How to Become a Surgical Nurse Practitioner? (Answered by an NP)

Written By: Kasee Wiesen DNP, APRN, FNP-C

Do you enjoy caring for surgical patients? Do you enjoy educating patients on pre-operative and post-operative instructions? What about working in a fast-paced and possibly challenging environment? Have you ever considered working as a surgical nurse practitioner. If you answered yes to any of these questions? The role of the surgical NP is expansive and may be the career path for you.

In the article below, I will answer how to become a surgical nurse practitioner? I will also provide the steps needed to become a surgical nurse practitioner, the pros and cons of becoming a surgical nurse practitioner, and information about the salary of a surgical nurse practitioner.

What Does A Surgical Nurse Practitioner Do?

What does a surgical nurse practitioner do? Their day can vary significantly based on the setting and organization where they work. Below, I will provide seven surgical nurse practitioner duties that surgical NPs do fairly regularly throughout their day—please know this list is only scraping the surface of what a surgical NP does.

1. Complete appropriate assessments based on patient's complaints:

The surgical NP will complete appropriate assessments based on the patient's complaints. Therefore, they need to have a strong knowledge of general surgery, including the concerns and diagnoses that are treated by the surgeon, including appendicitis, cholecystitis, abscess, skin cancer, breast cancer, etc.

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2. Interpret laboratory results and diagnostic imaging:

Besides knowing how to assess the patient, the surgical NP must know how to interpret lab and imaging results. This includes knowing what is considered normal and abnormal and knowing when general surgery is needed for the patient.

3. Develop treatment plans:

Once you have interpreted the diagnostic results, you must be able to develop a treatment plan when needed. Not all patients will require surgery or in-office procedures, but you must know which patients would benefit from your service and need referrals elsewhere.

4. Work closely with the general surgeon:

As a general surgery NP, you will work very closely with the general surgeon. You will assist the surgeon during surgeries, and the surgeon will be involved in developing most treatment plans.

5. Provide pre-operative and post-operative instructions:

As a general surgery NP, you will provide pre-operative and post-operative instructions specific to the patient's surgery.

6. Know how to complete post-op assessments:

As a surgical NP, you will also complete post-operative evaluations in the office. You must know about the surgeries completed by general surgeons and what to assess post-operatively to evaluate the patient's response to the surgery.

7. Knowledge of wound care and in-office procedures:

Knowledge of wound care is essential. You must know how to suture wounds, remove sutures, remove staples and assess for signs and symptoms of infection. You must also know how to drain an abscess in office and prescribe appropriate antibiotics when needed.

What Skills And Abilities Are Needed To Work As A Surgical NP?

There are many skills needed to work as a surgical nurse practitioner. These skills include a variety of technical skills along with interprofessional and personal development skills to be successful. Below, you will find a list of five skills that I believe are needed to be a confident, competent, and respected surgical NP.

1. Teamwork:

Teamwork is needed to succeed in almost any job you do. The majority of what you do as a surgical NP depends on collaboration among the healthcare team, including teamwork between you, the nursing staff, and the physician to get the patient to surgery on time or ensure the patient is receiving the appropriate care and education after surgery. Or it may be between the scheduling nurses or receptionist to get the patient the correct information before surgery or schedule for post-op visits or check-ups correctly. Regardless, it takes a team to care for patients, and your ability to work with a team will influence the overall outcome and satisfaction of the patient.

2. Strong Communication:

Strong communication ties directly in with teamwork. Poor communication will directly impact the care your patient receives. And you must also be able to communicate efficiently with your patient and their family members. This may include pre-surgical instructions, post-operative instructions, information regarding a diagnosis, or even medication. Regardless, solid communication skills are essential to working as a surgical NP.

3. Seeking Professional Development:

To be a surgical nurse practitioner, professional development is vital. To be successful and grow in your career, you must set goals for yourself and always look for ways to improve your practice. This can be done by meeting with your manager and discussing annual goals for yourself. You can achieve this by attending conferences, ongoing education, and staying current with practice trends and guidelines.

