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Role Transition: Operating Room (OR): Home

This is a guide for Role Transition students who have been placed in OR units/floors.

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Operating Room Nurse

What is an Operating Room (OR) Nurse?

Also called perioperative nurses or surgical nurses, they are in charge of taking care of patients before, during and after surgery (American Mobile).

What does an OR Nurse do?

They provide pre- and post-op teaching, perform various roles in the operating room, care for patients in the recovery room (post-anesthesia care unit (PACU)), and provide post-surgical care on medical-surgical units. 

There are many surgical sub-specialties for learning, including neurosurgery, cardiac surgery, trauma, pediatrics, oncology, general surgery, urology, ophthalmology, ear/nose/throat, dental, orthopedics, plastic and reconstructive, and transplant surgery. (Nurse.org)

What are the Roles & Duties of an OR Nurse?

Surgical nurses assist with all aspects of surgery and there are a variety of Perioperative nursing roles including:

  • Scrub nurses work within the sterile field in the operating room. Their role is to set up the operating room for the patient, choose and handle instruments and supplies, hand surgical instruments to the surgeon, and many other duties. 
  • Circulating nurses work outside the sterile field, and manage activities in the operating room. They inspect surgical equipment, ensure that consent forms are signed, review pre-op assessments with the patient, and perform many other tasks.
  • RN first assistants (RNFAs) work with the surgeon to help with controlling bleeding, suturing,  watching for signs of complications, applying dressings and bandages, and carrying out many other functions. Additional education and training are required before becoming an RNFA. 
  • PACU (post-anesthesia care unit) nurses care for patients immediately after surgery and anesthesia to monitor them closely as they stabilize, preparing them to be transferred to the medical-surgical or intensive care unit as appropriate. 
  • Operating room directors / surgical services directors assume the business functions of running an OR. This includes managing budgets, staffing, and ordering equipment and supplies. This position can also prepare you for roles in management consulting, clinical nurse education, or work in medical technology and supply companies.
  • Medical-surgical nurses provide care to patients recovering from surgery. They provide close monitoring immediately post-PACU and –critical care, and apply a range of technical and assessment skills to ensure patient safety and recovery (fluid and medication administration, monitoring for signs of bleeding and infection, wound care, and many others). They also provide post-op teaching for patients and caregivers. (Nurse.org)
  • Ambulatory surgery / same-day surgery nurses are perioperative nurses who do not work in a traditional hospital OR, but in an ambulatory surgery center (ASC). Ambulatory surgery centers are health care facilities that provide outpatient procedures. This includes same-day surgical care, as well as diagnostic and preventative procedures. The same-day surgery nurse cares for patients before and after same-day surgery and some patients undergoing outpatient procedures.This unit is used not only for surgical patients, but also for patients requiring many kinds of I.V. therapy and blood transfusions, radiographic interventional procedures, recovering from upper endoscopies and colonoscopies, recovery from pain control procedures, and even pediatric patients having outpatient surgery might be admitted here.
also called perioperative nurses and surgical nurses, are in charge of patients scheduled for surgery. OR nurses are specialized registered nurses (RN) and, depending on the situation, may act as scrub nurses or circulating nurses. Scrub nurses hand surgical instruments to the physician, while circulating nurses oversee nursing care during the procedure and ensure the operatingroom remains sterile. An operating nurse also acts a liaison between the patient, the patient’s relatives and the medical team. After extensive additional education and training, you may also become a RN First Assistant and deliver direct surgical care. - See more at: https://www.americanmobile.com/mobile/NZArticle/?articleId=3439#sthash.n5kYjTKW.dpufalso called perioperative nurses and surgical nurses, are in charge of patients scheduled for surgery. OR nurses are specialized registered nurses (RN) and, depending on the situation, may act as scrub nurses or circulating nurses. Scrub nurses hand surgical instruments to the physician, while circulating nurses oversee nursing care during the procedure and ensure the operatingroom remains