Why OR nursing?

Editorial Team / Admin · Mar 13, 2013

Hi there! I recently had the opportunity to observe in the OR for a day. They were doing a live donor kidney transplant and the circulating nurse pulled me back and forth between the donor and recipient. It was just about the coolest thing ever to watch! I'm also very thankful to the staff for explaining what was going on and making me feel welcome.
For you OR nurses out there, how did you decide to go into OR nursing? Do you get hired/trained into both scrub and circulating nurse roles or are those two separate positions? Do you miss bedside nursing/direct patient care?

I went into OR nursing directly out of school. I knew that floor nursing would never be my niche, but had zero exposure to the OR until my last semester, when I did my practicum in PACU and followed a patient from preop to OR to PACU, and knew I'd found my home.

Whether a facility trains you to both scrub and circulate depends on each individual policy/practice/preference. My facility generally hires surgical technologists for the scrub role and RNs (unless they have prior experience either as an ST or from a previous facility) only circulate.

I don't find the OR as an area lacking in direct patient care. Sure, interaction with the patient is much less, but you still are taking care of a patient and utilizing nursing skills.

Also, do OR nurses ever go back to school to be nurse anesthetists? I would imagine the OR experience would translate well, but it seems like CRNA programs want ICU experience.

OR nursing experience has almost zero to do with becoming a CRNA, and OR experience is not considered for acceptance to school. The reason for requiring ICU experience is to have students already proficient in managing lines, drips, and airways, which are the primary focus of the CRNA. The only benefit I can see is already knowing the OR environment.

sawms · Jul 27, 2013

I was a scrub tech for about 13 years in plastics before returning to nursing school. When I started nursing school I only knew two things about my nursing future: It would not be bedside nursing and nowhere near Ped's. Anyway, I did my practicum in the OR and knew I was home. I went right into the OR after passing NCLEX. I am one of the fortunate OR nurses that also scrubs. Sadly, this is a skill that is no longer taught in nursing school, but definitely gives you a heads up when you want to be in the OR as a circulator. I am considered a perioperative nurse as I work in all aspects of surgical care, preop, OR, and PACU. Currently I work a steady "PRN" job two days a week and agency two days a week all at ambulatory surgery centers. This works best for me as I get exposure in different specialties and different aspects of care. my steady "PRN" is in the OR circulating and my agency assignments can be pre, post or scrubbing. Typically if an OR nurse is looking for more responsibility in the OR and an increased pay (I can't validate if it is more), they will move on to first assist or RNFA. Perioperative nurses are more involved in patient care as Sweet_Wild_Rose stated in her post. CRNA's focus on anesthesia and don't really carry their "nursing" role into the perioperative setting. They are not always familiar with the equipment used in the OR or the instruments for each case. CRNA's are independent providers and definitely have more decision making authority in reference to the care of the patient. For me, perioperative nursing is about being there for the patient, being their voice when they are most vulnerable and cannot speak for themselves. I enjoy perioperative nursing, I think there is more autonomy in nursing in this arena. Duties are different depending on the facility, but for me, I check all the equipment before each case, bring in what equipment is necessary, pull extra instruments and suture that are frequently called for to cut down on time outside of the surgical suite, do my own preoperative assessment on each patient, and never leave the patients side until they are asleep. With that being said every setting is different and so is everyone's experience.

Good luck with whatever you choose!!!

kguill975, MSN, APRN, NP · Jul 28, 2013

I was also a scrub tech, before going to nursing school, so it was a natural transition from the scrub role to the circulating role. From there, I went on to become a Surgical NP/First Assist, so my love for the OR is still at the fore front, plus I still work weekends as an OR nurse.

I've known 3 OR nurses who went on to get ICU experience to go to nurse anesthesia school. They love being a CRNA, and don't regret leaving.

It would be a good idea to shadow a CRNA to see if you would be interested. It's a lot more than just intubations and pushing meds. Good Luck!

rwilliams22 · Jan 7, 2014

I am in a similar situation. I was a surgical tech for six years and became a nurse. I was not sure if I wanted a career in OR once I finished because I wanted to experience something else. It has been very difficult as a new grad to find a position, but I finally did and for the past two months I have been a triage nurse at a clinic. I love the variety and patient interaction. Recently I was offered a position as an OR nurse. I'm wondering if I should go for it. There are many positives if I take it. Do I have room to negotiate as a new grad even though I have OR experience??