What is Perioperative Nursing?

Perioperative nursing refers to registered nurses who work in surgical operating rooms. These nurses work directly with surgeons to provide patient care before, during, and after surgery. As a perioperative nurse, the caregiver is expected to act as a liaison between patients and doctors. Perioperative nursing is an extremely rewarding career with plenty of advancement opportunities. Getting started in the field is relatively easy with these nurses receiving training through college degree programs and post-graduate certifications.

What Is Perioperative Nursing?

Perioperative nurses are also often called surgical nurses or OR (operating room) nurses. They take on several roles throughout the surgical process. For starters, he or she will be responsible for educating patients on different aspects of their surgeries. Later, the OR nurse will provide direct assistance to the surgeon during the medical procedure. Perioperative nurses can fall into three categories: registered nurse first assistant, scrub nurse, or circulating nurse. Each of these positions has specific duties. However, for all of these job titles, the nurse will likely work in a hospital or surgery center. Perioperative nurses may choose to study a specialty besides general surgery and get involved in areas such as pediatrics, neurology, cardiology, and reconstructive surgery.

What Does a Perioperative Nurse Do?

Each type of perioperative nurse will have different responsibilities within a hospital or surgery center. The following is a brief overview of OR nurse duties:

• Scrub Nurse: A scrub nurse will work directly under a surgeon. Scrub nurses assist during surgeries and must provide the surgeon with the right instruments needed to perform the operation. Scrub nurses also prepare the operating room before surgery commences. Most scrub nurses are tasked with monitoring vital signs for the patient during and after the surgery.
• Circulating Nurse: The circulating nurse is considered the patient’s advocate while he or she is under anesthesia. This area of perioperative nursing involves ensuring patient safety while the person is sedated and will escort the patient to and from the surgery. Circulating nurses are also often involved in charting what occurs during surgery. Furthermore, they may be in charge of managing the supplies and instruments used inside the operating room.
• Registered Nurse First Assistant (RFNA): As the name suggests, an RFNA is the first assistant to the surgeon during operating room procedures. The RFNA assists with treatment plans and will educate patients before and after surgeries. RFNA can also assist with wound management, incisions, and suturing.

Why Are Perioperative Nurses Important?

Since they work directly with patients, OR nurses are key for providing high-quality patient care. According to the AORN Journal, perioperative nurses are essential for shaping patient experiences during surgeries since they are responsible for educating on postoperative pain management. They need to help facilitate recovery and monitor the patient’s status from pre-operative to post-operative. Perioperative nurses are also a source of emotional support to patients and families as they advise them throughout the surgical process. Nurses will be the source of information and must be prepared to answer any questions that patients or family members may have about the surgery.

Another responsibility is managing the operating room to ensure a safe and comfortable experience for both patients and hospital staff. Perioperative nurses are usually responsible for guaranteeing the operating room and all instruments are sterilized to prevent the spread of infection. Another way operating room nurses help prevent infections is by educating patients on wound cleaning and care.

How to Become a Perioperative Nurse

Perioperative nurses should be highly organized and thrive in structured environments. He or she should have the capacity to pay close attention to detail. Surgical nurses work directly with patients, so they need to have good communication and people skills. Communication is a vital part of being an OR nurse since he or she must give instructions to the patient. The nurse will also act as a liaison and must be able to vocalize patient concerns to physicians. Perioperative nurses have to be prepared for any type of medical situation that can arise in the operating room. This nursing field involves working with different patients daily with varying needs.

Perioperative Nurse Education and Training Requirements

The education for a perioperative nurse will start out similar to a registered nurse. In the majority of cases, a perioperative nurse will have at least one to two years of experience as a registered nurse. To start out in the field of perioperative nursing, the student will take a nursing degree program. Most hospitals and ambulatory surgery centers prefer nurses have a BSN or higher. Three-year hospital training programs or two-year ASN programs are also available to registered nurses. At the conclusion of the degree program, the prospective nurse will have to take and pass the NCLEX-RN examination. If the goal is to become an OR nurse, registered nurses should look for employment in hospitals and surgery centers.

To become a surgical nurse, the traditional pathway is to enroll in a Master of Science in Nursing program. If a Bachelor of Science in Nursing degree was never conferred, many colleges offer a direct-entry RN to MSN degree program. Many of the courses for these types of programs are available 100 percent online. While attending the MSN program, nurses can look for externships in their preferred specializations. For instance, a prospective perioperative nurse could look for openings in a pediatric operating room.

