The Journey to Office Cystoscopy Privileging

Christy B. Krieg, MSN, FNP, CUNP


Urol Nurs. 2020;40(2):99-103. 

In This Article


When I started the process of training for diagnostic flexible cystoscopy, it did not occur to me that my training and privileging avenue would become the required path for others in my organization. I sought credentialing for myself only. I fear the number of procedures (50) and the requirement to have a CUNP will be onerous for others within my organization, yet these were the standards set by the Credentialing Committee.

Of course, this is all subject to change. Our chief nursing officer (who is an NP) has just in the recent months asked us to submit lists of procedures unique to our specialty practice; her goal is standardization of a review process for APP procedures in the ambulatory setting. She is also, appropriately, investigating procedures performed by medical assistants and registered nurses. Historically, privileging forms have been generic in our system (e.g., "I&D abscess," "skin biopsy," "splint fracture"), but with increased specialization, our health care system is now actively moving towards more specialty-specific privilege lists.

My advice to those of you blazing the credentialing path is to request from your organization's credentialing body a few samples of procedural requirements from other specialties to use as reference when creating your own.

In addition, seek input from other APPs in your practice group or community and be prepared for remarkable variation between facilities. An NP colleague at our county hospital (a mere 2-minute walk from my aforementioned cancer clinic) stated her requirement for supervised cystoscopy training is three. Perhaps 50 is too many, but is three adequate? The "right" number likely lies somewhere in the middle, and until we have more literature support and/or formal U.S. guidelines to define training programs and competence, each practice group will make its own rules.

As APPs become a larger and more established part of the provider work force in health care, steps to procedure credentialing may eventually become more routine and mundane. But we must never allow this to diminish the importance of knowledge acquisition, nor should we become casual about the importance of competent practice, which remains at the same bar as our physician colleagues.