Everything You Need To Know About The Operating Room (OR) Nurse

The field of nursing is one of the most diverse fields in medicine. Once you’ve gotten your nursing license, there are several nursing fields that one can venture into for upward mobility and career growth. One of these is the operating room nurse, also known as a surgical nurse or perioperative nurse.

In this article:

• Who is an OR nurse?
• What do OR nurses do?
• Where OR nurses work
• OR nurse requirements
• Types of OR nurses
• OR nursing careers

Who is an OR nurse?

An operating room nurse is a registered nurse who works in the operating room, taking care of patients during invasive surgery or medical procedures.

What do OR nurses do?

The duties of an operative nurse usually depend on the stage of the surgery . Some of the most common surgeries handled by operative nurses include C- sections, mastectomy, breast biopsy, tonsillectomy, and coronary bypass.

Preoperative Duties

These are the duties carried out by the nurses before the surgery starts. They mostly include evaluation, preparation, and ensuring that everything is in place before the surgical process begins. Some of these activities include:

• Evaluating and educating the patient
• Developing a nursing care plan for the assigned patient
• Provision of critical patient medical history
• Ensuring that the operation room is sterilized
• Passing surgical instruments to the surgeon
• Starting IV lines and assessing the patient’s physical condition before surgery

Intraoperative Duties

These are the duties carried out by the perioperative nurse as the invasive surgery progresses. They mostly include evaluation and helping the surgeon whenever necessary as they progress with the invasive procedure. Some of these activities include:

• Passing medical instruments to the surgeon
• Monitoring the patient’s vital signs
• Assisting the anesthesia nurse with induction
• Helping with wound and drain dressings
• Preparing specimens for pathology

Postoperative Duties

These are the duties carried out by the perioperative nurse after invasive surgery. Like the preoperative procedures, they usually revolve around evaluation and checking if everything went as planned. Some of these include:

• Updating the patient and family about the surgery and the next steps to take
• Monitoring the patient’s vital signs as they wake up from anesthesia
• Patient discharge or transfer to another hospital unit
• Helping the scrub with the cleanup
• Providing a report to the anesthesia nurse

Where OR nurses work

Perioperative nurses are usually found in operating rooms in various medical facilities or in the departments that revolve around the operating room and its procedures.

Hospital Operating Rooms

A bulk of perioperative nurses are most likely to work in general service hospitals. Most general service hospitals have an operating room and handle various types of surgeries.

 Some of the surgeries handled in general service hospitals are mild or from conditions still in their early development stages.

Outpatient Centers

Outpatient centers or ambulatory centers are hospitals that focus on treating patients who do not require admission or overnight care. Perioperative nurses help with some outpatient surgeries, which don’t require admission or bedtime in most circumstances.  

More than half of the elective surgeries in the United States are performed as outpatient surgeries. These procedures mostly involve limited urologic, ear and nose procedures, nerve treatments, minor lumpectomy, meniscus repair, throat procedures such as tonsillectomy, and procedures that involve extremities.

Cancer Centers

Cancer centers are health facilities that deal with the treatment of advanced stages of cancer. Operations and invasive procedures in cancer centers mostly revolve around the cancer cells. These include curative surgeries, preventive surgeries, and diagnostic surgeries.

The most common invasive cancer treatments usually include removing cancerous tissue, the tissue surrounding the cancerous cells, and tumors. Perioperative nurses aid in the processes of all these operations.

Other locations

Most perioperative nurse’s careers don’t have to be tied to permanent employment at one medical center. Perioperative nurses can move from one health facility to another, filling staff shortages either nationally from state to state or internationally between countries.

Travel perioperative nurses usually stay in these facilities for short periods of time before moving to other facilities to help address nursing shortages. 

OR nurse requirements

Requirements to operate as a perioperative nurse vary from health facility to health facility after receiving a nursing degree. Going above the bare minimum and pursuing further certification increases one’s value and chances of securing quality employment as an OR nurse.

Two-year Associate of Nursing Degree

Obtaining a two-year Associate Nursing Degree is the minimum requirement to be licensed as a registered nurse. It’s possible to become an OR nurse with an Associate Nursing Degree alone, but employers often prefer further certification.

A Bachelor’s Degree in Nursing takes four years to complete. Two of these years are spent performing supervised clinical duties in a health facility. This degree is not a requirement to become an operating room nurse but is preferred by several employers. Some employers even require their OR nurses to complete this degree in the course of their employment.

Licensing

After completing a degree, aspiring OR nurses must pass the National Council Licensure Examination (NCLEX-RN) exam to become a registered nurse. This allows the nurse to obtain state certification and start practicing legally.

Work experience

Depending on the health facility, it may be required to have had experience practicing as a nurse before becoming a surgical nurse. Some health facilities offer a six-month to a one-year perioperative nurse training program.

Basic life support, as well as advanced cardiac life support, and a year of clinical experience, are requirements common in many hospitals to become an OR nurse.

Certificates / Credentials

Employers may require that aspiring OR nurses obtain a Certified Perioperative Nurse Credential (CNOR) in order to practice as an OR nurse.

Types of OR nurses

There are three broad types of OR nurses in any operating room.

Scrub nurse

A scrub nurse sterilizes the treatment area and generally prepares the operating room for surgery. It’s the responsibility of the scrub nurse to set up the surgical tools, count them, and ensure they are sterile. During the invasive surgery, the scrub nurse hands the surgeon various tools the surgeon needs to perform the procedure.

Circulating nurse

The circulating nurse passively participates in the surgery. It’s her responsibility to ensure that all protocols and procedures are observed during the operation. She is the patient’s advocate in the operation room and ensures that everything continues in the patient’s best interest.

She keeps track of the inventory and surgical tools used and is responsible for calling for a time-out.

RN first assistant

The RN First Assistant nurse participates actively in invasive surgery. They have the ability to intervene to prevent bleeding, stabilize rising and dropping blood pressure, administer life-saving drugs, and even offer CPR when the patient’s heart stops.

It is also the responsibility of the RN First Assistant to monitor the patient’s vital signs, such as blood pressure, heart rate, respiration, and pulse.

Closely related types of nurses

There are other types of nursing careers that bear many parallels with operating room nurses. These nurses also operate within the operating rooms, maybe specialized OR nurses, and help with the surgery when necessary. They include:

• Infection control nurses
• Nurse anesthetist
• Transplant nurses
• Nurse consultants

OR nursing careers

After becoming a licensed and certified operating room nurse, there are several career options that you can pursue from that point onwards. You can:

• Practice as an OR nurse in one single medical facility
• Practice as a travel perioperative nurse across states in several medical facilities
• Take administrative positions in operating room management
• Take administrative positions as a hospital nurse manager

Salary

The Bureau of Labor Statistics has not looked at specialized nurses separately but has data on the estimated yearly earnings of registered nurses.

The earnings of an OR nurse are dependent on various factors, including experience, medical facility, and level of study or specialization. AORN estimated the earnings of operative nurses to be an average of $69,900 a year in 2011 and $71,130 in May 2018.

The Bureau of Labor Statistics estimates that the median yearly earnings of registered nurses in America is $73,300 per year or $35.24 per hour. It is most likely that specialized nurses, such as OR nurses, are expected to earn higher than regular nurses.

Career Outlook

According to the Bureau of Labor Statistics, the career outlook for nursing in general, even before specialization, is positive – employment in the nursing sector is likely to grow by 7% between 2019 and 2029.