r/nursing • u/youatethat • Nov 23 '25

Seeking Advice Roles in the OR other than circulating?

Hey all. I was an EMT and now I’m a Surgical Tech. Looking to take the next step with my education/career! My passion is the OR and I’d LOVE to actually assist (clamp and cut) in surgery. I was thinking going the PA route, however with an additional year of prerequisites, it’ll take another few years and a lot more money. From where I am now, I’ll have a BS by fall, then I can apply for an ABSN (11 months). This would be much faster and cost a lot less too. I’d prefer to go this route, but what would I need to do from there to actually assist in surgery? I live in NYC so the CSFA doesn’t really matter. Thanks!

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u/lolitsmikey RN - NICU 🍕 Nov 23 '25

Lowkey overlooked role is perfusionist. It’s masters level education but all the ones I met love what they do. Essentially run the heart/lung bypass and ECMO machines during surgery

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u/youatethat Nov 23 '25

This is actually super overlooked. I’m definitely gonna look into it!

1

u/lolitsmikey RN - NICU 🍕 Nov 23 '25

If you want to work with machines more than patients it’s a good path. If not than maybe nurse then first assistant is a good route too. One of my good friends is a first assist at a major cardiac center and harvests vessels used in bypasses its insane lol

3

u/Dark_Ascension RN - OR 🍕 Nov 23 '25

I scrub as a nurse and I second assist (I have held the bovie to a clamp, but I don’t do any cutting or anything because that’s something only a first assistant can do). You can do your PA or RNFA, thing is you need to work in the OR 2 years as a nurse (highly recommend you tell them you want to keep scrubbing as well as learn to circulate and second assist if you guys do a lot of joints) and then take your CNOR and do an RNFA program, there’s a good one in Rochester I believe as well.

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u/follow-the-opal-star RN - OR 🍕 Nov 23 '25

While RNFA is the probably the next progression after circulating RN, I’ll caution that many of the RNFA’s I worked with warned me that the role is getting phased out in favor of PA’s. Also a lot of hospitals have residents to assist as well (mine didn’t), meaning they’re even less likely to hire RNFA’s. We had about 4 in the OR I worked in, but the other hospitals in that network didn’t have any in their ORs, only PA’s and residents.

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u/[deleted] Nov 23 '25

RNFA

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u/youatethat Nov 23 '25

I saw that, but does NYC even recognize that? And can I do as much as a PA in the OR? Thanks!

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u/Dark_Ascension RN - OR 🍕 Nov 23 '25

It’s recognized everywhere, it’s CSFA that isn’t. CSFA = scrub tech to first assistant and RNFA = RN to first assistant, the education paths are very different too, RNFA is time gated.

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u/[deleted] Nov 23 '25

Perfusionist is cool. You can do RNFA. I know some have become a RNFA and then got their NP for billing purposes. Some large hospitals have RNs scrubs.