4. Technical Skills:

Technical skills are essential when working as a surgical nurse practitioner. These skills include knowledge of appropriate assessments based on a patient's complaints. You must also know how to order and interpret diagnostic results, including laboratory and imaging. You must also know suturing and wound care as a surgical NP.

5. Flexibility:

The last skill I will discuss for a surgical NP is flexibility. This is critical for all surgical specialties, including general surgery. Your day may change at any moment—a patient may be late to an appointment, surgeries may be running behind, or you could have an emergent add-on in the middle of the day, shifting the remainder of your day.

Where Do Surgical Nurse Practitioners Work?

The surgical nurse practitioner has flexibility and variety in where they work. Most surgical NPs work in both the outpatient and inpatient setting—but this may vary based on the practice or organization you work. If you have the opportunity to work in the inpatient setting, most of your time is spent in the perioperative area or operating room. This time is spent assisting the physician with surgery and pre and post-care of the patient. If there are any surgical inpatients, you may also round on those patients to ensure they receive the care needed and improve from their surgery.

What Is The Typical Work Schedule For A Surgical NP?

The typical work schedule for a surgical NP is pretty consistent. The majority of the surgical NPs will work Monday through Friday—but the start time may vary based on if they are working in a clinic or assisting in the OR. If working in the clinic, the NP may work 8 am to 5 pm, but if assisting in the OR, they may need to get there around 7 am to help prepare for the first case. If working in the OR, the hours may occasionally run later than 5 pm based on the operative cases scheduled.

There may also be occasional weekends where the surgical NP is needed to assist in rounding on inpatients. This would not last all day and may just take a couple of hours on a Saturday and Sunday every couple of weeks.

Again, the work schedule is very dependent on the organization you work for and how many surgeons and advanced practice providers (APPs) there are.

What Is The Difference Between Surgical NP And Surgical Nurse?

The main difference between a surgical registered nurse (RN) and a surgical nurse practitioner is their scope of practice.

A surgical RN requires an associate’s degree in nursing (ADN) or a bachelor of science in nursing (BSN) degree—and it is becoming more and more common to have a BSN degree to work in many nursing positions. The education requirements are higher for becoming a surgical NP—you must have an advanced degree which includes a master of science in nursing (MSN) or doctorate of nursing practice (DNP) degree.

The certification process to become an RN vs. an NP is also different. The surgical RN must pass NCLEX and renew their RN license every two years. The surgical NP must pass the board certification exam specific to their degree (i.e., acute care, family medicine, pediatrics, etc.). The NP license must be renewed every five years--while maintaining good standing with their RN license, which requires renewal every two years.

The scope of practice also varies significantly between the surgical RN and NP. The surgical NP has a much broader scope of practice when caring for their patient. The surgical NP can assess, order, and interpret diagnostic results and develop a treatment plan based on these results, including the prescription of medication. While the surgical NP cannot perform surgery by themselves, they will assist the surgeon when needed. Like the RN, the NP will also provide education to the patient and family and answer any of their questions.

Pros Of Being A Surgical Nurse Practitioner

There are many pros of being a surgical nurse practitioner. Below I list four advantages of being a surgical nurse practitioner.

1. Higher Salary:

Surgical nurse practitioners can earn a higher salary—or an average of more than $102,000 a year.

2. Delivery to a specialty population:

As a surgical nurse practitioner, you have the opportunity to deliver care to a specialized population. This is a pro for many people because they are often very passionate about this population leading to a higher quality of care.

3. Job Satisfaction:

Job satisfaction is overall high for a surgical NP. This is because it is a specialty, and the NP chose to work in this environment and care for this specific population. Plus, they often have previous RN experience in medical-surgical, peri-op, or OR to prepare them for the expectations of the job.

4. Opportunity to assist in surgery:

Surgical nurse practitioners have the opportunity to help in many of the surgeries the surgeon does. This is a significant pro for many NPs as this is a huge reason they chose the specialty.

