Working in the OR as a nurse

December 12, 2014

Article by Global Pre-Meds
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A Gap Medics student on placement in the operating theatre

One area of nursing that can be exciting and provide a lot of direct patient care is working as an operating room nurse. But not all nurses working in the operating room do the same thing.

Different functions of OR nurses

There are three different classifications of operating room nurses, all of which have different responsibilities.

Scrub nurse

A scrub nurse is a registered nurse who works in the sterile field and performs a variety of functions during a surgical procedure. A scrub nurse may prepare the operating room including laying out and organizing instruments. They also assess the patient once they arrive in the operating room prior to the start of the surgical procedure. They may help prepare the patient including attaching equipment and monitors. During the procedure, scrub nurses may pass instruments to the surgeon and monitor the patient during the procedure.

Circulating nurse

 Another option for those interested in working in the operating room is working as a circulating nurse. Circulating nurses have different responsibilities than scrub nurses. For example, circulating nurses may ensure all patient paperwork is completed, such as consent forms. During the procedure, nurses may also document what takes place. Circulating nurses may also replenish surgical supplies as needed during the procedure. After the procedure, they may verify instrument count and complete charting.

Registered nurse first assistant

A registered nurse first assistant is a very specialized area of nursing. An RN first assistant assists the surgeon during a surgical procedure. The exact responsibilities vary depending on the type of surgery and the individual surgeon’s preference. But RN first assistants generally control bleeding, suture incisions and intervene during complications. For example, if a patient develops an abnormal heart rhythm during the procedure, an RN first assistant may administer medication to treat the condition.  

RN first assistants may also care for patients before surgery, such as providing pre-operative instructions or answering questions. After surgical procedures, RN first assistants may assess patients to see how they are recovering and provide discharge instructions.

How to get started working in the operating room

All three areas of surgical nursing are different and may have different requirements to get started. Nurses interested in working in the operating room will need to become registered nurses. Although some facilities may hire nurses with a two-year degree, many hospitals prefer to hire nurses with a bachelor’s degree.

Nursing school will include classes in microbiology, nutrition, and community health nursing. Clinical rotations in areas, such as pediatrics, emergency room care, and obstetrics is also part of most nursing school’s curriculums.

After graduating from nursing school, nurses must pass the state licensing exam, which is called the NCLEX. Most hospitals require nurses to have additional training before they can work in the operating room. Gaining experience in any area of nursing, which provides direct patient care is helpful.  But working in the emergency room, recovery room or intensive care unit is especially advantageous.

After gaining experience as a nurse, additional training is often required. Some hospitals offer periodic surgical nurse training classes at their facility. In other cases, nurses are hired and trained on the job. Training programs may vary but are often between six months and a year.

Working conditions

Operating room nurses work in both large and small medical centers. Depending on the size of the hospital, nurses may have a chance to specialize in a particular type of surgery.  In addition to hospitals, employment may also be found in outpatient surgery centers.

For those working in a hospital, operating room nurses are needed on all shifts. In some cases, nurses may also have to be on call for additional surgeries, which may arise.

If you are considering working in the OR, you can expect to work long hours. Although not all procedures are lengthy, many are. Nurses should have good stamina and physical strength. It is not uncommon for OR nurses to be on their feet for several hours during a surgical procedure.

Traits needed

Nurses who work in the operating room should be problem solvers and be confident making critical decisions. Although nurses in the OR, work under the supervision of a surgeon, they still need to be able to function independently. Surgeons depend on their team, including nurses, to perform their job without a lot of direction.

OR nurses should also work well as part of a team since they will be collaborating with other medical professionals. Good communication skills are also a must. OR nurses may be instructing patients, talking with families and conveying information to other healthcare workers. The ability to communicate information quickly, concisely and accurately is an essential aspect of the job.

Being detail oriented is also a needed skill for OR nurses. Small mistakes in the operating room can have a big impact on a patient’s condition. Nurses must also be able to handle several things at once. For instance, they may need to listen to the surgeon, monitor the patient and assist with the procedure at the same time.

Pros and cons

There are pros and cons to almost any career and working as a nurse in the OR is no different. OR nursing has several pros. For instance, working in the operating room can be challenging and exciting, and no two days are exactly the same.

Although it can be a rewarding and great career choice for many, it does have some potential cons. Nurses working in the operating room may have to deal with stressful situations and cope with the loss of patients. The hours can be long, which is physically and emotionally draining.


Salaries for operating room nurses may depend on their role. For example, RN first assistants often earn more than circulating nurses. In addition, the years of experience and credentials a nurse has also affects how much they will earn. According to the Association for Perioperative Registered Nurses, the average salary for nurses working in the operating room in 2013 was between $75,000 and $100,000 a year.


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Gap Medics provides year-round hospital work experience for people aged 16 and over. Our shadowing placements offer a unique insight into the work of doctors, nurses, midwives and dentists – helping students to focus their career aspirations before embarking upon medical training.