NP in clinic based surgical specialties

traumanightsRN, NP · Mar 12, 2023

I work in an outpatient orthopedic surgery clinic. I do not work for any of the surgeons, I do general orthopedics. I see my own patients but also do pre-ops and postop visits. I have zero OR experience and am not an RNFA. It's basically the same as any other clinic job except you will often need to consult the surgeons or have patients make follow up appat with the surgeons. I talk to them frequently if I have questions or need their treatment plan for their postops. What is a pain is they are rarely in clinic so if you need them you have to call or page them and hope they get back to you quickly.

treeye · Mar 12, 2023

traumanightsRN said:

I work in an outpatient orthopedic surgery clinic. I do not work for any of the surgeons, I do general orthopedics. I see my own patients but also do pre-ops and postop visits. I have zero OR experience and am not an RNFA. It's basically the same as any other clinic job except you will often need to consult the surgeons or have patients make follow up appat with the surgeons. I talk to them frequently if I have questions or need their treatment plan for their postops. What is a pain is they are rarely in clinic so if you need them you have to call or page them and hope they get back to you quickly.

thanks for sharing! How were you trained into this role? Are you overall happy at your job?

I actually was offered a position in an outpatient orthopedic surgery clinic seeing patients who are non-operative. I turned down that job partly due to hours and culture, partly due to the feedback from the person who used to hold this job. She told me that a lot of pts insist that they need surgery although they were not good candidates and she got tired of being yelled at.

traumanightsRN, NP · Mar 12, 2023

It's a tough job. The learning curve is really steep. I worked in primary care for 4 years before going to ortho and definitely was not prepared for the amount of anatomy I did not know. I learn something new every day. I don't hate it but I don't love it either. I think if I was in the OR I might like it more because I'd be in clinic less. It's a typical clinic job of M-F 8-5 with two 4 hour admin sessions a week. Can't complain about that. It's def a tough job but pays better than a lot of specialties because surgery is a money maker. I mostly work on my own, which I don't like. I prefer a team setting. But each job has its pros and cons. I just take it one day at a time.

twozer0, NP · Mar 14, 2023

I work in outpatient/inpatient Urology and sometimes see pre/post ops (generally the docs keep the major surgery folks). Recently I have switched to 100% outpatient. I did work PACU for several years before becoming an NP so I have some surgical experience prior to my NP. This made rounding on post ops pretty simple since I knew mostly what to expect and what general criteria we had for meeting discharge. I have, on occasion, gone into the OR to place a difficult foley via cystoscope. While I could train to get RNFA, being an additional hand during surgery wouldn't offer much (for me personally) to my current practice. We do all your major urological surgery except cystectomy including robotics.

To answer your question, you don't really need OR experience to work in a surgical specialty (unless they physically want you assisting). Most of the time they want you to have an understanding of handling inpatients in the post op setting and how to prep patients for surgery. Bonus points if you have RNFA if they want that.

treeye · Mar 17, 2023

traumanightsRN said:

It's a tough job. The learning curve is really steep. I worked in primary care for 4 years before going to ortho and definitely was not prepared for the amount of anatomy I did not know. I learn something new every day. I don't hate it but I don't love it either. I think if I was in the OR I might like it more because I'd be in clinic less. It's a typical clinic job of M-F 8-5 with two 4 hour admin sessions a week. Can't complain about that. It's def a tough job but pays better than a lot of specialties because surgery is a money maker. I mostly work on my own, which I don't like. I prefer a team setting. But each job has its pros and cons. I just take it one day at a time.

I totally agree with you, each job has its pros and cons. The only reason I still did not leave my current job is the two 4 hour admin time. I do like my field, however, no one cares at my work. Anyway, I wish I could have started looking sooner because good jobs are only open for very short period of time. You should as well.

Alicia777, MSN, NP · Apr 14, 2023

I worked briefly in outpatient urology. My main training is as a RNFA in surgery. There are many patient who surgery wouldn't be indicated. For instance, I had I had a big segment of female patients with overactive bladder. Sometimes the meds are all they need. You do need to know that botox in the OR is the third line, but wouldn't need hands on experience with that to refer them to the surgeon.

I think its a nice niche job. My main complaint was the skeleton support system, and the never-ending patient messages, but I thinks that everywhere these days.