Cons Of Being A Surgical Nurse Practitioner

There are cons to consider when becoming a surgical nurse practitioner. Below I will list four disadvantages of being a surgical medicine nurse practitioner. As I mentioned above, please note that there is some overlap between the pros and cons—because what one NP may consider a pro, another NP may consider a con.

1. Possibility of long days:

There is always the possibility of long days working in surgery. Based on the surgery schedule and if everything remains on time, you may have to be at the hospital or surgery center around 7 am and not leave until after 5 pm.

2. Difficulty finding a job:

Because surgical NPs are specialized, finding a career may be more challenging. This may be due to not having as many jobs available or that once a person gets into a specialty they love, they do not leave until retirement. Regardless, be mindful of this when pursuing this career and be open that you may have to work somewhere else before entering this specialty.

3. Possibility of working weekends and holidays:

There will be the possibility of working weekends and holidays based on where you work. In most instances, you will not work the entire weekend or day but instead, be required to show up and round on a couple of inpatients, and then you may return home.

4. Specialized care:

For many people, this will be considered a pro, but for others, this may be viewed as a con. Surgical NP is a highly specialized career choice—and it will not be uncommon to see many of the same surgical procedures and complaints among the population. This may cause some NPs to get bored.

How Long Does It Take To Become A Surgical Nurse Practitioner?

A question many nurses wonder, how long does it take to become a surgical nurse practitioner? This answer is not as simple as one may think—and it is dependent on multiple factors, which I will discuss below. However, the average length of time is between 6 to 8 years.

The first step in becoming a surgical nurse practitioner is completing your BSN degree which takes four years to do. If you do not attend a traditional four-year BSN program, you may pursue your associate’s degree in nursing (ADN) first or even attend school part-time, which may lead to completing your BSN in closer to 5-6 years.

To become a surgical NP, you must also complete graduate school with either a master of science in nursing (MSN) degree or a doctorate of nursing practice (DNP) degree. On average, it will take 2 to 4 years to complete either of these degrees, depending on your chosen path. If you do not want to achieve a terminal degree right away, you can also graduate and practice as a surgical NP with your MSN degree and return to school later to earn your DNP.

Lastly, I strongly recommend gaining experience as a nurse before applying to graduate school. This is not required, but I firmly believe it will help you in your NP practice. If you want to become a surgical NP, getting experience in the perioperative area and the medical-surgical unit will better prepare you for a surgical NP's job requirements and expectations.

How Much Does It Cost To Become A Surgical Nurse Practitioner?

Now, how much does it cost to become a surgical nurse practitioner?

You must first complete your BSN—and the average cost of getting your BSN ranges from $40,000 to more than $200,000. This is a significant range and is determined by multiple factors that can impact the cost of your degree. One of these factors is the school you choose—are you attending a public or private college or university? Also, keep in mind that in-state public tuition will be cheaper than private school or out-of-state public tuition.

Another factor to consider when discussing cost is whether you will attend part-time or full-time—this may impact tuition and your ability to work throughout the program.

You may also choose not to attend a traditional 4-year BSN program and instead complete your ADN first and then achieve your BSN. This may impact cost and is something to consider.

After completing your BSN, you must apply to graduate school—and you must either complete an MSN or DNP to become a surgical NP. The average cost for a BSN-to-MSN program is $81,810 to $185,280 and the average cost for a BSN-to-DNP program is $26,490 to $254,260. Factors that may impact the cost of your advanced degree are similar to your BSN—public in-state tuition vs. out-of-state public tuition or private tuition and the status you attend.

There are other costs to consider when becoming a surgical NP outside of schooling, including the cost of any preparation class for boards you take and the cost to sit for boards to become certified in your NP specialty. You will also have to pay to obtain your DEA license, and if you choose to pursue a fellowship or residency program, that will be an additional cost. Please note that your organization may cover the costs of some of these licenses and programs.

Step-By-Step Process Of Becoming A Surgical Nurse Practitioner

You may now be wondering how you become a surgical NP. Below, you will find a step-by-step process to becoming a surgical NP.

