What Is Perioperative Nursing? A Career Guide

Perioperative nursing is an exciting and rewarding career path taken by some registered nurses. Perioperative nurses — also known as operating room nurses — fulfill surgical nursing roles before, during, and after surgical procedures. They work closely with patients and a team of health care professionals as they perform a wide variety of tasks.

Our career guide about perioperative nursing includes details about potential job duties, work environments, and salaries. We’ve also included information about education, certification, and licensing you may need to become a perioperative nurse.

What is perioperative nursing?

Perioperative nursing is a specialty where highly trained registered nurses perform preoperative, intraoperative, and postoperative care for surgical patients. They work alongside other nurses, doctors, surgeons, and anesthesiologists as part of a patient’s surgical team. Perioperative nurses might work in hospital surgical departments, doctor’s offices, and outpatient surgery centers.

What does a perioperative nurse do?

A perioperative nurse often plays the role of patient advocate while the patient is undergoing surgery. This means they’re always on the lookout for the patient’s best interests. They may help make important care decisions and ensure proper safety procedures are followed by those in the operating theater.

Here’s a look at a few specific roles within perioperative nursing.

Perioperative nurse roles and job duties

Perioperative nurses play a variety of roles, with some operating room positions being more specialized than others.

• Pre-op nurses prepare patients before surgery by completing tasks like taking vital signs and starting IVs. They also provide patients and family members with medical explanations and emotional support. Pre-op nurses ensure patients are stable for surgical procedures and that all the proper paperwork is completed.
• Nurses who work inside the operating room during surgery are known as intra-op nurses. They might fulfill roles like instrument nurse or circulator. Instrument nurses — also known as scrub nurses — manage the sterile instruments and equipment during surgery. They’re also expected to anticipate the surgeon’s needs. A circulating nurse doesn’t scrub in but still assists with patient care and the needs of the team.
• Post-op nurses — also called PACU nurses — are responsible for receiving patients after surgery. They work in post-anesthesia care units to monitor a patient’s condition for up to three hours. PACU nurses make sure the patients aren’t experiencing any medical complications. They also ensure that it’s safe to discharge a patient from the hospital or transfer them to another department for further recovery.

Depending on their job duties, a perioperative nurse might have to:

• Clean and maintain surgical tools
• Ensure all OR equipment is in good working order
• Discuss treatment and recovery with patients and caregivers
• Collaborate with intensive care units (ICUs)
• Uphold sanitation and safety policies
• Monitor and communicate a patient’s condition
• Manage patient care from pre-surgery to recovery

What education do you need to become a perioperative nurse?

To apply for a perioperative nursing position, you must already be a licensed registered nurse (RN) in good standing. To become an RN, you’ll need to complete a two-year associate degree in a nursing program or a four-year bachelor of science in nursing (BSN) program. Some hospitals also offer nursing education programs and certifications.

Recent graduates will likely need to complete a nursing internship to gain hands-on knowledge and experience. There may also be a didactic portion of the internship where you’re taught what to do before you can actually assist with surgical care.

Depending on your goals, you can also earn higher-level college degrees in nursing during your career. You must complete a master’s of science in nursing (MSN) or a doctor of nursing practice (DNP) degree to become an advanced practice registered nurse (APRN). An APRN can go on to become a surgeon’s assistant.

More established RNs can also face lengthy orientations after accepting a perioperative nursing position. It’s especially common when an RN is coming from a different specialty. For example, if a nurse has never worked in pediatrics before, they’ll have to receive further instruction before they can perform their perioperative nursing job duties unsupervised.

What exams do perioperative nurses have to pass?

After gaining a degree or certification in nursing, those interested in becoming a registered nurse must pass a licensing exam.

The National Council of State Boards of Nursing (NCSBN) prepares the National Council Licensure Exam for Registered Nurses (NCLEX-RN) as a measure to protect the public from unsafe nursing care and to license qualified individuals. All prospective perioperative nurses must pass the NCLEX-RN exam.

Prepping for the exam is an important step toward being able to enter the nursing career path you desire. Many nursing students need extra help to pass this major test. If you struggle to learn from traditional lectures and textbooks, you may find more success with expert instructional videos and new study methods. Taking NCLEX-RN practice exams may also help you feel better prepared and pass the test on your first try.

Continuing education opportunities for nurses

To continue offering the best care in a surgical setting, nurses should keep learning about their specialties. Professional organizations, like the Association of Perioperative Registered Nurses (AORN), offer support, resources, and continuing education opportunities.

The Competency and Credentialing Institute (CCI) is an international leader in perioperative nursing education. They promote and offer continuous professional development to nurses to continually increase the safety and quality of patient care. CCI’s industry-leading certificate program includes six specialty perioperative nursing certifications that are valid for two to five years:

• Certified Perioperative Nurse (CNOR)
• Certified Surgical Services Manager (CSSM)
• Certified Perioperative CNS (CNS-CP)
• Certified Ambulatory Surgery Nurse (CNAMB)
• Certified Foundational Perioperative Nurse (CFPN)
• Nursing Professional Development Advance – Board Certified (NPDA-BC)

As a certifying agency, CCI validates a nurse’s knowledge, skills, and abilities. Certification shows that you’re highly committed to patient safety and understand current best practices in perioperative nursing. Certification may also lead to career advancement and higher earnings.

How to become an RN first assistant

A registered nurse first assistant (RNFA) is an advanced perioperative intra-op nurse. As the surgeon’s main assistant, an RNFA may perform tasks like suturing, wound management, and cutting tissue.

To become an RNFA, an RN or APRN must complete an RNFA educational program and earn certification from the National Assistant at Surgery Certification (NASC) board. An RN must have completed a bachelor’s degree to qualify for entry into an RNFA nursing program. They also have to earn a CNOR certification, which requires two years of perioperative nursing experience.

How much do perioperative nurses make?

The salary of a perioperative nurse varies based on years of service, location, and job duties. On average, an entry-level perioperative nurse makes around $28 per hour or $58,240 per year. More experienced nurses may earn up to almost $40 per hour or $83,200 annually.

Perioperative nurses may earn more than these averages, especially when and where demand is high for very skilled OR nurses. Nurses are also paid extra for working overtime.

Start your journey to become a perioperative nurse

Perioperative nursing is for RNs who are interested in working with surgery patients. The right candidates are stable and strong individuals who can stay calm amid chaos and continue working under pressure. Perioperative nurses also need excellent communication and organizational skills, and they must be able to work in harmony with a diverse team of medical professionals.

If you’re interested in becoming a perioperative nurse, start by achieving the necessary educational requirements and preparing for your exams. With thousands of videos, prep questions, and more, SimpleNursing can help reduce your study time, raise your test scores, and improve how you learn. Join SimpleNursing for free to see how the most trusted resource for nursing students can help you today.