How long before NPs will be able to do surgery solo?

SFCardiacRN · Apr 15, 2006

These kinds of things happen slowly and in baby steps, but they do happen. We now have the technology, through the Da Vinci robotic arm, for surgeons to operate remotely. It is not unconceivable that even major surgery will be performed by specially trained nurses with distant a surgeon on a satellite controlled robot in "charge". It's sure to start with nurses in rural areas doing "lumps & bumps" and progress from there. I don't look for it to happen this decade but it will happen. IMHO

brownrice · Apr 15, 2006

Platon....I DO NOT think this an insane idea at all. I too think this will happen. Doctors do not have an extra layer of cerebral cortex. What they do have is training, and the protection offered by the definition of "medical practice" that was carved out so long ago. This words defining this scope relegated all nonphysician folks to then divide up the left over peanuts...Podiatrists can only touch the feet, Chiropractors can't prescribe antibiotics, etc. With proper training, of course nurse practitioners could perform basic surgeries.

Why does nursing as a profession at times seem to have such a low self esteem? I am highly impressed by the NP's with a "pioneering attitude". They have fought hard to win prescriptive priviledges, etc. I am confident these same folks will eventually win other scope of practice battles. I plan to help them! I do not desire to do basic surgeries. But, I know other NP's that would be very capable. As with other care delivered by NP's, It would be more cost effective. We need to do something with health care delivery in the US. We rank something like number 77 in the world for healthcare/quality of life issues. Look at European countries ranking above us. Then look at what some of the physicians in Europe earn. How about $70,000 a year for a physician in France or Germany? So the high pay for the physicians in the US with the extra layer of cerebral cortex doesn't seem to be doing us any justice.

Keep up the progressive thought!

Corvette Guy · Apr 15, 2006

Platon....I DO NOT think this an insane idea at all. I too think this will happen. Doctors do not have an extra layer of cerebral cortex. What they do have is training, and the protection offered by the definition of "medical practice" that was carved out so long ago. This words defining this scope relegated all nonphysician folks to then divide up the left over peanuts...Podiatrists can only touch the feet, Chiropractors can't prescribe antibiotics, etc. With proper training, of course nurse practitioners could perform basic surgeries.
Why does nursing as a profession at times seem to have such a low self esteem? I am highly impressed by the NP's with a "pioneering attitude". They have fought hard to win prescriptive priviledges, etc. I am confident these same folks will eventually win other scope of practice battles. I plan to help them! I do not desire to do basic surgeries. But, I know other NP's that would be very capable. As with other care delivered by NP's, It would be more cost effective. We need to do something with health care delivery in the US. We rank something like number 77 in the world for healthcare/quality of life issues. Look at European countries ranking above us. Then look at what some of the physicians in Europe earn. How about $70,000 a year for a physician in France or Germany? So the high pay for the physicians in the US with the extra layer of cerebral cortex doesn't seem to be doing us any justice.
Keep up the progressive thought!

When I think of surgery it is the variety of exploratory laparotomy, total knee replacement, coronary artery bypass, etc. These are the areas I would not want an NP as the primary surgeon. However, the outpatient day surgery centers where less complex & less likely a life-threatening event could occur I can definitely see where an NP could be an asset as the primary surgeon. This is in no way an insult to NPs but more with the number of years of medical education & training involved. Of course, I highly admire & respect NPs, which are at the top of the nurse food chain [meant has a compliment, LOL].

IMHO, what would assist this Thread is to narrow down the focus to the general type of surgical procedures for which an NP may someday go solo [the primary surgeon].

platon20 · Apr 16, 2006

All I can say is INSANE IDEA.......... I think NPs are great, but if I have to go under the knife, I want it to be in the hands of a doctor.

People said the same things about nurses writing prescriptions

"I would NEVER go to a nurse and let them write prescriptions for me!"

austin heart, BSN, RN · Apr 16, 2006

People said the same things about nurses writing prescriptions
"I would NEVER go to a nurse and let them write prescriptions for me!"

