Perianesthesia Nurse Career Overview

What Is a Perianesthesia Nurse?

A perianesthesia nurse takes care of patients before and after surgery that requires anesthesia. The medications that render patients unconscious during surgery must be carefully administered by an anesthesiologist, and as the medications wear off, perianesthesia nurses use their experience and knowledge to make sure their transition to wakefulness is as smooth and uneventful as possible.

Preoperative care is also important, and perianesthesia nurses use this time to educate their patients on their procedure, answer any questions, and perform screenings that could catch an anesthetic contraindication.

Where Do Perianesthesia Nurses Work?

Because perianesthesia nurses’ work hinges around surgery, they often work in hospitals. However, more and more surgical procedures can now be done in outpatient clinics, so perianesthesia nurses can also find work there. The first anesthetic was given by a dentist, and perianesthesia nurses continue to assist dental surgeons before, during, and after procedures done in dental surgery clinics.

The nature of perianesthesia work requires nurses to have access to a lot of medical equipment, medications, and monitoring devices. No matter the type of surgery, anesthesia medications carry some risk, so perianesthesia nurses must have the equipment they need to properly monitor patients after the end of any procedure. While hospital surgical suites may offer more staff in any given operation, all surgeries require several medical specialists to collaborate for a successful outcome.

What Does a Perianesthesia Nurse Do?

Before surgery, perianesthesia nurses welcome their patients to a preoperative room. There, they will help ready the patient for surgery by:

• Administering any pre-medication required
• Assisting patients into hospital gowns
• Ensuring patients followed all pre-operative instructions, like bathing and diet restrictions
• Providing education and reassurance to patients and families
• Starting an IV
• Transporting patients to the operating room (OR)

Once a patient is settled in the OR, their perianesthesia nurse won’t see them again until after surgery. In some facilities, perianesthesia nurses are asked to keep families updated on surgery progress throughout the operation. When a surgical procedure has finished and the patient is stable, the OR team transports the patient back to the perianesthesia nurse. After surgery, patients need close monitoring. During this period, perianesthesia nurses are responsible for:

• Body fluid management
• Lab specimen collection
• Mental status assessment
• Nausea management
• Pain management
• Patient respiratory status
• Surgical wound assessment and care
• Vital sign monitoring

Sometimes, patients can wake up confused and disoriented after anesthesia, and perianesthesia nurses can comfort and reassure them by reminding them where they are and how their surgery went. As perianesthesia nurses monitor a patient’s postoperative recovery, they collaborate with the entire health team to address patient needs as they arise.

How Do I Become a Perianesthesia Nurse?

Anyone who wants to be a perianesthesia nurse must first attend and graduate from an accredited nursing program with an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). After they graduate, nurses may apply for perianesthesia nursing positions as graduate nurses (GNs).

They can begin their orientation as GNs under nurse preceptors, who train them until they pass the NCLEX-RN, their state licensing exam. Once they pass the NCLEX, GNs become registered nurses (RNs) and, after their orientation period, can practice nursing on their own. Before treating any patients, perianesthesia nurses must obtain their basic life support (BLS) and advanced cardiovascular life support (ACLS) certifications.

After a few years of experience, perianesthesia nurses may want to take an exam to earn a specialty certification. They can also return to school to earn a Master of Science in Nursing (MSN) and become a surgical nurse practitioner (NP). Perianesthesia nurses can graduate with their MSN in two years but can take longer to complete it if they work full-time.

Perianesthesia nurses can earn their certified post-anesthesia nurse (CPAN) and certified ambulatory perianesthesia nurse (CAPA) through the American Board of Perianesthesia Nursing Certification (ABPANC). To do so, they will have to give evidence of:

• A current RN license
• 1,200 hours of direct clinical experience within two years prior to application

These two certifications focus on different aspects of surgical nursing. The CPAN covers postanesthesia phase I, while the CAPA specializes in:

• Preanesthesia phase
• Postanesthesia phase II
• Extended care

Perianesthesia nurses can test for both certifications at once, but dual certification requirements are a little different:

• A current RN license
• At least 1,200 hours of direct clinical experience with patients in postanesthesia phase I AND
• At least 1,200 hours of direct clinical experience caring for patients in preanesthesia phase, postanesthesia phase II, and/or extended care

How Much Does a Perianesthesia Nurse Make Per Year?

The annual salaries for perianesthesia nurses look similar to those of registered nurses. RNs earn an average of $94,480 per year, according to the U.S. Bureau of Labor Statistics (BLS). Salaries can change based on location and experience, from the low-end average of $63,720 to the high-end of $132,680. Depending on your workplace, your employer may be able to offer higher or lower compensation:

• General Medical and Surgical Hospitals: $96,830
• Outpatient Care Centers: $102,640

Salaries also vary depending on which state a perianesthesia nurse practices. The West Coast, New England states, and Alaska pay their nurses the best, but the cost of living in these areas can also be high. The lowest-paying states are in the Midwest and some Southeastern states.

The top-paying areas for perianesthesia nurses include:

• San Francisco-Oakland-Hayward, CA: $174,370
• Vallejo-Fairfield, CA: $171,620
• San Jose-Sunnyvale-Santa Clara, CA: $170,780
• Napa, CA: $166,180
• Sacramento–Roseville–Arden-Arcade, CA: $154,510
• Santa Rosa, CA: $152,930
• Modesto, CA: $145,190
• Santa Cruz-Watsonville, CA: $140,880
• San Luis Obispo–Paso Robles–Arroyo Grande, CA: $140,560
• Stockton-Lodi, CA: $138,420

Perianesthesia nurses with a specialty certification can earn more than nurses who are not certified. The more experience a perianesthesia nurse has, the more they can earn.

Are Perianesthesia Nurses in High Demand?

Every year, 40 to 50 million people in the U.S. have major surgery. The American population is aging, and according to the U.S. Census Bureau, everyone from the baby boomer generation will be 65 or older by 2030. As people age, health risks increase, and more surgeries may be needed in the future. As surgery demand increases, so will the demand for perianesthesia nurses. According to the U.S. Department of Health and Human Services, 24% of U.S. hospitals have reported critical staffing shortages, meaning the United States needs more nurses in all specialties.

Additional Resources for Perianesthesia Nurses

To learn more about becoming a perianesthesia nurse, these websites offer additional resources:

• American Society of Perianesthesia Nurses
• Journal of Perianesthesia Nursing
• American Board of Perianesthesia Nursing Certification, Inc.
• Association of periOperative Registered Nurses (AORN)