Dissecting the Critical Role of an Operating Room Nurse

Nurses are known for staying cool and collected under pressure, but RNs who work in the stressful environment of the operating room (OR) seem to have superhuman abilities to focus and be calm. Even routine surgeries can have complications and must be handled with precision and care. These operating room nurse jobs aren’t for the faint of heart!

Despite the potentially stressful work environment, you could see yourself working in the OR—but you aren’t sure if you have what it takes. Being an operating room nurse isn’t as easy as handing the surgeon a scalpel like you’d see on TV!

Just like other nursing specialties, working in the OR comes with pros and cons. Join us as we learn what it’s really like for nurses in the OR, from their typical job duties to the qualities they need to do their jobs well.

What do OR nurses do?

There are several nursing specialties that work with patients who are undergoing surgery. You might hear the term “perioperative nurses” to describe RNs who work with patients before, after or during surgery. These distinct job duties may be combined in the OR nurse job description or they might remain separate specialties, depending on the healthcare facility.

Pre-op nurses assist with preparing the operating room and patients before surgery. Some of their job duties include:

• Ensuring that patients have had the necessary lab work done before surgery
• Reviewing patients’ medical history
• Communicating with patients and their families about the procedure and any risks involved
• Making sure that all necessary paperwork has been signed
• Starting IV lines and assessing patients’ physical condition before surgery

Intra-op nurses are the RNs who are actually inside the operating room during surgery. The Association of Perioperative Registered Nurses (AORN) divides these nurses into three types, each with their own special tasks in the OR:

• Scrub nurses who hand the surgeon necessary tools and supplies
• Circulating nurses who monitor the overall environment of the OR and ensure a safe, sterile field
• RN first assistants who actively help with surgeries by assisting the surgeon in controlling bleeding and suturing wounds

Post-anesthesia care (PACU) nurses care for patients during the first few hours after surgery. These nurses assist patients as they begin their recovery, including duties like:

• Monitoring patients as they come out of anesthesia and watching for signs of infection or excessive bleeding
• Offering pain management and helping patients stay comfortable
• Communicating with patients and their families about effects of the surgery and explaining next steps for post-op care

OR nurses can choose to specialize even further by focusing on a specific type of surgery, such as cardiac, trauma, pediatric or ear/nose/throat.

Where do OR nurses work?

Many OR nurses work in hospitals, but these RNs are also needed in locations like cancer centers, traveling operating rooms and surgical centers. These locations come with a few on-the-job differences, but one thing they all have in common is the operating room itself. OR nurses can expect to work in a sterile environment during surgeries. They need to follow best practices to keep equipment and scrubs part of the sterile field for patient safety.

Although many surgeries are scheduled during regular daytime hours, urgent situations might require emergency surgeries. These unplanned surgeries can happen at any time of day or night and require fast preparations. Unfortunately, accidents and the resulting emergency procedures that come with them don’t follow a typical 9 to 5 schedule, so prospective OR nurses should expect the potential for overnight, on-call or otherwise non-traditional work schedules.

What are some common surgeries OR nurses assist with?

The types of surgeries an OR nurse encounters depends largely on the type of healthcare facility they work at. However, there are several surgeries that are more common than others, according to Stanford Health Care:¹

• Appendectomy
• Breast biopsy
• C-section
• Coronary bypass
• Lower back surgery
• Mastectomy
• Tonsillectomy

OR nurses should expect to see some of these common surgeries during their time in the operating room.

What skills and qualities do OR nurses need?

Of course there are important technical skills OR nurses need to succeed on the job. This includes general nursing skills, like patient care and case management, as well as more specialized skills like maintaining a sterile field.

But it also takes a certain set of soft skills to be successful in this nursing specialty, according to the AORN. OR nurses must have strong communication skills as they share surgery details with patients and families, as well as physicians and other medical staff. They should be detail-oriented as they need to meticulously maintain the sterile field of the OR. And they should bring plenty of empathy to the table as they interact with families who may be experiencing a wide range of difficult emotions.

How do you become an OR nurse?

Working in an operating room sounds intimidating, but OR nurses are well-prepared for the job thanks to the required training and education. The first step for any would-be OR nurse is to first become a nurse by enrolling in nursing school, completing the required clinical training and passing the National Council Licensure Examination (NCLEX).

Some employers will hire OR nurses with a two-year associate of nursing degree (ADN), but many may prefer RNs who have a bachelor of science in nursing (BSN)—our analysis of over 62,000 operating room nurse job postings’ minimum education requirements found that 61 percent were seeking candidates with an ADN, while 37 percent were seeking candidates with a BSN.² Only registered nurses in good standing with their licensing are able to work.

There are also several certifications available for OR nurses. Although these are optional, they can show employers that you’re committed to a surgical specialty. The Certified Perioperative Nurse Credential (CNOR) or the Certified Ambulatory Surgery Nurse credential (CNAMB) can both be earned by meeting eligibility requirements and passing an exam.

Can you make the cut in the OR?

Now that you know what it’s like to be an operating room nurse, you might be able to picture yourself working in this medical setting. This role requires a unique set of nursing skills and comes with challenges that might not appeal to every nurse—but those who do enjoy it will thrive. If you’d like to get started on the first step to becoming an OR nurse, visit the Rasmussen University Professional Nursing Associate’s degree page to learn more.

If OR nursing doesn’t sound like a great fit for you, don’t sweat it! There is a wide variety of nursing roles to potentially apply yourself to. To learn more about your options, check out our article, “Top 25 Types of Nurses Employers Are Looking to Hire.”

¹Stanford Health Care, General Surgery – Common Surgical Procedures, [accessed April, 2020] https://stanfordhealthcare.org/medical-treatments/g/general-surgery/procedures.html
²Burning-Glass.com (analysis of 62,339 operating room nurse job postings, May 1, 2019 – April 30, 2020)