sterile. An operating nurse also acts a liaison between the patient, the patient’s relatives and the medical team. After extensive additional education and training, you may also become a RN First Assistant and deliver direct surgical care. - See more at: https://www.americanmobile.com/mobile/NZArticle/?articleId=3439#sthash.n5kYjTKW.dpufalso called perioperative nurses and surgical nurses, are in charge of patients scheduled for surgery. OR nurses are specialized registered nurses (RN) and, depending on the situation, may act as scrub nurses or circulating nurses. Scrub nurses hand surgical instruments to the physician, while circulating nurses oversee nursing care during the procedure and ensure the operatingroom remains sterile. An operating nurse also acts a liaison between the patient, the patient’s relatives and the medical team. After extensive additional education and training, you may also become a RN First Assistant and deliver direct surgical care. - See more at: https://www.americanmobile.com/mobile/NZArticle/?articleId=3439#sthash.n5kYjTKW.dpufalso called perioperative nurses and surgical nurses, are in charge of patients scheduled for surgery. OR nurses are specialized registered nurses (RN) and, depending on the situation, may act as scrub nurses or circulating nurses. Scrub nurses hand surgical instruments to the physician, while circulating nurses oversee nursing care during the procedure and ensure the operatingroom remains sterile. An operating nurse also acts a liaison between the patient, the patient’s relatives and the medical team. After extensive additional education and training, you may also become a RN First Assistant and deliver direct surgical care. - See more at: https://www.americanmobile.com/mobile/NZArticle/?articleId=3439#sthash.n5kYjTKW.dpufalso called perioperative nurses and surgical nurses, are in charge of patients scheduled for surgery. OR nurses are specialized registered nurses (RN) and, depending on the situation, may act as scrub nurses or circulating nurses. Scrub nurses hand surgical instruments to the physician, while circulating nurses oversee nursing care during the procedure and ensure the operatingroom remains sterile. An operating nurse also acts a liaison between the patient, the patient’s relatives and the medical team. After extensive additional education and training, you may also become a RN First Assistant and deliver direct surgical care. - See more at: https://www.americanmobile.com/mobile/NZArticle/?articleId=3439#sthash.n5kYjTKW.dpufalso called perioperative nurses and surgical nurses, are in charge of patients scheduled for surgery. OR nurses are specialized registered nurses (RN) and, depending on the situation, may act as scrub nurses or circulating nurses. Scrub nurses hand surgical instruments to the physician, while circulating nurses oversee nursing care during the procedure and ensure the operatingroom remains sterile. An operating nurse also acts a liaison between the patient, the patient’s relatives and the medical team. After extensive additional education and training, you may also become a RN First Assistant and deliver direct surgical care. - See more at: https://www.americanmobile.com/mobile/NZArticle/?articleId=3439#sthash.n5kYjTKW.dpuf
also called perioperative nurses and surgical nurses, are in charge of patients scheduled for surgery. OR nurses are specialized registered nurses (RN) and, depending on the situation, may act as scrub nurses or circulating nurses. Scrub nurses hand surgical instruments to the physician, while circulating nurses oversee nursing care during the procedure and ensure the operatingroom remains sterile. An operating nurse also acts a liaison between the patient, the patient’s relatives and the medical team. After extensive additional education and training, you may also become a RN First Assistant and deliver direct surgical care. - See more at: https://www.americanmobile.com/mobile/NZArticle/?articleId=3439#sthash.n5kYjTKW.dpuf
also called perioperative nurses and surgical nurses, are in charge of patients scheduled for surgery. OR nurses are specialized registered nurses (RN) and, depending on the situation, may act as scrub nurses or circulating nurses. Scrub nurses hand surgical instruments to the physician, while circulating nurses oversee nursing care during the procedure and ensure the operatingroom remains sterile. An operating nurse also acts a liaison between the patient, the patient’s relatives and the medical team. After extensive additional education and training, you may also become a RN First Assistant and deliver direct surgical care. - See more at: https://www.americanmobile.com/mobile/NZArticle/?articleId=3439#sthash.n5kYjTKW.dpuf

For more information on OR / surgical nurses, check out these professional organizations' websites:

