Frequently asked questions - Surgeons

What is a Perioperative Nurse Surgical Assistant (PNSA)?

A PNSA is a highly experienced registered nurse with advanced perioperative and postgraduate training in surgical assisting. Their role is equivalent to a GP or doctor surgical assistant, focusing on retraction, haemostasis, suturing, and facilitating surgical flow.

How does a PNSA benefit my surgical practice?

They provide reliable assistance, are often more available than GP assistants, reduce theatre time by anticipating needs, and enhance team cohesion as they often work regularly with theatre staff and have a comprehensive understanding of theatre flow.

Are PNSAs qualified to assist?

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.

How does a PNSA compare with a medical surgical assistant?

Functionally, there is no difference in intraoperative tasks. Medical assistants who are GPs or junior doctors have limited surgical exposure, while PNSAs are senior nurses with years of perioperative experience and postgraduate surgical assisting training. Surgeons who regularly use PNSAs prefer their services for their reliability and theatre expertise.

Are there medico-legal risks in using a PNSA?

No greater than with any other surgical assistant. PNSAs are covered by their own professional indemnity insurance and work within defined competencies. The surgeon remains responsible for the operation.

Are PNSAs recognised by hospitals?

Yes. PNSAs are credentialed through hospital processes, similar to other assistants. While MBS provider number access is still under review, many hospitals credential PNSAs, and they are accepted for billing under some state-based schemes such as WorkCover and Surgery Connect.

Can the PNSAs be involved in pre- and post-operative care?

Many PNSAs prefer to focus on intraoperative care. However, some PNSAs may be happy to also work in your clinic and be involved in pre- and post-operative management.

Can patients claim a Medicare rebate for a PNSA’s fee?

Currently, Medicare rebates for surgical assistants are limited to doctors. PNSAs cannot yet access Medicare provider numbers, although the MBS Review Taskforce has recommended this change. Most private health insurers and DVA do not reimburse PNSA services, though WorkCover and Surgery Connect do.

How does billing work for Scrub Assist PNSA services?

Billing is flexible. Options include invoicing the patient directly or billing through your rooms. The fee is typically 20% of the surgeon’s fee. Patients can pay via bank transfer, credit card, or Afterpay. WorkCover and Surgery Connect are billed directly by the PNSA, with no administrative burden for your rooms