Surgical NP

Specialties NP

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I've received quite a few PMs recently regarding how I became a surgical NP. Which specialty is the best route and in general what my typical day looks like so I thought I'd post something.

I started as an Med/surg nurse and then a travel nurse in cardiac step-downs but OR nursing always intrigued me. So I became an OR nurse and was there for about 10 years. My hospital had an excellent reimbursement program and a friend of mine had started NP school and I decided I didn't want to be a lifer LOL so I decided to start chipping away at an NP program too.

I always envisioned myself doing something procedural based with it. I didn't really see myself as a primary care NP so that was always my goal-although none of my training in NP school was in inpatient surgery. I decided to go with an FNP program figuring that that would be the broadest education. At that time the Acute NP programs were just becoming more popular-still I feel like FNP works well.

It took me quite a bit of work to get my first surgical NP job. I hounded my first boss with emails when I saw position posted and when I finally got an interview I really played up my OR nursing experience.

My training was all hands-on. They were generous enough to pay for my RNFA program-RN first assist program which is required in my state for all NPs to practice in the operating room. It Required about 200 hours of precepting from a surgeon and it took me roughly 5 months together these hours. By no means did I feel skilled at the end of those hours but I felt competent enough for small cases/closures.

I've been at it for about two years now and have since changed hospitals. I do not take call, work weekends or holidays. I typically round by myself and chat with the doctors either on the phone or via text. I assist in the OR almost every day and I love it. I feel like I'm getting a lot better. I occasionally see patients in the ER, consult and consent for procedures. I dictate on consults after speaking with the surgeon and discharge plans. I oversee patients in the day surgery unit and write prescriptions and orders for them as well.

I'm thrilled with my move. I feel like I've been able to spend a lot more quality time with my family and I even still moonlight at my old hospital for 'play money'!

I definitely recommend the specialty although it is difficult to get your first job and your foot in the door as we all know we are not typically trained this way so it helps to know people or to have the luxury of waiting for the perfect job.

Hello Alicia 777

I am going to finish my FNP program in 2019. I am taking a class per one semester. I am a med-surge /step-down nurse but interested in OR nursing. Sadly I am having a hard time to get in the Preop101 program. I have an interview with outpatient OR facility in this week. I believe it is a surgery center, and they will train on preop, scrubbing, and PACU. I want to take a path you did and like to work at outpatient OR as a FNP in the future. Do you think this new opportunity would help me to achieve my goal later? I have to succeed the interview first, but this job will be pay-cut and a longer commute. I want to make sure it is for me first.

Thank you.

Hello Alicia777!

I am so glad I found your post!

You have the exact position/title that I was looking for. I wasn't sure there was a field like that for nurses. I thought this role was only filled by surgical PAs.

Just a bit of background: I am graduating with my BSN in May and accepted a nurse residency position in an OR.

I know that I want to be in the operating room, but pretty sure CRNA is not really what my heart is calling for...

I really like the technical aspect of being an RNFA and how it is more hands on.

So from reading your post/responses, would you recommend FNP -> RNFA and then look for a surgical NP position?

Do you work in a hospital setting/outpatient?

I know not all states utilize RNFAs. The hospital I will be working at unfortunately do not use RNFAs which the manager mentioned at the interview.

I would just like any input in terms of the path I should go/what I should be working on now to go that route.

Thank you!

thegentlelion said:
Hello Alicia777!

I am so glad I found your post!

You have the exact position/title that I was looking for. I wasn't sure there was a field like that for nurses. I thought this role was only filled by surgical PAs.

Just a bit of background: I am graduating with my BSN in May and accepted a nurse residency position in an OR.

I know that I want to be in the operating room, but pretty sure CRNA is not really what my heart is calling for...

I really like the technical aspect of being an RNFA and how it is more hands on.

So from reading your post/responses, would you recommend FNP -> RNFA and then look for a surgical NP position?

Do you work in a hospital setting/outpatient?

I know not all states utilize RNFAs. The hospital I will be working at unfortunately do not use RNFAs which the manager mentioned at the interview.

I would just like any input in terms of the path I should go/what I should be working on now to go that route.

Thank you!

I honestly think going the ACNP route would be the better option for someone wanting to work in OR and round on their in-patients. Since you will be part of the team controlling those orders and managing patients in some of the most acute times of their care, having that ACNP certificate would be much more useful than an FNP. FNP would only be valuable if you are planning on working on the clinic side with having surgery expectations. But if your future employer doesn't use RNFAs, then I imagine they aren't too sold on using NPs in OR either. I'd say since this will be your first nursing gig, get all the acute care experience you can for sure and go the ACNP route. Then find a hospital that uses RNs more in the OR down the road.