1. Complete your BSN:

The first step of becoming a surgical NP is completing your BSN degree. You must have this degree to apply to graduate school.

2. Pass NCLEX and Obtain RN License:

Once you have achieved your BSN degree, you must pass the NCLEX certification exam to become a nurse. Once you pass the NCLEX, you can get your RN license and begin your nursing career.

3. Get Experience:

This step is not required, but I strongly encourage it. The experience you get as a nurse is invaluable. This includes knowledge of medications and comfort with talking to other healthcare professionals, including physical and occupational therapy, physicians, radiology, respiratory therapy, pharmacy, etc. You gain experience communicating with patients and their family members and delivering education. Plus, you have continuous exposure to various medical diagnoses and treatment plans.

4. Apply to Graduate School:

Once you decide to pursue a career as a surgical nurse practitioner, you must apply to an accredited graduate program. Be mindful during the application process of all requirements to use and any pre-requisites that you must complete before starting the program.

5. Attend and Graduate from Accredited Graduate Program:

To apply to take your board certification exam, you must send a copy of your transcripts to the state.

6. Pass NP Board Exam:

The next step is to pass the board certification specific to the specialty you pursued in graduate school. If you want to become a surgical NP, this will most likely be adult or pediatric acute care—but some organizations/practices may accept other specialties such as FNP, pediatrics, or adult-gerontology.

7. Obtain NP License:

Once you pass the NP board certification exam, apply for state licensure to become an NP. You must apply for licensure in your primary state of residence.

8. Apply for Surgical Fellowship or Residency Program if you desire:

Completing a fellowship or residency program in surgery is optional but may open the door to more opportunities. Be mindful that it may take another year of school to complete this program before you can start practicing.

9. Apply for Surgical Nurse Practitioner Jobs:

Once you have selected general surgery as the area you want to work as an NP, start to apply for jobs. You may begin to apply for surgical NP jobs towards the end of your NP program before you graduate—but if you don’t get the job at that time, don’t hesitate to apply again once you are a certified NP.

10.

Enjoy your New Career as a Surgical NP

11. Complete DNP if you desire:

This step is entirely optional. Some of you may choose to pursue a DNP instead of an MSN degree from the beginning. This degree is completely optional and beneficial to those who may want to pursue a career in research or education.

Recommended Certifications To Enhance Your Job Role As A Surgical NP

There are no specific certifications for the surgical NP outside of completing a fellowship or residency program. However, there are certifications for the surgical nurse that may benefit the surgical NP. Below I will discuss two of these certifications that may enhance your job role as a surgical NP.

Medical-Surgical Nursing Certification (MEDSURG-BC): The Medical-Surgical Nursing Certification is provided through the American Nursing Credentialing Center (ANCC). The certification demonstrates competency in the delivery of medical-surgical nursing care. You must renew your certification every five years to remain valid.

Certified Medical-Surgical Registered Nurse (CMSRN): The CMSRN is provided through the Certified Medical-Surgical Nursing Certification Board. This certification is for RNs working in the medical-surgical specialty who have a passion and commitment to delivering high-quality care to their patients. You must renew your certification every five years to remain valid.

List Of Fellowships & Residency Programs For Surgical Nurse Practitioners

Residency and fellowship programs are a great option to further advance your knowledge in the specialty of your choice. Completing these programs will also make you more competitive, leading to greater job opportunities. There are fellowship and residency programs for many specialties that NPs can pursue—and general surgery is no different. Below, I will list two residency or fellowship programs for those who want to become a surgical nurse practitioner.

Mayo Clinic:

The Mayo Clinic in Rochester, MN, offers a 12-month postgraduate fellowship program for NPs and physician assistants (PAs). The curriculum includes patient care and didactic—to improve competency and confidence in delivering general surgical care.

University of Colorado:

The University of Colorado Anschutz Medical Campus offers a general surgery fellowship program for Acute Care NPs and PAs. The program curriculum includes didactic and clinical experiences at the University of Colorado Anschutz Medical Campus in Aurora, Colorado, and the Medical Center of the Rockies in Loveland, Colorado.

