Operating room nurses are registered nurses who are often referred to as perioperative nurses. Although some descriptions of perioperative nurses include nurses who work in preoperative and postoperative care units—such as pre-op holding and the post anesthesia care unit (PACU)—this guide focuses on nurses who specifically work within the operating room.
These nurses work within one of three nursing roles within the operating room: RN first assistant, scrub nurse, and circulating nurse. Both the RN first assistant and the scrub nurse work within the sterile field, and the circulating nurse works outside the sterile field. All are part of an interdisciplinary team along with the surgeon, anesthesia staff, and others who may be involved during the patient’s surgery—including surgical technicians, medical students, x-ray technicians, and other healthcare professionals.
What Does an Operating Room Nurse Do?
The operating room nurse who is the RN first assistant provides direct patient care with hands-on support for the surgeon by:
Helping to control bleeding
Providing optimal wound exposure
Assisting with other surgical tasks as needed
The operating room nurse who is the scrub nurse is responsible for an array of tasks, including:
Inspecting and setting up the operating room prior to surgery
Donning sterile garb and then assisting the rest of the surgical team with doing the same
Conducting pre-operative and post-operative counts of various small items used during surgery, including sponges, needles, and surgical instruments
Handling sterile dressings, instruments, and other supplies
The operating room nurse who is the circulating nurse works outside the sterile field and is responsible for managing patient care, supporting error prevention, and serving as a patient advocate throughout the surgery. A circulating nurse’s work includes many tasks, such as :
Meeting with the patient in the pre-op holding area and providing any nursing care needed
Accompanying the patient to the surgical suite
Helping to position the patient and monitoring the patient’s position throughout surgery
Obtaining additional equipment or supplies that may be needed
Monitoring IVs and emptying drainage bags
Serving as the communication link with those outside of the operating room
Accompanying the patient to the PACU or intensive care unit (ICU)
Operating room nurses need to possess excellent communication skills, since failure to accurately exchange critical information in the fast and often intense environment of the operating room can have serious consequences for patient care.
The authors of one study, “Communication and relationship dynamics in surgical teams in the operating room: an ethnographic study,” framed the importance of effective communication like this: “In surgical teams, health professionals are highly interdependent and work under time pressure. It is of particular importance that teamwork is well-functioning in order to achieve quality treatment and patient safety. Relational coordination, defined as ‘communicating and relating for the purpose of task integration,’ has been found to contribute to quality treatment and patient safety. Relational coordination has also been found to contribute to psychological safety and the ability to learn from mistakes.”
How Much Does an Operating Room Nurse Make Per Year?
According to salary data from the Bureau of Labor Statistics (BLS), the median annual wage for registered nurses was $77,600 in May 2021—with half of nurses earning more than that amount and half earning less. Wages of nurses in the lowest 10 percent were less than $59,450. Wages of nurses in the highest 10 percent were over $120,250.
The BLS does not provide a pay breakdown according to specialty but does provide median annual wages for registered nurses according to general categories of work location. Since operating room nurses care for patients in the hospital or in an ambulatory surgery center, the following BLS median annual pay ranges reported for May 2021 may apply, depending upon the operating room nurse’s employer:
General medical and surgical hospitals: $85,020
Outpatient care centers: $93,070
Operating room nurses who work in hospital settings may also enjoy the financial benefits of potentially receiving a higher rate of pay for working off-shifts and being on call. The salary of an operating room nurse is also influenced by factors such as education, experience, and geographical region of the country.
Since operating room nurses are registered nurses, they must attend an accredited nursing program that leads to a bachelor’s degree in nursing or an associate’s degree in nursing.
RNs must also be licensed in the state in which they work. Licensure can be obtained by passing the National Council Licensure Examination (NCLEX-RN) and meeting any additional requirements of the state’s board of nursing. The National Council of State Boards of Nursing (NCSBN) offers a resource to determine state-based nursing licensure requirements.
An operating room nurse can also obtain perioperative specialty certification by meeting eligibility requirements and taking specific types of certification exams, such as those offered by the Competency & Credentialing Institute (CCI):
What Are the Benefits of Being an Operating Room Nurse?
There are many benefits to being an operating room nurse, including the ability to work in a variety of roles in either an inpatient or outpatient setting. Additionally, operating room nurses can look forward to fast-paced work that’s interesting and allows them to have a positive impact on the patients they care for.
As one operating room nurse said, “I love that my job is fast paced and constantly changing. It’s never dull. The best part is being integral to a team. Doctors, nurses, respiratory therapists, x-ray techs, and OR aides work together to care for each patient that enters the operating room. …In the OR I get to see improvement in patients’ health. Many people are cured by the end of their operation. Seeing that every day of my career is truly gratifying.”
Additional Resources About Becoming an Operating Room Nurse
To learn more about becoming an operating room nurse, these additional resources may help:
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