How do I become a surgical NP?

Home Health Columnist / Guide · Feb 3, 2020

Family Nurse Practitioner /FNP is an outpatient role. Acute Care NP would be more suitable for inpatient role.

I'm familiar with Delaware County Community Colleges RN First Assistant in Surgery Program --been around over 35 years has good info re education requirements + courses: https://www.dccc.edu/academics/academic-divisions/allied-health-emergency-services-nu Their 6 credit certificate program is hybrid online with 5 days on campus; Graduates eligible for RNFA Certification Exam.

AORN has list of approved RNFA programs and resources along with position statement on NP RNFA delineates the definition and educational requirements for the APRN who functions in the perioperative environment, including the preoperative, intraoperative, and postoperative patient care areas. .https://www.aorn.org/guidelines/clinical-resources/rn-first-assistant-resources

mcjobson, MSN, NP · Feb 12, 2020

Hi, I'm in the adult/gero acute care program at the University of Michigan. I would definitely do an acute care program and not FNP or primary care.

You can get your RNFA, but it is not necessary. I know NPs at the University of Michigan hospital who have their own OR time and perform procedures without a physician. None of them have their RNFA certification. However, getting your RNFA will definitely give you skills that go beyond what you will learn in the acute care program and better set you up for getting a job that you want post-graduation.

QqGgKk, BSN, MSN, RN · Mar 1, 2021

Hi,
I am in California and most programs offered are FNP rather than Acute care NP. Thoughts ?

mcjobson, MSN, NP · Mar 1, 2021

16 minutes ago, QqGgKk said:

Hi,
I am in California and most programs offered are FNP rather than Acute care NP. Thoughts ?

Hey Q,

There are some things to consider when deciding on a program.

The first is, after graduation where do you intend to work, and with what population? The State Boards of Nursing and Universities are really pushing the Consensus Model. If this trickles down to health care systems (which it has started to do already), you might have a hard time finding a job in an inpatient setting with an FNP certification. I have interviewed for positions in Hawaii and Colorado and both systems have required an Acute Care certification.

Second, if you do have your FNP and you work in acute care, you could be opening yourself up to litigation. FNP's are primary care providers and inpatient is tertiary care. This is technically outside of the FNP's scope of practice. In the past, FNPs were filling a need in hospitals and there is still a shortage of ACNPs. However, this will slowly change as ACNPs are able to meet demand. If you decide to become an FNP and work in acute care, I would do your research. Check with your state board of nursing and make sure your employer will cover your insurance in case of a lawsuit.

Third, you might consider moving somewhere that offers an acute care program. I know that this is a big decision and is more difficult than it has to be. This is just my opinion, but you are going to school to become a provider, and going about your education via the path of least resistance doesn't serve you, your patients, or the NP profession well. NPs are under scrutiny because of the way we educate some of our peers. Generally, those who are educated at better programs make better providers and those who are educated at For-Profit University of Whatever Online make poor providers.

Lastly, if the only option available to you is an MSN/DNP with a concentration in FNP, I would recommend you take it. You can get your acute care certification at a later date via a post-masters certification program. I have a professor who got her FNP and started her first job in an ICU. She went back to school and attained her ACNP cert.

Whatever you decide to do, make sure that you are aware of what your choices mean for you, your practice, and your patients. The biggest consideration is what risks are you exposing yourself and your patients to if you practice outside of your scope. And if you are looking to work in the OR, the surgeons you would like to work with might not look kindly on a sub-par education as physicians are usually the most critical of nurse practitioner education.

Here is a link on what you need to be an RNFA in each state: https://www.rnfa.org/wp-content/uploads/2018/04/RNFA-Scope-and-Qualifications-Chart-updated-04172018.pdf

QqGgKk, BSN, MSN, RN · Mar 5, 2021

Hi mcjobson,

Thank you so much for the insights and resources provided. I am glad that the forum make it possible for me to ask questions and receive different opinions during my pre-contemporary phase in making changes. I am consulting different programs including MSN nursing education, MSN AG CNS, and AG-ACNP programs. I also consider MSN nursing education because I have a master degree in education prior to my nursing career and I am always passionate about helping socioeconomic disadvantageous people with achieving their academic goals in life. During my research for the advanced programs, I found out that there are many AG-ACNP programs available in my areas. What’s the CNS’s potential roles in the OR, any thoughts ?

mcjobson, MSN, NP · Mar 5, 2021

CNSs are important members of the team. How they are utilized and whether or not they are used to their full potential depends on the system you work for. Technically, CNSs are trained to assess, diagnose, and treat patients, though this isn't how I've seen them used in Michigan.

Generally, I've seen them used as experts in areas of care or specific populations. They drive change based on best evidence. In the OR, you can expect that a CNS would streamline processes, improve the quality of care delivered, focus on the safety of the OR for patients and staff, etc. But it may be different where you live. The CNS might do all of these things and provide direct patient care as well. Again, I would look to your local health systems and ask CNSs there how they are used.