Continuing Education Requirements For Surgical Nurse Practitioners

Continuing education units (CEUs) are necessary to maintain licensure as an RN and a surgical nurse NP. You must complete CEUs specific to your RN license, CEUs specific to your NP license, and CEUs specific to any certifications you have.

To practice as a surgical NP, you must remain in good standing with your RN and NP license. Your RN license needs to be renewed every two years, and your APRN license every five years in most states. Your state determines the CEU requirements for these licenses. Be aware of any specific hours, including pharmacology hours, directed explicitly towards prescribing opioid drugs for your NP license. For detailed information regarding CEU requirements, visit your state board of nursing.

As stated above, you will also have CEU requirements for any certifications you hold. For example, if you have the Medical-Surgical Nursing Certification, you must renew that every five years. Their website contains specific details for recertification, including a specific number of professional development hours.

What Is The Starting Salary Of A Surgical Nurse Practitioner?

The average starting surgical nurse practitioner salary is $74,410 a year. This is an average salary and is influenced by multiple factors, including whether you work full-time or part-time and your experience as a nurse. If you practice rural community or in a more urban environment may influence your salary as well as the setting you work in and whether you work in private practice or for a large organization.

Per Hour	$35.77
Per Month	$6,200
Per Year	$74,410

What Is The Average Salary Of A Surgical Nurse Practitioner?

Then, what is the average salary of a surgical nurse practitioner? The average surgical nurse practitioner salary is $102,222 a year. Again, this number is an average and may be impacted by multiple factors, including the setting you work, where you live, and your years of experience as a nurse, nurse practitioner, and, more specifically, a surgical NP.

Per Hour	$49.15
Per Month	$8,520
Per Year	$102,222
(Source: Ziprecruiter.Com)

Job Outlook For Surgical Nurse Practitioners

Medicine is constantly advancing—leading to new and successful treatments for various disease processes. These advancements, coupled with the growing population, indicate a clear need for more practitioners to provide care to the people. Over the past several years, the role of the nurse practitioner has grown and expanded. This is due to advancements in medicine and population growth to ensure we can provide care to those who need it.

Many of these advancements have occurred in general surgery, including the ability to perform laparoscopic procedures and advances in breast cancer treatment, along with many others. Surgical NPs work directly alongside general surgeons in ensuring the patients receive the appropriate care to have the best possible outcome. The need for more surgical NPs will continue to grow as we continue to develop better treatment plans leading to longer and healthier lives.

Useful Organizations & Associations

Below, I will provide information on three different organizations that may be useful to those becoming a surgical nurse practitioner. None of these organizations are specific to NPs, but instead to nurses in general—allowing you to obtain membership and get involved before becoming a surgical NP.

American Pediatric Surgical Nurses Association (APSNA):

The APSNA is an organization for pediatric surgical nurses to provide safe, evidence-based care to their patients. The organization provides education in various forms, including web series and conferences. They also offer publications and access to journals and up-to-date new articles to keep you in the know of changes occurring in pediatric surgery.

Academy of Medical-Surgical Nurses (AMSN):

The AMSN is the only organization dedicated to medical-surgical nurses. The organization provides networking opportunities, medical-surgical resources, publications to read, and opportunities to participate in the writing of publications and educational opportunities. The organization's purpose is to build confidence and competency in the delivery of medical-surgical nursing care.

Association of PeriOperative Registered Nurses (AORN):

AORN is an organization for perioperative RNs passionate about delivering high-quality and evidence-based perioperative care. This organization provides various resources and educational and networking opportunities for RNs. Once a member, you also have access to a comprehensive list of job openings for the perioperative nurse.

Finally, Is Surgical Nursing The Right NP Specialty For You?

After reading the information above, do you now know how to become a surgical nurse practitioner? Above, I provided information regarding the steps to becoming a surgical nurse practitioner, the pros and cons of becoming a surgical nurse practitioner, and the salary. Pursuing a career as a surgical NP will be rewarding and gratifying—so what are you waiting for!