Choosing a career path is no simple matter. We all want to feel fulfilled and energized by our jobs. We want to learn and feel useful. We want to earn good money while striving to achieve work-life balance.
To make matters even more complex, there is no one-size-fits-all career choice. Nurses have diverse personality types, interests, and skills and will thrive in very different work settings. Therefore, finding the ideal nursing career path is a very personal journey.
Are you interested in operating room nursing?
In this ultimate guide, you will find everything you need to know about operating room nursing to help you decide if this highly demanded specialty is for you. Learn about:
- Current salary projections
- Work environments
- Becoming an OR nurse
- Personality traits needed to thrive
What does OR stand for?
The abbreviation OR stands for operating room. The definition of an operating room is literally: a room in a hospital where operations are performed.
What does surgical nurse mean in medical terms?
Surgical nurses specialize in perioperative care, providing care to patients before, during, and after surgery.
Some surgical nurses sub-specialize in one of these 3 stages of care:
- Pre-operative
- Intraoperative
- Postoperative
While the terms are often used interchangeably, “OR nurse” usually refers specifically to intraoperative nurses—those who work alongside surgeons and anesthesiologists during the actual operation.
Furthermore, OR nurses can also sub-specialize in specific areas, such as pediatrics, neurology, general surgery, urology, cardiology, or oncology.
Common surgeries in the US
The following are some of the most common surgeries performed in the United States, with which OR nurses assist:
- Appendectomy
- Breast biopsy
- Cataract surgery
- Cesarean section or c-section
- Coronary artery bypass or bypass surgery
- Debridement of wound, burn, or infection
- Dilation and curettage (D&C)
- Free skin graft
- Hemorrhoidectomy
- Hysterectomy
- Low back pain surgery
- Mastectomy
- Prostatectomy
- Release of peritoneal adhesions
- Tonsillectomy
How much do OR nurses make?
Salaries for OR nurses have risen steadily due to the continued demand for specialized surgical skills. In 2026, the national average for registered nurses (RNs) has climbed significantly.
Average RN salaries by setting
The setting where you work remains one of the biggest factors in your take-home pay.
Advanced practice salaries
Advanced practice registered nurses (APRNs), such as nurse practitioners or clinical nurse specialists in surgical settings, have seen even greater gains:
- Average APRN salary: $132,000–$153,000 per year
- Hospital inpatient roles: As high as $189,000, depending on the region and sub-specialty
Where do operating room nurses work?
OR nurses work wherever surgeries take place. Primary workplaces include:
- Hospital surgical departments: Inpatient and outpatient suites, medical-surgical units
- Ambulatory surgery centers (ASCs): Fast-paced, day-surgery operating rooms
- Specialty clinics: Focused surgeries such as plastics, ophthalmology, or orthopedics
- Physicians’ offices: Minor, minimally invasive procedures
Lately, we see an increasing shift toward ambulatory surgery centers (ASCs) as more procedures move outside the traditional hospital setting
What is a surgical unit in a hospital?
Hospital surgical units may provide different types of care. Some offer intensive care, such as surgical intensive care units (SICUs).
On the other hand, others may provide non-intensive care, such as surgical units caring for pre- and post-surgical patients or performing certain types of orthopedic joint surgery.
What does a surgical nurse do?
Surgical nurse responsibilities differ depending on the phase of surgery they assist with.
Some nurses focus on caring for patients before surgery; others assist with the surgeries themselves, and others care for patients after surgery. Each of these surgical nursing roles implies different duties.
What is the specific role of an OR nurse?
Whereas pre-op nurses help prepare patients for surgery and post-op nurses care for patients after surgery, intra-op or OR nurses assist with the surgeries themselves. In turn, intra-op nurses may also have different roles within the OR.
- Scrub nurses: These nurses prepare the operating room for surgery by sterilizing the room and hand instruments. They also anticipate the surgeon’s needs during surgery, being ready to pass the surgeon's instruments and supplies.
- Registered nurse first assistants (RNFAs): RNFAs assist surgeons directly during surgery by controlling bleeding, suturing, dressing wounds, monitoring vital signs, and watching for signs of complications.
- Circulating nurses: For the most part, circulating nurses fulfill the role of pre-op nurses, helping prepare patients and family members for surgery. Nevertheless, they also play an important role during surgery by keeping the family informed about the operation's status. They also help in the OR, assisting the anesthesiologist or scrub nurse, answering phones, etc.
How to become an operating room nurse?
Nurses need to become licensed registered nurses (RNs) to work in an OR.
To become RNs, potential nurses can pursue an Associate Degree of Nursing (ADN) or a Bachelor of Science in Nursing (BSN). While many facilities still hire ADN-prepared nurses, most job postings for this specialty specifically require a BSN.