Master of Science in Nursing programs should be from an accredited college or university. Graduate-level courses will cover topics such as clinical nursing, nursing research, evidence-based practices, advanced pharmacology, nursing assessment, and nursing leadership.

Perioperative training programs are available for registered nurses looking to break into the field. The most well-established program was developed by the Association of Perioperative Registered Nurses. Topics covered in the courses include:

• Roles of surgical team members
• Managing patient care assignments
• Ethical and legal responsibilities of surgery teams
• Creating a sterile environment with disinfection processes
• Patient safety and care
• Scrub nurse responsibilities

Perioperative nursing certification is needed in the field to get ahead of the competition. The following are examples of the types of certifications available to perioperative nurses:

• CNOR: To qualify for CNOR, the nurse must have a current RN license and have a minimum of 2,400 hours of perioperative nursing experience. Out of the 2,4000 required hours, 1,200 of the hours should be in the operating room. CNOR certification requires renewal every five years to remain valid.
• CNFA: This certification is available to those who work as Registered Nurse First Assistants. To qualify for this certification, the applicant must already have the CNOR. A completed RFNA program is required as well along with 2,000 documented practice hours. Another option for RFNAs is to also receive certification through CSFA.
• CMSRN: To receive this certification, licensed registered nurses must have two years of practice in a surgical setting.      

Surgical Nurse Career Outlook

Surgical nurses must perform well under pressure. The job can be very stressful and is ideal for someone who is able to manage high-tension situations. The nurse must make quick decisions and think on his or her feet. Perioperative nurses must be able to work as part of a team and become familiar with different patients on a daily basis. A drawback of being a perioperative nurse is that many of them must work hospital shifts. The perioperative nurse may have to clock in overtime hours often due to emergencies or scheduling issues. An on-call schedule may also be a requirement when taking a job as an OR nurse.

Perioperative nurses will have greater job opportunities over the next ten years. Due to a numerous aging population and the subsequent call for more specialized nurses, perioperative nursing jobs will increase by as much as 15 percent through 2026. Perioperative nurses could choose to enroll in training programs for sub-specialties. Nurses with operating room experience may also pursue openings in nurse management roles.

Perioperative Nurse Salary and Employment

Salaries for perioperative nurses are competitive. The Bureau of Labor Statistics states that the median wage for registered nurses is $71,730 annually. In comparison, an operating room nurse can make in excess of $94,000 a year. Experience and location will have a direct effect on how much a surgical nurse earns annually. Top-paying states for nursing jobs include California, Oregon, Utah, Nevada, and Arizona.

Perioperative Nursing Resources

Perioperative Nursing FAQs

Q: What types of assessments are expected from perioperative nurses?
A: Good assessment skills are a must for surgical nurses. The OR nurse must always be aware of the patient’s status and be constantly monitoring vital signs. The nurse must watch a patient as he or she wakes up from anesthesia to check for any potential complications.

Q: Can perioperative nurses have flexible schedules?
A: Meeting family obligations is possible when working as a perioperative nurse. Perioperative nurses are needed 24/7—allowing shift openings during daytime hours, evenings, and weekends. Operating nurses could also arrange for shift coverage if an emergency arises.

Q: What type of setting offers the best pay for surgical nurses?
A: According to survey data collected by AORN, perioperative nurses that work in ambulatory surgery centers in a university setting have the highest earning potential. The lowest-paying settings were a general hospital and community ambulatory center.

Helpful Organizations, Societies & Agencies

Professional organizations allow the perioperative nurse to network with other medical caregivers in the field. The organizations may also provide resources such as online training and medical journals. Current and prospective perioperative nurses should join these organizations as a way to stay up to date on the latest nursing trends.

Association of Perioperative Registered Nurses

American Society of PeriAnesthesia Nurses

Academy of Medical-Surgical Nurses

Perioperative Nursing Scholarships

Looking for a way to become a healthcare professional? Check out our scholarship here!

List of Perioperative Nursing Programs

Check out this list of potential nursing programs to get you started!

What now?

Becoming a perioperative nurse is a rewarding endeavor for those who prefer to work in a challenging and dynamic environment. RN to BSN Programs can assist prospective operating room nurses with finding the best degree program to meet your nursing career goals. Please contact us with any questions about finding a job in the perioperative nursing field.