In the OR there are circulators, scrubs
, and sometimes assistants. Most of the time the circulator is an RN, the scrub is a certified surgical (or scrub) technician, and the assistant is a CST plus a certified first assistant. However, RN's often scrub also. The scrub's duty is to pass instruments, cut suture, suture, assist the surgeon, retract, etc. directly involved with the sterile surgical field. The circulator's duty is to be responsible for positioning of the patient, monitoring input/output, thermodynamics, hemodynamics, charting, and coordinating the perioperative experience for the patient and surgeon (getting things for the sterile field such as suture, medication, and instruments after the surgery is underway and making sure all necessary equipment is in the room and functioning properly). This sometimes requires the knowledge attained by RN's and in most hospitals must be an RN. The RN is responsible for monitoring medications used on the field and is responsible for the scrub's actions. The RN is also responsible for making sure the instrument/sponge count is correct. RN's who are working as scrubs (when we don't have enough scrubs primarily) are still responsible for medications given/injected on the field and other actions involving nursing judgement.
If an RN can scrub she has the best job opportunities because she can double when an OR is short on scrub staff. A scrub cannot double as a circulator because it requires a nursing license in most OR depts.
I would recommend at least a year on a floor, maybe two...and ICU or surgical ICU would be tremendously helpful before entering an OR job. A thick skin against verbally hostile surgeons is helpful too. It's almost never personal but happens often. 6 months minimum orientation in the OR before you're independent would be adviseable with further mentoring for at least a year.
Hope this helps.