BSN-prepared nurses earn, on average, $10,000–$17,000 more annually than their ADN counterparts.
Rasmussen University analyzed 62,000 OR nurse job postings and found that 61% accepted candidates with ADNs, while 37% required BSNs. Therefore, although many ADN-educated RNs can find work in ORs, obtaining a BSN opens more job opportunities for nurses.
Surgical nurse certification
In addition to becoming a licensed RN, any nurse should obtain a Basic Life Support (BLS) certification. This 1-day course trains nurses and other participants to recognize life-threatening emergencies quickly, perform high-quality chest compressions, deliver appropriate ventilations, and use an automated external defibrillator (AED) promptly.
In addition, surgical nurses must hold the Advanced Cardiovascular Life Support (ACLS) certification. This course builds on the foundation of BLS skills, emphasizing the importance of continuous, high-quality cardiopulmonary resuscitation (CPR).
In addition to the required basic certifications, surgical nurses may pursue other credentials. The Competency and Credentialing Institute (CCI) offers the following surgical certification options for RNs:
- Certified Perioperative Nurse (CNOR): The gold standard for perioperative nurses
- Certified Surgical Services Manager (CSSM): For those moving into surgical management
- Certified Ambulatory Surgery Nurse (CNAMB): Specifically for the growing ambulatory surgery sector
How long does it take to become an operating room nurse?
If nurses want to certify as surgical nurses, they must have approximately 2 years of work experience after graduation before obtaining a surgical nurse credential.
Furthermore, pursuing a master’s in nursing requires an additional 2-3 years of training, in addition to the often-required 2 years of prior work experience.
Is surgical nursing hard?
Although many nurses love working in the OR and wouldn’t change their jobs for any other, certain challenges seem to come hand-in-hand with the job. According to OR nurses on Reddit, these are the greatest challenges of working in the surgical specialty:
“...the OR is a lot like the military. Know your rank. You’re a recruit, so shut up and be able to take direction well, and know when to speak up. It’s a fine line. That’s the personality aspect of it- that’s the hardest part.”
“The personalities though...yeah, very strong personalities.”
“A lot of my struggle has been speaking up, learning to be assertive, etc. In high school I was varsity captain of a national volleyball league, top of my class, very outspoken and competitive type. The hospital is just a different game to me- everything is done in very specific ways...you need to know when to keep your mouth shut and when to speak up.”
Why choose operating room nursing?
If you enjoy a highly controlled, detail-oriented environment where you focus on one patient at a time, the OR is likely your home.
With the rise of internal agency roles, OR nurses also have more flexibility than ever, often choosing higher-paying local contracts that offer the pay of a travel nurse with the stability of staying home.
What makes a good surgical nurse?
These are some of the traits that make for an excellent perioperative nurse:
- Detail-oriented: OR nurses must be meticulous with hygiene when preparing the operating room and the surgical instruments. They must also monitor patients’ vitals during surgery and take detailed notes.
- Critical thinking: Surgeries are complex, fast-paced situations. Nurses must be able to act quickly and even anticipate surgeons’ needs.
- Emotional intelligence: While the patient is asleep during the intra-op phase, the family is not. You are their advocate.
- Anticipation: Knowing what tool the surgeon needs before they ask.
- Physical stamina: Expect to be on your feet for 8, 10, or 12 hours at a time.
Tips for new OR nurses
For seasoned OR nurses, effective communication, teamwork, and organizational skills are second nature, and these are 3 skills that new surgical nurses must strive to develop.
Effective communication
A review of 16,000 hospital deaths due to error found that communication errors were the primary culprits, causing twice as many deaths as clinical inadequacy.
Since nurses act as liaisons between physicians, patients, and family members, excellent communication skills are indispensable.
Teamwork
Surgeons and anesthesiologists depend on nurses to perform successful surgeries. Furthermore, nurses depend on one another.
For example, once a nurse is scrubbed in, they depend on circulating nurses to get additional supplies from outside the OR. Surgical teams may develop this skill to such an extent that surgical team members often won’t even need to voice requests.
For instance, a nurse may have an instrument ready before the surgeon asks for it. Therefore, as a new nurse, try to anticipate your team members’ needs and don’t be afraid to ask for help.
Organization
Working in the emergency room or an ICU may be chaotic, but the environment in an OR is highly controlled. Everyone in the OR has a specific role, and every object has a specified place. Even when complications arise, there is an established plan or protocol.
Due to the nature and requirements of operating rooms, OR nurses must strive to be highly organized and detail-oriented.
Are you cut out for the OR?
Do you think this nursing specialty might be for you?
The journey to the OR is rigorous, but for the right person, it is one of the most rewarding seats in the house. Need some guidance on choosing your specialty?
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