Surgical NP's

[dana16]

Long story short, I'm pretty interested in becoming an NP in some sort of surgical setting, but I'm not sure what route can best get me there. What is the best NP specialty to go for to someday end up in a surgical setting? Any surgical NP's have any insight as to the job itself as well? (what your role is like, schedule, etc). Is it possible for a FNP to work in a surgical setting? Thanks!

[Dodongo, APRN, NP]

52 minutes ago, Reaz said:

Can you go into a little more detail as to what you do as a surgical NP? I am highly interested in this career path.

So my typical day depends. At the moment, I am in clinic one week and inpatient the next. In clinic I have my own patient panel 20-25 a day. These are new patients and F/Us. Typically 8-4:30 on these days. There is really no difference between me and the physicians in clinic. When I'm inpatient, we have set OR blocks on M and W, and minor procedures on T and Th. Fridays are physician procedure days so I just round and am available if there is an emergent case. Usually, I get there around 7 to round, write notes, enter orders, etc. On OR days we operate all day and see patients in between. Plus the physicians and APPs split call during the week and on the weekend.

To be honest, I'm considering critical care because I miss the more broad, medical management aspect, but don't want to lose procedural work. I like working with my hands. Also, no call.

[Loboness]

I am in a very similar situation right now, FNP vs ACNP, have years of surgical experience and looking to start NP program soon. My dream job is to round on surgical patients, assist in the OR and experience outpatient follow up patient care. Having trouble deciding on which online program to take and where to squeeze in an RNFA certification... any thoughts? Would love to hear what you and others have decided to do. Thank you!

[Alicia777, MSN, NP]

36 minutes ago, Loboness said:

I am in a very similar situation right now, FNP vs ACNP, have years of surgical experience and looking to start NP program soon. My dream job is to round on surgical patients, assist in the OR and experience outpatient follow up patient care. Having trouble deciding on which online program to take and where to squeeze in an RNFA certification... any thoughts? Would love to hear what you and others have decided to do. Thank you!

Hey Loboness. Yeah, it’s a cool little niche corner that NPs can practice in. Coming in with surgical experience you will be that much more attractive to potential employers than fresh PAs just coming out.

I posted a while back on here, but I was originally a OR RN for 10 years (and a floor RN before that) and went back to school for my FNP. I think I chose that path in part because the ACNP program was not offered at the NP school I was interested in and I wasn’t quite convinced I’d be hired for the role.

I waited for my RNFA until I was hired for my first job. Luckily, my employer agreed to pay for my RNFA-a certification that is required in my state-and to help set up my surgeon preceptor training while I was being paid. It costs roughly 3K so I think whether an employer agrees to pay depends on how badly they need NP/PAs and what candidates come in offering already.

Good Luck!

[airmedicRN]

So you want to be a surgical NP? Go to an AGACNP program, after you graduate, do RNFA through NIFA (with any luck your employer will pay for this, mine did.) Then do a Post-Master's trauma certificate through UT HSC Houston (not required but will put you at the top of the list of any applicants.) After this you'll want to apply to a trauma service. HCA is popping up level II trauma centers everywhere (there's no practical difference between level I and leval II trauma centers in TX btw.) With all of the above credentials, you'll be qualified to manage sick/critical patients from admission in the trauma bay, to scrub in the OR, in SICU doing invasive procedures and critical medical management, all the way through the trauma step-down unit and clinic follow up. It's one of the best jobs ever, that is if you're into stuff like that.

Houston has the biggest medical center in the world, literally. Memorial Hermann is one of the biggest hospitals in the system with over 13 facilities. They no longer credential FNP's in any acute setting. Most hospitals in TX are moving toward this as well.

Hope this helps

[Reaz, BSN]

2 hours ago, airmedicRN said:

So you want to be a surgical NP? Go to an AGACNP program, after you graduate, do RNFA through NIFA (with any luck your employer will pay for this, mine did.) Then do a Post-Master's trauma certificate through UT HSC Houston (not required but will put you at the top of the list of any applicants.) After this you'll want to apply to a trauma service. HCA is popping up level II trauma centers everywhere (there's no practical difference between level I and leval II trauma centers in TX btw.) With all of the above credentials, you'll be qualified to manage sick/critical patients from admission in the trauma bay, to scrub in the OR, in SICU doing invasive procedures and critical medical management, all the way through the trauma step-down unit and clinic follow up. It's one of the best jobs ever, that is if you're into stuff like that.

Houston has the biggest medical center in the world, literally. Memorial Hermann is one of the biggest hospitals in the system with over 13 facilities. They no longer credential FNP's in any acute setting. Most hospitals in TX are moving toward this as well.

Hope this helps

Thank for you this info!! Very helpful and makes me highly consider this route more than the PA route which is what I was leaning towards. Do you think it would be wise to be an OR nurse or ER nurse prior to going to school? I’m approaching my 6 month mark at my current job on surgical/tele and want to make the transfer if I can into either of those areas, haven’t decided yet. What do you think? Both interest me a lot!!

[airmedicRN]

If you want to eventually go to acute care NP school then I would say you should get some ED experience and then eventually promote to the ICU.

[tg2125]

You do not need ACNP to first assist don't listen to people who arent OR nurses. I work in the OR and many of the nurses (that can also scrub) that I work with are getting their FNP and RNFA and working for surgeons they networked with in the OR in which they scrub into surgery on days and work in the office on other days. TBH FNP with RNFA is better than Acute Care NP you work for docs that can pay you at a higher rate vs being a slave to a hospital system forever. 

[SopranoKris, MSN, RN, NP]

On 5/9/2021 at 4:52 PM, tg2125 said:

You do not need ACNP to first assist don't listen to people who arent OR nurses. I work in the OR and many of the nurses (that can also scrub) that I work with are getting their FNP and RNFA and working for surgeons they networked with in the OR in which they scrub into surgery on days and work in the office on other days. TBH FNP with RNFA is better than Acute Care NP you work for docs that can pay you at a higher rate vs being a slave to a hospital system forever. 

This is highly dependent on the area in which you live and the hiring practices at each hospital. While that may be the case where you work, I know many hospitals won't even consider you if you don't have the ACNP. I did the best of both worlds and got a dual ACNP/FNP to cover all the bases ?

[tg2125]

On 5/22/2021 at 10:08 AM, SopranoKris said:

This is highly dependent on the area in which you live and the hiring practices at each hospital. While that may be the case where you work, I know many hospitals won't even consider you if you don't have the ACNP. I did the best of both worlds and got a dual ACNP/FNP to cover all the bases ?

you are right and that is true but I am talking about working for the surgeon not the hospital. There is a difference, tbh I rather work for a surgeon than a hospital system theirs a higher ceiling of what you can do and you're income. the ACNP doesnt really help you during intraop it serves more purpose pre and post op if the patient is critical. For example you can be a FNP and work in an a plastic surgeon outpatient and do just fine if the surgeon doesnt do work on critical patients. 

[SopranoKris, MSN, RN, NP]

28 minutes ago, tg2125 said:

you are right and that is true but I am talking about working for the surgeon not the hospital. There is a difference, tbh I rather work for a surgeon than a hospital system theirs a higher ceiling of what you can do and you're income. the ACNP doesnt really help you during intraop it serves more purpose pre and post op if the patient is critical. For example you can be a FNP and work in an a plastic surgeon outpatient and do just fine if the surgeon doesnt do work on critical patients. 

But you have to consider that the hospital has to credential you or you can't step foot in their facility. So, you do need to know if the hospital is going to reject an FNP vs. ACNP. Many are going the ACNP only route. Something to think about.

[Aortic_Surgery_RNFA, BSN, MSN, DNP, NP]

@dana16 - ACNP / RNFA in Open Aortic Surgery - 80% of my time is spent first assisting in the Operating Room - I also take call as part of our emergent aortic response team (ruptures, dissections, etc.).  Please feel free to msg me

[Aortic_Surgery_RNFA, BSN, MSN, DNP, NP]

On 8/27/2019 at 12:26 PM, airmedicRN said:

So you want to be a surgical NP? Go to an AGACNP program, after you graduate, do RNFA through NIFA (with any luck your employer will pay for this, mine did.) Then do a Post-Master's trauma certificate through UT HSC Houston (not required but will put you at the top of the list of any applicants.) After this you'll want to apply to a trauma service. HCA is popping up level II trauma centers everywhere (there's no practical difference between level I and leval II trauma centers in TX btw.) With all of the above credentials, you'll be qualified to manage sick/critical patients from admission in the trauma bay, to scrub in the OR, in SICU doing invasive procedures and critical medical management, all the way through the trauma step-down unit and clinic follow up. It's one of the best jobs ever, that is if you're into stuff like that.

Houston has the biggest medical center in the world, literally. Memorial Hermann is one of the biggest hospitals in the system with over 13 facilities. They no longer credential FNP's in any acute setting. Most hospitals in TX are moving toward this as well.

Hope this helps

@airmedicRN - having spent time observing the trauma teams (including the flight nurse team), I must say that the Red Duke Trauma Institute is second-to-none in the world. The most integrated and practical facility with acute care capabilities (I.e. # of helipads, Direct Helipad to OR, etc.) that I have not seen at other top tier trauma centers.