Can NP's perform surgery legally?

[jdc6773]

I am a nursing student working on my second degree BSN. I initially wanted to go to PA school but later changed my mind to go ahead and go to nursing school with intent of getting my nurse practitioners license. I have always been intrigued with orthopedic surgery and I know that PAs can perform surgery legally. Vanderbilt states that a nurse practitioner can practice whatever form of medicine that the primary physician practices I was just curious if that included surgery. I read in a couple of the older forums that nurse practitioners can perform surgery but it's very rare but I haven't been able to find any proof of that. Thanks!

[cayenne06, MSN, CNM]

Agree with previous posters. As a CNM I was doing laceration repair and first assist at c/s. I know CNMs who do circs and 3rd degree repairs as well- you just need to be trained. I work outpatient now so no surgery (boo ) but I do minor office procedures and will be trained for biopsies and colpos as well.

[Jerodcrnp33]

That sounds like a stab phlebectomy. Minimally invasive removal of bulging varicosities. I'm A ACNP and have worked with neurosurgery and currently vascular surgery. Yes, you assist in all procedures and operations but the MD should never leave the OR and let the NP perform, only if you are closing the wound. I have started spinal cord stimulator pulse generator insertion with MD not in room but they were either scrubbing in or had already seen the pt and advised me to get started with incision and dissection. It's all experience and the comfort level between you and surgeon. Also you need privileges from medical staff to do anything even with physician supervision. If you like surgery ACNP is the way to go, you get OR time, rounding and clinic, it's nice to follow patients through entire spectrum from clinic until discharge post operativly.

[Purrsx2]

I have seen a couple of occasions where the orthopedic PA did the surgery in its entirety (with the ortho surgeon in OR).

One was short TFN, and PA did the entire procedure, from incision to closing, surgeon was scrubbed, was holding retractors and giving advice (this particular older ortho surgeon does not operate a lot, only when on call (very rarely), and is not comfortable doing TFNs. He used to do DHS, but we got rid of DHS instrumentation a while ago and had none at the time he was called-in on off-shift for a trocanteric hip fx). Ortho PA did the surgery very quick (25 min from incision to the beginning of the closure), some ortho MDs take much longer, I asked ortho PA where he learned to do TFN on his own, he told me that in another hospital ortho PAs often did TFNs by themselves while surgeons were in OR dictating their previous cases (not even scrubbed in).

Another time it was a different ortho PA, but the same surgeon, ortho PA pretty much did an I&D of the shoulder by himself, surgeon was scrubbed, held the retractors, after lavage he scrubbed out and left the OR to dictate and talk to the family, ortho PA finished the surgery alone.

Also our ortho PAs fix the dislocations in ER by themselves (no MD present), do minor I&Ds, etc.

[mommy.19, MSN, RN, APRN]

APRNs can be first assists, and even bill insurance. The FA training specially for APRNs can usually help outline the specific issues to your state of practice.

[Jerodcrnp33]

That's the thing. Anyone can learn a sugary technique if they assist and watch it enough. It's not difficult to follow steps and know anatomy. I personally wouldn't trust a PA over a surgeon, maybe an ortho surgeon but that's about it. PAs lack critical thinking skills. they come out of school and have zero bedside experience, or independent critical thinking skills, I would trust an ICU nurse over a lot of PAS, not to mention a ACNP who worked ICU and is now covering ICU

[evolvingrn, BSN, RN]

Jerodcrnp33 said:

That's the thing. Anyone can learn a sugary technique if they assist and watch it enough. It's not difficult to follow steps and know anatomy. I personally wouldn't trust a PA over a surgeon, maybe an ortho surgeon but that's about it. PAs lack critical thinking skills. they come out of school and have zero bedside experience, or independent critical thinking skills, I would trust an ICU nurse over a lot of PAS, not to mention a ACNP who worked ICU and is now covering ICU

Um ..... Whatever.

[PG2018]

My cousin just had his gallbladder removed by a FNP in an old ambulance converted into a mobile surgery center. They had a respiratory therapist doing anesthesia and everything. He said he's going back to them in two weeks for teeth cleaning.

Not really.

Although he would agree to something like that.

[PG2018]

Jerodcrnp33 said:

That's the thing. Anyone can learn a sugary technique if they assist and watch it enough. It's not difficult to follow steps and know anatomy. I personally wouldn't trust a PA over a surgeon, maybe an ortho surgeon but that's about it. PAs lack critical thinking skills. they come out of school and have zero bedside experience, or independent critical thinking skills, I would trust an ICU nurse over a lot of PAS, not to mention a ACNP who worked ICU and is now covering ICU

Do you normally mKe friends easily?

[kphos]

I am a ACNP working in General Surgery. I have been asked similar questions from people interested in either PA vs NP career paths. I have encouraged them to find a really respected NP and PA and arrange to shadow them each and from that time make the determination. The educational path and focus of the programs is often very different. PA's schools tend to produce procedurally based graduates geared for operative roles. NP's schools look towards the greatest gap in healthcare and focus of deficits in clinical needs. I chose the NP path. I worked as a RN in the OR (both as a scrub and circulator) and a RN in a Level I trauma ICU. My working history prepared me for the roles I have been in since graduation. Regardless of what you choose, prepare yourself for both clinical and operative roles and seek out these experiences, you will make your career into what you want it.

ALso look into your states regulations for both PA's and NP's. Each state has it's owns laws and rules for both. It is very hard for anyone on this website to make a blanket statement for what is allowed or not allowed for NP's/PA's, there are so many variations for each state and to make it more confusing each hospital has it's own idea of what a NP/PA can do.....

[synaptic]

Yes, of course we can do surgery. We do heart transplants, liver swaps, and gall bladders all the time. I mean, only a fool would go into general surgery. All those student loans and you don't learn anything we don't know. We are the mighty nurses, king of the universe. Doctors are just overpaid and undertrained goobers that think they r smarter than we are. Don't let them fool you!!!!