Published Oct 8, 2009
Inspired By Silence
158 Posts
I'd like to get my CNOR and CRNFA credentials and aout 2 to 5 years experience before taking on graduate school.
I'll be specializing in pediatric neurosurgery for very personal reasons. I've looked at CNS pediatric and neurology specialty certificates and even the CNL certificate because a perioperative nurse's second most important role--after patient advocate, of course--is leader of the OR. I've looked at neurosurgery critical care specialties too.
I've heard that AORN (the periopeartive association) is putting together a perioperative cns specialty. Is that true? if so, what is the apn's role in the operating room and post operation?
What else might be a good graduate specialty, preferably apn, for a periopearitive nurse?
jer_sd
369 Posts
Acute care PNP would be a good focus for your interests.
Why would you suggest that? Really, what does that allow me to bring in this particular setting?
in pediatric neurosurgery there will probably be pre-operative duties, introperative duties and post operative duties that an advanced practice RN could do. as a NP or CNS you can bill for first assisting in the OR. NP gives the ability to help manage the kids before and post operative including H+P, medication perscribing, progress notes, order and interperate testing. In some states a CNS can do these functions but not all states.
PNP has two specilty tracts one for primary care and one for acute care. If you want to workin the surgical enviroment the acute care track is must more applicable.
CNS- depends on state law,in somestates theya re nto recognized as advanced practice nurses.
CNL- if you want to move into administration this might be benificial, but would not lead to advanced clincial skills or the ability to bill for services provided.
RNFA/CRNFA- additional clinical skills, limited in the ability to bill for services in most states (makes a great addition to NP/CNS/CNM).
Jeremy
in pediatric neurosurgery there will probably be pre-operative duties, introperative duties and post operative duties that an advanced practice RN could do. as a NP or CNS you can bill for first assisting in the OR. NP gives the ability to help manage the kids before and post operative including H+P, medication perscribing, progress notes, order and interperate testing. In some states a CNS can do these functions but not all states.PNP has two specilty tracts one for primary care and one for acute care. If you want to workin the surgical enviroment the acute care track is must more applicable.CNS- depends on state law,in somestates theya re nto recognized as advanced practice nurses.CNL- if you want to move into administration this might be benificial, but would not lead to advanced clincial skills or the ability to bill for services provided.RNFA/CRNFA- additional clinical skills, limited in the ability to bill for services in most states (makes a great addition to NP/CNS/CNM).Jeremy
So you're suggesting that adding a NP/CNS to my educational qualifications after obtaining an RNFA can increase the amount I can bill for first assisting? But I'd still be billing less than a PA-C first assistant, wouldn't I?
PA-C/NP/CNS can all bill the same for first assisting for medicare. Each private payer such as blue cross, blue shield ect sets their own policies. But usually PA-C and NPs are lumped together.
As a CRNFA very few insurance plans will pay for services.
PA-C/NP/CNS can all bill the same for first assisting for medicare. Each private payer such as blue cross, blue shield ect sets their own policies. But usually PA-C and NPs are lumped together.As a CRNFA very few insurance plans will pay for services.Jeremy
I find this odd because NP's aren't formally trained in first assisting as PA's are. Are you suggesting I could first assist as a NP without formal CRNFA training? That doesn't seem right to me. But what do I know.
This is where facility credentialing comes into play. In order to practice at a facility you will need to meet their requirements not just state laws. For example the hospitals I work at
Hospital A- NPs can first assist if their sponsoring physician allows them to (NP/PA exact same credentials in the faclity)
Hospital B- required graduation of a RNFA program and CNOR certification for NPs to first assist
Hospital C- must request and provide documentation of training/competency in assisting for specific procedures.
I would strongly recomend a formal RNFA program if you want to practice as a first assistant as a NP/CNS even though there are a few places you can do OJT but it would be hard to meet credentialing elsewhere.
This is where facility credentialing comes into play. In order to practice at a facility you will need to meet their requirements not just state laws. For example the hospitals I work atHospital A- NPs can first assist if their sponsoring physician allows them to (NP/PA exact same credentials in the faclity)Hospital B- required graduation of a RNFA program and CNOR certification for NPs to first assistHospital C- must request and provide documentation of training/competency in assisting for specific procedures.I would strongly recomend a formal RNFA program if you want to practice as a first assistant as a NP/CNS even though there are a few places you can do OJT but it would be hard to meet credentialing elsewhere.Jeremy
Thank you so much for your time and wisdom. It's greatly appreciated.