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Discussion

Surgical NP, is this a thing?

Haven't researched into this yet, but wanted to know if anyone else has seen Nurse Practitioners practice in the OR? I am an RN Circulator, and found out there is an NP who is a "first assist" for a couple of pediatric surgeons, but is NOT an RN first assist.

Is anyone on here currently an NP who practices in clinics as well as practices with Surgeons in the OR? Where did you go to school? what was the program length? can I work full time in an NP program? Masters or Doctorate?

Will Google this after I post, just want to hear people's experiences etc. ?

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    • Solved by sunflower775

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    There are no specific or formal NP training in Surgery. Some of the Acute Care focused programs that offer AGACNP or PNP-AC may potentially provide some exposure to OR time but that is quite variable depending on the institution.

    Having said that, it's not uncommon to find some NP's who work with a surgeon or in a surgical specialty where assisting in the OR is part of their role. NP's as a rule can first assist (like PA's do) and bill for that role without having to go through a formal RNFA program.

    However, because NP training programs typically offer zero to little OR exposure, many NP's who work alongside surgeons in the OR also obtained RNFA certification or have a background in peri-operative care as RN's. Some were trained in the role after being hired.

    You could potentially explore this role if it interests you since you already work in the OR. The first step is to decide on which NP programs to pick. Having the RNFA certification increases your chances of being employed in the role.

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    • Author

    So looking around it sounds very much I should get my ACNP with an RNFA. I did find one program that provided both which is really tempting for me. I do worry about finding a job afterwards, but at least I could still work as an RN while looking for a job. I have also read PA-C's are more desirable to hire than NPs are. What I can't yet find is NPs who did programs with an RNFA attachment to the program, and how successful they were at getting jobs?

    Thank you for responding I appreciate it ? Very helpful information!

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    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.

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    • Author

    Thank you! I would definitely love to have information where you went to school. And I did see that UAB has the combined program. Like you said, it sounds like having an RNFA would mainly help with getting a job

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    In states that are strict with the consensus model (like mine), the BON requires any nurse including APRNs to have RNFA to assist. Just throwing that out there. It doesn't apply in all states.

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    yes and no, to work in OR the NP needs to complete a first assist/PA program or you can work with a specialized service such a general, ortho etc. and will complete pre/post-op orders, assessment etc. for that group but as NP you're not allowed to scrub in cases without RNFA certificate.

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    I'm currently a RNFA and I'm working as a circulator. One thing that I've been told is that hospitals are no longer giving FNPs credentials to work in the OR. The ACNPs are having to attend an RNFA approved program before being credentialed. Some are grandfathered in but is required to complete a program before they reapply for credentials.

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    This is a debate in my hospital where I work. They are currently not allowing uncredentialed RNFA NP's to assist in surgery due to insurance liability, but will assist/pay for RNFA training (Which is completely ridiculous because you are not billing as an RNFA so it truly is a meaningless investment). As for preferences; I am currently in Ortho as a bedside RN and a few MDs do use NP's and a few others use CNS's. Most don't prefer PA's over NP's per say because the bottom line is the PA education model doesn't provide much meaningful OR experience (this coming from most PA's I've spoke to). A lot of physicians would rather someone who is going to truly stick with them be teachable and learn their preferences so that they can generate more revenue (Total Joint Orthopods love to run 6-7 cases/day sequentially around here) The short version is if your institution provides an RNFA then great, if not don't worry it can be obtained later if necessary. Don't sweat it, just get into a program you like and learn.

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