*rubs hands together* Ah! I feel like I can have some authority on this! I, too, came from a med/surg-but-mostly-post-op floor, which was my first job out of school for a year, and now am in the OR.
Whether you are circulating or both scrubbing and circulating depends on the facility. Where I work, we are trained to both circulate and scrub (or "scrubulate" as they like to call it!). We have OR techs who scrub, and while the RNs mostly circulate, it's helpful to be flexibile enough to scrub if needed. Also, they work with you on your preferences; there are some RNs where I work that primarily scrub.
Scrubbing is more than just handing instruments. You are responsible, with the help of the circulator, to make sure your case cart has everything you need for the cases for the day. Sometimes you are running around gathering supplies and making trips down to CPD (central processing department, where everything is sterilized). You make sure all the equipment in the room is in working order. You set everything up, which for some big cases like in neuro, can involve two mayo stands, two back tables, and a million instruments and pieces of equipment, and is just a major to-do. The scrub, along with the RN, is responsible for the count. Counting instruments and keeping track of everything can be quite the task (I did a plastics case with 97 needles last week! Talk about exercising organization skills!) Scrubs
become well-versed in individual doctors preferences, and are great multitaskers; I've seen experienced scrubs pass instruments, cut grafts, ask for suture, and start a count all at the same time.
You are an advocate for the patient in that you are keeping an eye out that sterile technique is maintained. When clueless med students are in the room, you have to be extra vigilant.
The ciruclator definitely does more than document. You are running the show. When you first come in, you, along with the scrub, check equipment in the room, and help make sure they have everything they need to set-up. You are the contact person for everyone else involved in the patient's care- they are in touch with the nurse caring for them from where they are coming and to where they are going, with the doctor, with anesthesia, with sales reps, and making sure everything is in order for the cases you have. You go get the patient, speak with them and the family, verify name, birthday, procedure, right/left and is it marked?, NPO status, allergies. Discuss what to expect and where the family is to go. Take the patient back. Then this is busy time. Not only are you keeping track of all your important time notations (time you came in the room, time patient was induced, time the time-out was done, time surgery started, etc) and making sure it lines up with anesthesia's times, but you are calling the anesthesiologist, sometimes paging the surgeon, helping transfer the patient, initiating a time-out (and exercising your confidence and assertiveness as most physicians don't want to listen *cough*), standing by during induction, helping with positioning (which, depending on the procedure can be a hell of a job) and securing the patient, placing padding to prevent ulcers, doing a look-over assessment on the patient as you do so, setting up for caudal if necessary (though I think that might just be peds), placing the Bovie pad, inserting a foley, doing a count, doing another time-out because God knows its a miracle if the anesthesiologist and the surgeon are in the room at the same time, prepping the surgical field, helping secure draping, plugging things in, turning on equipment and adjusting settings, putting local and maybe additional prep on the field, fetching whatever the scrub needs, AND THEN documenting. Whew!
And even then, depending on the case, you're still running around for a lot of it. Think about it - besides the anesthesia team who has their own stuff to worry about, you're the only non-sterile person in the room. That means anything like answering phones, making calls, getting report and making sure your next patient is set up and ready to go, fetching what is needed during the surgery, handling any specimens, handling any labwork, keeping the room clean and organized (like the dirty sponges that seem to get tossed around), monitoring who is in the room and what times they are in/out (time notation seems to be big in the OR), updating the count, getting an oxygen tank and monitor ready for when the patient wakes up, contacting PACU, etc etc...you stay busy! All the while, keeping an eye and ear out for your patient (if you hear that monitor change, you better be over there!) because you are their ultimate advocate.
So I agree that anyone that says OR is boring has never been an OR nurse!
I found that a lot of people gave me crap about "losing my skills" and "being bored" but I actually found out that apparently, many people were pretty jealous I was leaving the floor for the OR. I will never go back. I love it here.
Also, there is a particular anesthesiologist who encourages me to do the IVs sometimes so I don't lose that skill. If you end up working with nice ones, ask! I'm sure they'd be okay with it!
As far as other skills, yeah, you're not going to be putting in an NG or anything, but you gain a whole new invaluable knowledge and skill set.
If you can both scrub and circulate and get trained in different services, I don't see how it can be boring - it's something new every day!
As far as advancement, at my particular hospital, we don't use RNFAs, but that is an option. I personally plan on getting CNOR certification to better myself. There is an opportunity for advancement where I work (and I imagine most places) of a "team leader" role, which means you are basically the charge nurse of your service (cardiothoracic, neuro, general, etc) and you have a little more responsibility and authority. And of course, OR charge nurse, clinical nurse specialist, educator, manager, etc. If you are at all interested in being a CRNA, then the OR is where you need to be.
It's been interesting because a girl who is my age and has similar experience as I do started at the same time as me, and I love it and she hates it. She says that she doesn't like working as a team - she enjoyed having her own load of patients and doing her own thing and not working so much with other staff - and doesn't like that the patients are asleep for most of the time. If these are things that you think would bother you, then I would reconsider. Personally, I thought floor nursing was hard. 7 patients at a time (I worked nights), lots of pain management, lots of complaining, lots of trying to make everyone happy at once....the dynamic is different in the OR. You DO see the patient awake, even if it's only for a half an hour total. You are still a very important figure to them and their family, and you are there calming them up until the moment they go to sleep. That's enough "patient contact" for me. Though I hear this is the biggest issue when people get to the OR and realize they don't like it. OR nursing is challenging, but I think it's much easier than floor nursing, and not as exhausting.
Like I said, I love it. I'm really happy I made the decision to go to the OR. Good luck with your decision!