I did ACNP + RNFA. You do not, however, need the RNFA to scrub, assist and more importantly, bill CMS/insurance. There is no difference between a NP and a PA working on a surgical service. The RNFA, will however, help with securing a job, IMO.
UAB offers a combined ACNP and RNFA. I am not sure how long that will last. If you want more information about which programs I attended, I can send you the info via PM.