon who is hiring a FNP in Montana told me it will take him about 2 years of training until the FNP will be able to do what he wants her to do.

There are some post grad course you can take but the best is simply OJT.

The hours vary depending on what type of surgeon you work with. Ortho is the most common but I've seen them first assist neuro as well.

ACorEtACri · May 25, 2011

We had someone talk about this in a lecture. FNP can train as first assist with training. If I remember correctly, there are programs to get certified as a first assist. It is actually a financial benefit, because the FNP can bill for their time as compared to nurse.

The other alternative is to go to PA school. At my school, there are a number of nurses in the PA program. According to some sources, PA program gives more procedural training and would be more likely to include surgical related stuff like a rotation in general surgery. I have no idea if PA need additional training to be a first assist. PA can also bill as a first assist.

With an mid-level role, you have the scope of practice to round on the patient afterward the surgery and write orders for the patients. The speaker stated some physician enjoyed this additional benefit, because it allows them to see more patients. I would guess this is dependent on experience and the relationship with the physician.

If you are really interested, you might want to talk to someone who does this type of work and get their opinion.

nomadcrna, DNP, CRNA, NP · May 25, 2011

You do not need to become certified as a first assist as a NP. They have programs for non-np RNs to become RNFAs but that is not the same, close though. RNFAs are not NPs.

You can bill for first assist as a NP or PA from day 1. No other certification needed, at least in the states were I practice. :)

Most PAs and NPs who first assist learn by OJT.

ACorEtACri · May 25, 2011

Thanks for clarifying the certification thing. I did not mean to imply that certification was needed to bill. I was trying to highlight possible business economic reasons for using a PA or NP as first assist rather than an a RN. Is there any evidence to support using one type versus the other?

CCRNDiva, BSN, RN · May 25, 2011

UAB has a combined ACNP/RNFA program where the ACNP is trained to manage inpatients and assist during surgery. One of my volunteer buddies is a FNP who works as first assist for a large ortho group in town. He really likes it and does quite well. He worked in ortho prior to becoming a FNP though. Another option, is to do some of your FNP clinical with a ortho doc. One of the RNs I work with did that and the doc used it as time to train her and feel her out before adding her to his practice. He liked that she could serve as his 1st assist and also see pts independently, thus freeing up his time.