In the broad field of preoperative nursing, an operating room (OR) nurse fulfills a very specific and necessary role in the surgical process. While preoperative and postoperative nurses handle patient care before and after surgery, respectively, an OR nurse will be in the thick of things, providing patient care during surgery itself.
Of course, as with anything in medicine, there are further hierarchies and categories within the field of OR nursing. For someone wondering how to get started in OR nursing, it can be quite a learning curve! We’ll be delving into some of these roles and responsibilities throughout the rest of this article.
Whether you’re an active nurse looking for a career change or just getting started on your path through the wild and wonderful world of nursing, OR nursing may be the perfect career path for you. This article will help answer a few of the questions you may have about this specific role within the greater surgical nursing field.
Let’s get started!
Surgical Nursing Vs. Perioperative Nursing Vs. OR Nursing
To start, let’s make a few important distinctions clear: The terms surgical nurse and perioperative nurse mean the same thing. Some hospitals or surgical centers will refer to their surgery-based nursing staff as one or the other, but both titles functionally cover the same scope and responsibilities.
A surgical or perioperative nurse is a nurse involved in any sort of patient care within the surgical process. This can mean preoperative care (before the patient goes in for surgery), intraoperative care (during surgery), or postoperative care (after surgery).
In contrast, an OR nurse is any nurse specifically working in the OR. As a result, these nurses are typically only involved in the intraoperative portion of nursing. As an OR nurse, your role will be handling patients who are actively undergoing surgery and assisting doctors and other hospital staff with the surgical process.
However, this assistance itself can take several forms.
Role of an OR Scrub Nurse
A scrub nurse—sometimes known as an instrument nurse—is responsible for providing support to the medical professionals working directly with the patient during surgery.
In popular media, the scrub nurse can be seen standing nearby the doctor, handing them the instruments they need or request and sterilizing used equipment so it can be reused without risking infection.
The scrub nurse may also be responsible for monitoring and communicating patient vitals, ensuring that patient care is communicated and coordinated accordingly.
In some cases, the instrument nurse and the scrub nurse hold separate positions, in which the instrument nurse sterilizes the equipment and communicates patient vitals, while the scrub nurse is solely responsible for expediting the doctor’s work (adjusting equipment, handing off tools, etc.)
This setup typically depends on the size and protocols of the facility where the surgery takes place.
Role of an OR Circulating Nurse
Often, the operating room can feel like an isolated bubble within the facility. Once the lights go off, and the surgery is underway, everyone in the room must be in complete harmony and as free as possible from distractions.
However, surgery often takes complicated and unexpected turns, and with the patient being under anesthesia and unable to make decisions for themselves, someone needs to advocate for the patient’s wants and needs and communicate with the patient’s family throughout the surgery.
This role typically falls to the circulating nurse. As a circulating nurse, you will be “circulating” in and out of the room, providing updates for the patient’s family, advocating for the patient's interests in their absence, and generally providing a bridge between the operating room and the outside.
Role of a Registered Nurse First Assistant (RNFA)
RNFAs can contribute to surgery in a number of ways. They sit at the top of the nurse hierarchy within the OR and are among the most seasoned staff members on the team. As such, they provide more hands-on care for the patient throughout the surgical process, often physically assisting doctors during the surgery.
During a given surgery, the RNFA may suture the patient’s wounds, provide surgical site exposure (physically holding open a wound site), staunch the patient’s bleeding, and may even perform incisions. The RNFA’s work allows surgeons to focus on more precise surgical procedures knowing their patient is in capable hands.
Of course, the added responsibility of this role means that RNFAs must have a strong track record in the OR. They are also paid well for their work.
See also: What are the Highest Paying Nursing Specialties?
Other OR Nursing Roles
Every nurse knows that there are few hard-and-fast rules throughout the American healthcare system. Every hospital you work with is bound to have different protocols, setups, and hierarchies. To complicate this further, different facilities will require different staff, equipment, and jobs, based on the needs of their specific patients and the general care the facility provides.
In a surgical unit or OR, a nurse typically falls into one of the roles outlined above; however, the specifics of that facility will determine the exact role of an OR nurse and other staff.
For instance, some facilities may have a nurse helping with the anesthesia as well. This role requires specialty training and pays very well. This nurse will work with the anesthesiologist, monitoring the patient’s progress and directly administering anesthesia during the surgery.
Other nurses work at the periphery of the surgery, ensuring rooms are stocked with the right equipment, helping the patient prepare, and generally handling logistics in advance of the surgery.
While the ins and outs of OR nursing can seem challenging and complex, the setup of the OR staff usually depends heavily on the specific facility itself. That said, regardless of the facility, wherever help is needed for a patient to undergo surgery successfully, a nurse will be there to assist.
Interested in a Career in OR Nursing?
As mentioned above, OR nursing is a mixed bag of different roles, duties, and expectations. However, when the OR door closes and the lights go down, no one knows how the surgery will go. It will be your role as an OR nurse to roll with the punches and help the patient, whatever that may take.
If you tend to enjoy high-pressure environments alongside a tight-knit team, then OR nursing might be the best choice for you. You will be able to see the direct result of your work every day a patient leaves the OR after a successful operation.
On the other hand, OR nursing can be very stressful, especially when surgery doesn’t go according to plan. The ability to improvise and follow instructions quickly is key in any OR nursing role.
At Nursa, we believe in helping nurses make informed decisions about their future nursing careers. We provide regular blog articles tackling every aspect of per-diem nursing and providing helpful information on various aspects of American nursing and the greater healthcare system. Visit our nursing blog for more information!