I don't think that this is quite the same...........

suzanne4, RN · Apr 16, 2006

Fellow NPs, I think this is coming soon. I know many NPs who are first assists right now. They do 95% of the surgery while the MD does the other 5%
However, the NPs I know are well trained to where they could easily do the other 5% of the surgery that the MD does currently
I think its time for our PAC and lobbying organizations to get behind this effort. Doing surgery has been part of nursing practice for a long time now, its time for the world to recognize that we NPs are surgeons too and we can do it just as well as the MDs, if not better.
We need to move on this issue.

Just so I understand where you are coming from, what is your actual training up to this point? Are you in an NP program? Are you an RNFA? Do you actually have an RN? It would make it easier for me to understand since you are a very new poster here.

And yes, I have my RNFA.

platon20 · Apr 16, 2006

Just so I understand where you are coming from, what is your actual training up to this point? Are you in an NP program? Are you an RNFA? Do you actually have an RN? It would make it easier for me to understand since you are a very new poster here.
And yes, I have my RNFA.

yes I am an RNFA at a small rural hospital. Like I said, NPs dominate the surgery service here and the attending MDs train us like they train surgery residents at other programs.

platon20 · Apr 16, 2006

I don't think that this is quite the same...........

In both cases, everybody said nurses were not capable or didnt have the understanding/training to do it. So although its not exactly the same thing, NPs/RNFAs CAN be trained to do surgery just like surgeons.

Once you have a certain experience level in the OR then appys and lap choles are NOT that hard to do. AGain, I'm talking about bread and butter surgeries here, not brain surgery. Start small, and work our way upwards.

It would be very easy to slightly modify the RNFA training to allow this role. Or alternatively you could have a separate track for NPs who want to do surgery.

Corvette Guy · Apr 16, 2006

In both cases, everybody said nurses were not capable or didnt have the understanding/training to do it. So although its not exactly the same thing, NPs/RNFAs CAN be trained to do surgery just like surgeons.
Once you have a certain experience level in the OR then appys and lap choles are NOT that hard to do. AGain, I'm talking about bread and butter surgeries here, not brain surgery. Start small, and work our way upwards.
It would be very easy to slightly modify the RNFA training to allow this role. Or alternatively you could have a separate track for NPs who want to do surgery.

Did you read post #27 :confused:

Papadoc · Apr 16, 2006

Just so I understand where you are coming from, what is your actual training up to this point? Are you in an NP program? Are you an RNFA? Do you actually have an RN? It would make it easier for me to understand since you are a very new poster here.
And yes, I have my RNFA.

Yeah! It'll help us understand better. Also, Platon20, I noticed that you refer to an NP as a surgeon. But surgeon is a title designated to an MD/DO/DDS, a physician. FNP and FP (MD/DO) are not the same, even though their scope of practice overlap. Please be so kind, and enlighen us on the level of your education and training.

Thanks

TopherSRN · Apr 16, 2006

Either this is a troll post or the OP smokes crack, but I'll humor you.

RNFAs dont need that much more training to do surgeries solo. i would suggest maybe an extra year, followed by a year working an apprenticeship under an MD surgeon.

a RNFA is a far cry from a surgeon. 1 yr experience and another week of classes + a test does not equal medical school + surgery residency.

We can do the job just as well as an MD surgeon.

No they can't because they haven't had the advanced A/P and that silly surgical residency.

NPs not being allowed to run surgeries solo is the same thing years ago when NPs could not script drugs.

Writing scripts and performing surgery are two different things.

We DO have the capability and knowhow to pull it off.

Again, no.

We dont need to be stomped under the feet of surgeons who think they run the whole show.

Sorry, but surgeons do run the show whether your ego recognizes it or not. Nurses are subordinates (professionally) to physicians. Without the surgeon RNFAs and S.A.s wouldn't have jobs.

As far as nurses performing 'bread & butter' surgeries, even those can go wrong in more ways than one and would necessitate the advanced training an actual surgeon has. If you want to play surgeon then I'd suggest going back to medical school and actually investing the 10+ years required. Because if you intend on waiting around for nurses to be anything more that FAs then you will be sorely diasppointed.

brownrice · Apr 16, 2006

My how times can change.....it's interesting to note that in the 70's, med students worked at shopping malls piercing ears, as no one else was allowed. Now, in 2006, the folks piercing ears may not even have their GED.