Operating Room / Perioperative Nursing

Perioperative nurses are the nurses who are with the patient as they go through all levels of surgery. They are there to greet the anxious patient and their family upon arrival to the preoperative area. They remain with the patient throughout the surgical procedure, always keeping patient safety at the forefront. They are the nurses who will be with the patient in the postoperative area, carefully monitoring and caring for the patient's needs. Throughout the surgical process, perioperative nurses serve as liaisons between the OR and patients' families and friends to provide support and communication while ensuring the highest quality of patient care.

Necessary Skills/Qualities

Perioperative nurses need excellent interpersonal and communication skills to work with patients and other professionals in what can sometimes be an intense and emotional environment. Compassion and empathy are necessary to help comfort anxious and suffering patients. Energy, stamina, and emotional stability will help the nurse to thrive in an intense and face-paced operating room environment. Because their job requires strict adherence to safety and sanitary procedures, perioperative nurses should be excellent decision makers with a keen eye for detail.

Work Environment

Perioperative nurses work in hospital surgical departments, day-surgery units (ambulatory surgery), radiology departments, clinics, and physicians' offices. They work closely with the surgical patient, family members, and other health-care professionals to help plan, implement, and evaluate treatment.

Duties/Responsibilities

Pre-operative

Nurses caring for patients before and after surgery are also known as perianesthesia nurses. The perioperative nurse in this phase of care:

• Uses interviewing and assessment skills to identify possible or actual patient problems prior to surgery
• Carefully reviews the patient's current and past health history, lab values, psychological status, and understanding of the procedure
• Prepares the patient for surgery

Intra-operative

In the operating room, the perioperative nurse may serve as:

• Circulating Nurse
  • Manages the overall patient care in the surgical suite and helps to maintain a safe, comfortable environment.
  • Ensures patient safety during the procedure
  • Coordinates with the surgeon, scrub nurse/tech, and anesthesia provider to provide quality care to the patient
• Scrub Nurse
  • Uses sterile technique while selecting and passing instruments and supplies used for the operation
  • Maintains patient safety

Other responsibilities during the intra-operative period

• Acts as a patient advocate at all times, especially while the patient is under anesthesia
• Assists with completion of surgical "counts" to be sure that no foreign objects are left unaccounted for
• Helps with repositioning of the patient
• Provides warming blankets

Post Operative

Post-operative care is provided by the nurse in the post-anesthesia care unit (PACU). Post-op nurses should have extensive experience in intensive care nursing as they care for the life-sustaining needs of the patient. They also discuss with patients and families post operative care in the home.

Education

• Graduate from accredited Registered Nurse (RN) or Licensed Practical/Vocational Nurse (LPN/LVN) nursing program
• RN: Diploma, ADN, BSN or higher degree
• LPN/LVN: Certificate, diploma, or degree
• Successfully pass NCLEX-RN or NCLEX-PN
• Current, unencumbered RN or LPN/LVN license in U.S. state of practice

While an LPN/LVN typically handles preoperative and postoperative care, most scrub nurses are RNs. While RNs with an associate's degree are qualified for this position, the Association of periOperative Registered Nurses (AORN) highly recommends that these professionals hold a bachelor's degree (BSN).

RNs often transition into the scrub nurse role after many years of acute care nursing experience. With additional education and experience, perioperative nurses can function as (not all-inclusive):

• operating room directors
• manage budgets
• manage staffing and other business aspects of the OR

Advanced Education/Training

With further advanced education and training, perioperative nurses may choose to become Certified Registered Nurse Anesthetists (CRNA) or may even consider a career as a certified RN First Assistant. They may also pursue careers as Clinical Nurse Specialists (CNS), Clinical Nurse Educators (CNE) or researchers.

Certifications (not all-inclusive)

CNOR®

The Competency and Credentialing Institute (CCI) administers the Certified Perioperative Nurse (CNOR) exam. It is the only accredited certification for perioperative Registered Nurses.

Other CCI exams include:

CSSM®

The Certified Surgical Services Manager (CSSM) certification is the only perioperative management credential for perioperative managers, directors, and nurses who oversee personnel, a budget, business unit, or service line.

CNS-CP®

The Clinical Nurse Specialist Perioperative Certification (CNS-CP) credential is for Advanced Practice Registered Nurses (APRN) who have completed graduate preparation (Master's or Doctorate) in the CNS role.

Salary (2020)

According to salary.com, the average salary for an OR Nurse in the U.S. is $78,591 with a range typically falling between $70,516 and $86,880.

According to salary.com, the RN Surgical First Assistant average salary in the U.S. is $98,143 but the range typically falls between $88,791 and $109,338. 

According to ZipRecruiter, the average annual pay for a Perioperative Nurse in the U.S. is $91,629 with salaries that range between $62,500 to $124,500.

Must Read...

What Do Operating Room Nurses Do?

Why Wasn't I Offered the OR Position?

Resources

Association of periOperative Registered Nurses (AORN)

AORN Journal

American Society of PeriAnesthesia Nurses (ASPAN)