Does anyone know of a perioperative NP or CNS program?

Advanced Practice Columnist / Guide · Jan 16, 2011

This is the only one I found so far:

http://www.usuhs.mil/gsn/curriculum/pcns.html

...but it sounds like civilian applicants have to be sponsored by any of the branches of the armed forces or US Public Health Service.

Advanced Practice Columnist / Guide · Jan 16, 2011

...which I find quite odd because I see a few job postings for perioperative CNS positions across the US. We actually have a perioperative CNS where I work (this person has a PhD) but I don't know exactly what route this CNS took to get to that role.

core0 · Jan 17, 2011

Does anyone know of a perioperative NP or CNS program? AORN has published a position statement endorsing perioperative advanced practice nurses. I am looking for a program, preferably on-line, that specializes in the perioperative setting. I know that several programs offer ED, critical care, and other areas but I have been unable to find a MSN program that covers this niche. I currently work in a Magnet facility and they are creating positions for APNs on many of the units. My director is behind me all of the way on working to create this position.
Luv The OR

The biggest problem is that AORN considers RNFAs "expanded practice RNs". They regard this essentially as the perioperative APN. Given that RNFA by itself doesn't meet the standards for an APN in any state they have adopted the "perioperative APN" but really haven't pushed things beyond that. There is only one NP program that I know of that adopts the periopertive role. The UAB ACNP/RNFA. http://www.uab.edu/nursing/images/stories/info_sa/msn_flyer_np_rn_first_assist.pdf

Other than that some CNS programs will allow you to specialize within the specific area. Thats what our CNS did. Whether the CNS is considered an APN is dependent on state licensure.

LuvTheOR · Jan 17, 2011

Thanks for the information. I was hoping to find a school that offered an online program with clinicals near where I live. I know that a number of online programs offer this option with little or no time spent on campus. So many of the programs that I have looked at do not really apply to the OR environment. I would be working for the hospital not for a specific physician like many NPs do. I already have the first assistant experience so the RNFA.

AORN recently came up with a new position statement on perioperative APNs. I will attach it below.

AORN Position Statement on

Perioperative Advanced Practice Nurse

PREAMBLE

The registered nurse practicing as an advanced practice nurse (APN) builds on the foundation and core values of the nursing domain. The APN practices autonomously to design, implement, and evaluate patient-specific and population-based programs of nursing care. The APN practices in many roles and arenas. The purpose of this document is to define the role of the perioperative advanced practice nurse.

POSITION STATEMENT

The perioperative APN is, first and foremost, a registered professional nurse who is competent in the use of specialized perioperative nursing knowledge and skills in the care of patients and families undergoing operative and other invasive procedures. The APN possesses a minimum of a master's degree in nursing, concentrated in a recognized area of advanced clinical nursing practice (ie, nurse practitioner [NP], clinical nurse specialist [CNS], certified registered nurse anesthetist [CRNA], or certified nurse-midwife [CNM]), which forms the foundation for an advanced practice role.

A hallmark of the APN's skills are the autonomy and expertise in diagnosing and treating complex responses of clients (ie, patient, family, community) to actual and potential health problems that are related to the prospect of or the performance of operative or other invasive procedures. The perioperative APN fosters patient advocacy and patient safety. Formulating clinical decisions in managing acute and chronic illnesses by assessing, diagnosing, and prescribing treatment modalities, that may include pharmacological agents, are all inherent in the perioperative APN role. In addition, the perioperative APN promotes wellness, and does this primarily by conducting comprehensive health assessments.

The perioperative APN integrates clinical practice, education, research, management, leadership, and consultation into a single, but multifaceted, role. Because the focus of this role is care of surgical patients, the perioperative APN continually functions in a collegial relationship with nurses, physicians, health care organizations and systems that influence care of the surgical patient.

RNJohnny23 · Feb 26, 2012

Thr problem with AORN's position statement re: the Perioperative APN is that it is too vague and inclusive. CRNA's and CNMW's have a very clearly defined role already. The Perioperative CNS or NP (or new CNL) have no SPECIFIC DEFINITION of roles WITHIN THE PERIOPERATIVE SETTING. This definition is especially important because these APN's will not function as physician extenders, due to the surgeon and anesthesiologist or anesthetist being present at all times. Already there is a Pre-op RN, Circulating RN, scrub nurse (CST or RN), possibly an RNFA or another scrub nurse, then there is a PACU RN. All these in addition to the surgeon, CRNA or anesthesiologist. There is also Nurse Manager or Director of the Department, who increasingly holds a MSN in Management or an MBA. The Clinical Educator role is often held by someone with a BSN or an MSN in Education. What does the Perioperative CNS, NP, or CNL bring to the team that is unique and valuable beyond the roles that are already clearly defined in the OR? How does such a person sell themselves? I'm asking because this is something that I'm interested in doing, but I'm put off by the very real possibility of having to explain the value of my role to a potential employer.

LuvTheOR · Feb 27, 2012

For several good articles on the role of the peri-operative APN look at Elsevier's Perioperative Nursing Clinics articles. I have also found a few in the AORN Journal. Just do a search on Ebsco. Aorn published its first statement on APRN competencies in 1994 and revised it in 2006. These articles would give you a good starting point in writing a job description for your bosses...

Luv The OR :nurse:

nomadcrna, DNP, CRNA, NP · Feb 27, 2012

Physician extender?

No NP that I'm aware of is a "physician extender".

I find that term extremely derogatory.

Thr problem with AORN's position statement re: the Perioperative APN is that it is too vague and inclusive. CRNA's and CNMW's have a very clearly defined role already. The Perioperative CNS or NP (or new CNL) have no SPECIFIC DEFINITION of roles WITHIN THE PERIOPERATIVE SETTING. This definition is especially important because these APN's will not function as physician extenders, due to the surgeon and anesthesiologist or anesthetist being present at all times. Already there is a Pre-op RN, Circulating RN, scrub nurse (CST or RN), possibly an RNFA or another scrub nurse, then there is a PACU RN. All these in addition to the surgeon, CRNA or anesthesiologist. There is also Nurse Manager or Director of the Department, who increasingly holds a MSN in Management or an MBA. The Clinical Educator role is often held by someone with a BSN or an MSN in Education. What does the Perioperative CNS, NP, or CNL bring to the team that is unique and valuable beyond the roles that are already clearly defined in the OR? How does such a person sell themselves? I'm asking because this is something that I'm interested in doing, but I'm put off by the very real possibility of having to explain the value of my role to a potential employer.