Operating Room Nurse

Last Updated On Sep 4, 2024

Expert Verified: Catherine Burger, MSOL, RN, NEA-BC, LNC

8 Min Read

What is an Operating Room Nurse?

The perioperative or ‘OR’ nurse is an individual who works with the patient being prepped for surgery, their family, and as a member of the interdisciplinary care team. The OR/surgical/perioperative nurse helps to evaluate the patient, then plan and implement various steps to, during, and beyond surgery. Nurses who enjoy direct patient care and a good deal of change may enjoy spending time in the OR.

How to Become an Operating Room Nurse

Consistently looking for job postings in the perioperative role throughout local hospitals or medical networks is the most effective way for nurses to find a position that they’re interested in applying for.

Newly graduated and licensed nurses may have to complete an internship that includes both a didactic and practical component before being deemed ready to fulfill the role independently.

Experienced nurses who approach the role from a different specialty and background will have a similar lengthy orientation and learning curve to the OR/surgical/perioperative role but it may be shorter, depending on their prior knowledge and experience.

What Are the Schooling Requirements for an Operating Room Nurse?

OR/Surgical/Perioperative nurse positions require that the applicant have an RN license in good standing. This can be achieved, at minimum, by completing a 2-year Associate's Degree in Nursing (ADN) program. A BSN is not required for all operating room nurse positions, although many employers prefer it. Some employers may require that an applicant agrees to complete his or her bachelor’s degree within a certain timeframe after hire. This can be done at any number of accredited nursing schools.

OR nursing positions are typically open to new graduate RNs who have successfully completed an internship program, as well as to experienced nurses with at least one year of bedside experience.

Any Certifications or Credentials Needed?

The Association for Perioperative Registered Nurses (AORN) has a list of the various certifications available for the different roles within the OR:

CNOR for perioperative RNs
CRNFA for First Assistants who assist the surgeon
CSSM for Bachelor's educated OR Managers
CNS-CP for Master's educated Clinical Nurse Specialists

Where Do Operating Room Nurses Work?

The OR nurse typically works in:

Hospitals
Outpatient surgical clinics
Physician’s offices
Anesthesia Units

Roles of an Operating Room Nurse

The terms ‘Operating Room,’ ‘OR,’ ‘Surgical,’ and ‘Perioperative’ nurse are actually umbrella terms for a few different roles in the surgical department:

Pre-Op RN
Intra-Op RN
Post-Op or PACU RN

Pre-Op Nursing Role

The Pre-Op nurse performs the necessary duties to prepare the patient for a surgical procedure. These may include collecting vital signs and health history, starting intravenous catheters (IVs), performing a detailed head-to-toe assessment to ensure the patient's condition is stable for surgery, verifying that the appropriate paperwork is complete, and providing emotional support and teaching to the patient and family.

Intra-Op Nursing Role

The Intra-Op nurse works in different roles inside the operating room. The nurse may assist the surgeon as a Circulator to ensure a sterile and controlled environment. This nurse also ensures all necessary personnel, equipment, and supplies are readily available, completes necessary paperwork, and ensures anyone who enters the OR is a necessary and documented addition to the environment.

Post-Op Nursing Role

The Post-Op, or PACU nurse, works in the recovery room and receives the patient from the operating room immediately after the surgical procedure. The patient will have either just woken up from anesthesia or is now awake but sleepy. The Post-Op nurse monitors for complications during this process. Usually, a patient remains in the recovery room for 1-3 hours, depending on their condition and the standards of the hospital. The PACU nurse then either discharges the patient home or transfers them back to the floor of the hospital or ICU, where safe care will be continued.

Simply put, the exact type of work you’ll be doing as an OR/surgical/perioperative nurse will depend on the area of work you specialize in. To break it down, here is a simple chart that shows the subtle differences between the different roles:

	Pre-Op RN	Intra-Op RN	Post-Op or PACU RN
Certifications	RN License, Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS)	RN License, Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Certified Nurse Operating Room (CNOR)	RN License, Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Certified Post Anesthesia Nurse (CPAN)
Key Responsibilities	Patient assessment and history, Pre-surgical preparations, IV insertions and medications, Patient Education	Assisting surgeons during operations, Monitoring patient vitals, Managing surgical instruments and supplies, Maintaining sterile field	Monitoring patients as they wake from anesthesia, Managing pain and nausea, Assessing patient recovery and readiness for discharge, Providing post-operative care instructions
Workplace	Pre-operative care unit, Patient rooms, Pre-admission testing units	Operating room, Sterile environment, Surgical suites	Post-anesthesia care unit (PACU), Recovery rooms, Intensive care unit

What Are the Roles & Duties of an OR Nurse?

Coordinates use of supplies, instrumentation, and equipment for operative care
Ensures equipment is functioning correctly
Maintains patient safety standards
Monitors, records, and communicates the patient’s condition and needs with the interdisciplinary team
Manages overall care of the patient before, during, and after the surgical procedure
Advocates on behalf of the patient
Documents preoperative and intraoperative care to be delivered per the surgeon, hospital, and regulatory agencies
Evaluates, remediates, and documents the surgical environment for aseptic merit
Provides patient care with an understanding of age, culture-specific needs
Addresses the biological, emotional, developmental, psychosocial, and educational status of the patient and his or her family and seeks to address concerns
Coordinates professional development within their practice
Performs core job functions with minimal supervision

Operating Room Nurse Salary & Employment

Even with the emphasis on preventative care, perioperative nursing roles are expected to increase by about 19% into the next decade, according to the Bureau of Labor Statistics. While job growth rates vary throughout the country, locating close to busy hospitals and teaching facilities might mean higher rates of perioperative opportunities and room for advancement as opposed to less urban regions.

The median salary for an operating room/surgical/perioperative nurse is $129,668 with a range of $101,000 – $184,000 according to ZipRecruiter. Location, experience, education, and certifications affect salary. California is by far the highest-paying state for OR/surgical/perioperative nurses. Here are some of the top-paying cities in that state: