Frequently Asked Questions for Patients

What is a Perioperative Nurse Surgical Assistant (PNSA)?

A PNSA is a highly experienced registered nurse with advanced surgical training who assists the surgeon during operations. They perform many of the same tasks as a doctor assistant, such as tissue handling, retraction, and suturing.

Is it safe to have a nurse assisting my surgeon instead of a doctor?

Yes. PNSAs are experienced professionals who meet rigorous standards for training, registration, and ongoing education. They work directly under the supervision of your surgeon, who remains fully responsible for your operation.

Are PNSAs qualified to assist in surgery?

Yes. PNSAs are registered nurses who have undertaken additional specialised postgraduate training in surgical assisting. They work under strict professional standards, hospital policies, and the direct supervision of the surgeon.

What’s the difference between a PNSA and a doctor (medical) surgical assistant?

Both perform the same role in theatre. A doctor assistant usually comes from a GP or junior doctor pathway, whereas a PNSA is a senior nurse with extensive operating theatre experience and specialist training. Many surgeons prefer PNSAs because of their surgical knowledge, reliability, and consistency.

Do I get to choose who assists my surgeon?

Usually, no. Your surgeon selects their assistant based on who they trust and work best with. This ensures a safe, well-coordinated surgical team.

Do PNSAs replace my surgeon?

Absolutely not. The surgeon is always in charge and performs all critical parts of your operation. The PNSA supports the surgeon so they can focus on performing your surgery with the best outcomes.

Will the PNSA be involved in my care outside the operation?

In most cases, the PNSA’s role is limited to the operating theatre. They may meet you before surgery to introduce themselves and explain their role. However, some PNSAs may also work in your surgeon's clinic and be involved in your pre- and post-operative care managed by your surgeon.

Will I be billed for the PNSA’s services?

Surgical assistants (whether they are doctors or nurses) charge a fee for their services. Billing arrangements are flexible and negotiated by your surgeon. In most cases, the fee is around 20% of the surgeon’s fee, with a minimum fee of $200. This may be billed directly to you or via your surgeon’s rooms. Payment options include bank transfer, credit card, and Afterpay.

Do you have a provider number I could use to try and claim the cost of your assistance back from Medicare and my health insurance company?

Currently, PNSAs do not have access to Medicare provider numbers. This means I cannot issue a provider number for you to use when making a claim through Medicare or most private health insurance companies.

This is not a reflection on the quality or safety of PNSA services – it is simply a limitation of the current funding system. The Medicare Benefits Schedule (MBS) Review Taskforce has formally recommended that PNSAs should be able to access provider numbers in the future, and this recommendation is currently under consideration by the government. Many professional organisations and surgeons support this change, as it would reduce out-of-pocket costs for patients.

For now, most private health insurers and the Department of Veterans’ Affairs (DVA) do not provide rebates for PNSA services. However, some schemes do cover these costs in full, including WorkCover and Surgery Connect (Queensland). In these cases, I bill the scheme directly, so you do not need to pay or claim anything yourself.