  • Association of periOperative Registered Nurses (AORN): AORN members are part of a community of 43,000 professionals who share a passion for advancing perioperative nursing care and ensuring patient safety and optimal outcomes.
  • Certified Perioperative Nurse (CNOR) Certification: CNOR certification assesses the knowledge and skills of a perioperative nurse with a minimum of two years of clinical practice. More than 40,000 nurses internationally hold the CNOR credential and consider the designation a personal and professional accomplishment.
  • Registered Nurse First Assistant (RNFA): AORN defines the RNFA as a perioperative registered nurse who works in collaboration with the surgeon and health care team members to achieve optimal patient outcomes. Intraoperatively, the RNFA practices at the direction of the surgeon and does not concurrently function as a scrub nurse. The new RN First Assistant (RNFA) Educational Standards by the Association of PeriOperative Registered Nurses came out in December of 2013, requiring the completion of a formal, accredited college, RNFA Program for all perioperative nurses and APRNs practicing in the expanded role of first assistant at surgery.
  • American Board of Perianesthesia Nursing Certification, Inc. (ABPANC): The American Board of Perianesthesia Nursing Certification, Inc. (ABPANC) is responsible for developing, sponsoring and managing the Certified Post-Anesthesia Nurse (CPAN) and Certified Ambulatory Perianesthesia Nurse (CAPA) nursing certification programs. These national professional certification programs are designed for registered nurses caring for patients who have experienced sedation, analgesia and anesthesia in a hospital or ambulatory care facility.
  • Academy of Medical-Surgical Nurses (AMSN): Medical-surgical nurses provide care to adults with a variety of medical issues or who are preparing for/recovering from surgery. They have a broad knowledge base and are experts in their practice. Medical-surgical nurses have advanced organizational, prioritization, assessment and communication skills and are leaders in coordinating care among the interprofessional health care team. Medical-surgical nursing is practiced in several settings across the health care industry, including hospitals, outpatient settings, in homes, via telemedicine and other non-traditional settings.

Professional Organizations

For more information on OR / surgical nurses, check out these professional organizations' websites:

  • Association of periOperative Registered Nurses (AORN): AORN members are part of a community of 43,000 professionals who share a passion for advancing perioperative nursing care and ensuring patient safety and optimal outcomes.
  • Certified Perioperative Nurse (CNOR) Certification: CNOR certification assesses the knowledge and skills of a perioperative nurse with a minimum of two years of clinical practice. More than 40,000 nurses internationally hold the CNOR credential and consider the designation a personal and professional accomplishment.
  • Registered Nurse First Assistant (RNFA): AORN defines the RNFA as a perioperative registered nurse who works in collaboration with the surgeon and health care team members to achieve optimal patient outcomes. Intraoperatively, the RNFA practices at the direction of the surgeon and does not concurrently function as a scrub nurse. The new RN First Assistant (RNFA) Educational Standards by the Association of PeriOperative Registered Nurses came out in December of 2013, requiring the completion of a formal, accredited college, RNFA Program for all perioperative nurses and APRNs practicing in the expanded role of first assistant at surgery.
  • American Board of Perianesthesia Nursing Certification, Inc. (ABPANC): The American Board of Perianesthesia Nursing Certification, Inc. (ABPANC) is responsible for developing, sponsoring and managing the Certified Post-Anesthesia Nurse (CPAN) and Certified Ambulatory Perianesthesia Nurse (CAPA) nursing certification programs. These national professional certification programs are designed for registered nurses caring for patients who have experienced sedation, analgesia and anesthesia in a hospital or ambulatory care facility.
  • Academy of Medical-Surgical Nurses (AMSN): Medical-surgical nurses provide care to adults with a variety of medical issues or who are preparing for/recovering from surgery. They have a broad knowledge base and are experts in their practice. Medical-surgical nurses have advanced organizational, prioritization, assessment and communication skills and are leaders in coordinating care among the interprofessional health care team. Medical-surgical nursing is practiced in several settings across the health care industry, including hospitals, outpatient settings, in homes, via telemedicine and other non-traditional settings.