Specializes in Surgery.
thegentlelion said:
Hello Alicia777!

I am so glad I found your post!

You have the exact position/title that I was looking for. I wasn't sure there was a field like that for nurses. I thought this role was only filled by surgical PAs.

Just a bit of background: I am graduating with my BSN in May and accepted a nurse residency position in an OR.

I know that I want to be in the operating room, but pretty sure CRNA is not really what my heart is calling for...

I really like the technical aspect of being an RNFA and how it is more hands on.

So from reading your post/responses, would you recommend FNP -> RNFA and then look for a surgical NP position?

Do you work in a hospital setting/outpatient?

I know not all states utilize RNFAs. The hospital I will be working at unfortunately do not use RNFAs which the manager mentioned at the interview.

I would just like any input in terms of the path I should go/what I should be working on now to go that route.

Thank you!

Hey there! From my perspective back in 2010 when I entered NP school FNP made the most sense-as ANCP programs were not as widely available. ACNP probably is the better choice now, as this will allow you acute inpatient experience which will benefit your practice if you want to be working in a hospital setting. I think you still *could* get into the field with a FNP with a strong OR RN background.

For me, yes-I work in a hospital. We are a satellite of a larger hospital system in the city. So, I would say its 70/30, with the majority of our cases being day surgery.

thegentlelion said:
Hello Alicia777!

I am so glad I found your post!

You have the exact position/title that I was looking for. I wasn't sure there was a field like that for nurses. I thought this role was only filled by surgical PAs.

Just a bit of background: I am graduating with my BSN in May and accepted a nurse residency position in an OR.

I know that I want to be in the operating room, but pretty sure CRNA is not really what my heart is calling for...

I really like the technical aspect of being an RNFA and how it is more hands on.

So from reading your post/responses, would you recommend FNP -> RNFA and then look for a surgical NP position?

Do you work in a hospital setting/outpatient?

I know not all states utilize RNFAs. The hospital I will be working at unfortunately do not use RNFAs which the manager mentioned at the interview.

I would just like any input in terms of the path I should go/what I should be working on now to go that route.

Thank you!

Do what I did - get 2 years of peri-op nursing experience then attend an ACNP program and RNFA program (can be done at the same time). You'll get far more surgical training than a PA (and make sure you display this on your resume and talk it up in your interview) and you'll be utilized just like a PA would.

I am very late into this forum and glad I came across it because I currently work in the OR and will be starting a FNP program this fall and would just like to know if I'm on the right track. Again so sorry I'm so late to this post

IvySkye16 said:
I am very late into this forum and glad I came across it because I currently work in the OR and will be starting a FNP program this fall and would just like to know if I'm on the right track. Again so sorry I'm so late to this post

Generally I'd say no. If you're interested in working in surgery as an np, your best bet is acute care np.

On 4/5/2018 at 8:46 PM, Dodongo said:

Do what I did - get 2 years of peri-op nursing experience then attend an ACNP program and RNFA program (can be done at the same time). You'll get far more surgical training than a PA (and make sure you display this on your resume and talk it up in your interview) and you'll be utilized just like a PA would.

How are you able to attend the programs at the same time? Is it through the same institution? I’m currently trying to get into a nursing program so I’m far off from even applying to an NP program, but I’ve been doing my research now so I have an idea of how to achieve my goal.

Specializes in Hospitalist Medicine.
18 minutes ago, thalsanxx said:

How are you able to attend the programs at the same time? Is it through the same institution? I’m currently trying to get into a nursing program so I’m far off from even applying to an NP program, but I’ve been doing my research now so I have an idea of how to achieve my goal.

There are programs that have NP with RNFA specialty (UAB is one of them I know off the top of my head).

4 minutes ago, SopranoKris said:

There are programs that have NP with RNFA specialty (UAB is one of them I know off the top of my head).

Thank you so much!

Specializes in Nephrology.

Hi Alicia777,

Do you have ANCC or AANP for your certification?

On 11/20/2019 at 1:34 PM, thalsanxx said:

How are you able to attend the programs at the same time? Is it through the same institution? I’m currently trying to get into a nursing program so I’m far off from even applying to an NP program, but I’ve been doing my research now so I have an idea of how to achieve my goal.

I did 2 separate programs. I did the RNFA program concurrently with my NP program for 2 semesters.

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