NP in the OR?

mas28 · Dec 10, 2011

Hi Sheri444,

I work now as a Surgical Assistant in the OR and yes it is possible for you to work for a surgeon or surgical group as a NP. Yes, this area is mostly dominated by PA's, but there are quite a few doctors who have NP's assisting them. The rest of the doctors use either surgical assistants or PA's. The only downside is that most NP programs don't have a surgical rotation, so you have to find someone willing to teach you how to suture, assist, place trocars, etc. But yes, you can work in the OR as a Surgical NP. I am applying to an direct entry MSN/NP 3 year program and I have doctors already willing to hire me. Of course my circumstance is unique because I already assist in surgery exactly like PA's and NP's, but rounding and following patients afterwards is only reserved for NP's, PA's and of course MD's. I know a lot of Cardio-Thoracic surgeons who have NP's assisting them in the OR and Cath lab as well as Orthopedics. So good luck in finding your dream job!!

foreverLaur · Dec 30, 2011

Why not become a PA or RNFA if that is what you want?

mas28 · Dec 30, 2011

To foreverLaur,

Why not become a NP? I'm confused as to why people think PA's are exclusive to the OR. They are not. They may be more common, but definitely not exclusive. For me I have more options as a NP. Not only can NP's do everything a PA can do, but sometimes they have way more autonomy; i.e. The ability to practice independently of an MD. (Not in surgery of course, but other places.) Every situation is different. RNFA's don't have prescriptive authority, (at least not in my state) and in the OR they don't do anything different than what I do now. I'm not sure if they can round or pre-op patients for surgery. They certainly can't give pain med orders, especially narcotics. Again that depends on the state. Also, I'm pretty sure I don't wanna be in the OR @ 60 either, so I have tons of flexibility as a NP. This is just what works for me. Now do you understand why I'm going for NP vs PA/RNFA?.

iPink, BSN, RN · Dec 30, 2011

@mas28, you have certainly opened my eyes of NPs in surgery. Im in my final semester of my ABSN program and enjoyed my rotation in Cardiac Cath and endoscopy. It has peaked my interest in OR and thought of abandoning my NP goal to pursuing a RNFA since I thought that was the only option I had. Now I know it's not. Do you have any advice when I start my new career as a new grad RN in 2012, hoping for a future as an NP, with the possibility of going into OR?

mas28 · Dec 31, 2011

Hi Glad2baSN,

My advice would be to go work in an OR or Cathlab. I think gaining the experience as an OR/cath lab nurse is invaluable if you want to be a NP in the OR. It also establishes connections and relationships between you and the surgeons. They will be all over you if you already know them and how they work. As with any situation, you are more likely to choose something that is familiar and comfortable. Most surgeons would probably choose you over a new PA or NP if they have worked with you for the past few years. Get as much knowledge in the field as possible. Even you did RNFA, that would be good as well. As an OR nurse you will learn positioning, prepping, and draping techniques. I'm sure the surgeons will be glad to have you work for them in the OR!! Just wait, you will know exactly what I mean when I say, " I have doctors already willing to hire me".

Clearly you already have and know what it takes to be successful if you are in your final semester. (CONGRATS!!) Keep up the good work! :yeah:

Good luck to you in all your endeavors. I wish you much success!!!

Sincerely, mas28

iPink, BSN, RN · Dec 31, 2011

Thanks mas28 for the great advice and the encouraging words! It is greatly appreciated.

foreverLaur · Dec 31, 2011

Just don't discount the fact that PA grads have done an 8 week rotation in surgery (and if interested in surgery, can often do another 16 week rotation in a surgical subspecialty of choosing) plus a class devoted solely to surgical skills.

mas28 · Dec 31, 2011

To: foreverLaur,

Where in any of these posts did you see someone discounting a PA or the length of time of their surgical rotation. I never said it and neither did anyone else. I am very familiar with how much surgical training PA's get and I never said or mentioned that they were inadequate in surgery or whatever it is you are trying to get by that indirect post. Like I previously wrote, I work with PA's everyday. I have a lot of respect for them, it's just not the direction I choose to go. I meet the requirement for PA school as well. I simply stated that you can work in the OR as an NP if one so chooses and for that person to follow their dreams. I'm glad PA's can get as much surgical rotations as they need. Good for them! That doesn't mean a whole lot to me, who has almost 10 years of surgical experience. Whatever route anyone chooses, the moral to the story is that to follow your dreams. It wasn't meant to be make you think I was discounting their experience. Both NP and PA's are vital members of the healthcare team.

mas28

CCRNDiva, BSN, RN · Jan 10, 2012

UAB has a combined ACNP/RNFA program that includes surgical rotations. Also, it is possible to get a surgeon to serve as a preceptor. A former coworker was able to work with a ortho surgeon for clinicals and he used it as time to train her in the OR so if she did well, he would hire to serve as his 1st assist in the OR. He also liked that she would be able to round on patients and see them in the office. He looked at it as a win-win situation.

I think it also depends on your state of residence. Our state just provided prescriptive authority to PAs in 2008 and our state universities are just getting around to having PA programs bringing the grand total to 4. Also, I believe NPs have fewer restrictions of practice in comparison to PAs in our state. My point is that it is all relative. Surgeons may prefer to work with NPs or PAs depending on their ability to practice as independently as they would like. For instance, the trauma docs at our facility wanted a NP because of their level of independence (we're a collaborative practice state) while the CT surgeons prefer PAs because they prefer a higher level of supervision and prefer not to provide surgical skills training.