How to Become a Surgical Nurse


Although all registered nurses spend some time in the operating room during their initial education, surgical, or perioperative, nursing is a specialty that requires extensive additional training. Some organizations require that an aspiring perioperative nurse obtain experience in general, critical care or emergency nursing prior to becoming a perioperative nurse. Specific perioperative nursing courses may be available, although some perioperative nurses train on the job.

Perioperative Nursing Duties

  • Perioperative nurses have three main functions in the operating room: scrubbing, circulating or working as an RN First Assistant. The scrub nurse manages the sterile area, and hands instruments or other sterile items to the surgeons. The circulating nurse moves about the operating room, brings equipment or supplies, and may go out to the waiting room to keep family members informed about the patient. RNFAs work directly with the surgeons as the surgical assistant. They may help expose a wound, suction blood, apply traction or place sutures.

Educational Programs

  • All registered nurses have three options for their initial education: a two-year associate degree, a two- or three-year nursing diploma, or a four-year bachelor’s degree. Although any of these meet the requirements for the national NCLEX-RN licensing exam, the Bureau of Labor Statistics notes that RNs with bachelor’s degrees are likely to have better job opportunities. Many organizations offer Periop 101, a program developed by the Association of periOperative Registered Nurses. This training program is based on the AORN’s guidelines for perioperative practices, and is designed to be used with an experienced perioperative preceptor. An RNFA must complete an additional educational program that meets AORN’s standards.

Skills and Qualifications

  • In addition to education, perioperative nurses should have specific skills and qualifications for the job, according to the AORN website. Emotional stability is very important, and the nurse must be able to interact with all kinds of people, even in tense, stressful situations such as an emergency surgery. All nurses need empathy, collaborative and communication skills. Perioperative nurses need physical strength and stamina to spend long hours on their feet, transport patients and move equipment. Leadership skills are also important, as they may need to direct other members of the surgical team or allied health personnel, or coordinate the patient’s care in the operating room. Finally, perioperative nurses must be able to make good decisions, often without complete information.

Licensing and Certification

  • Although a license is required to practice as an RN, certification is optional. Some organizations, however, may prefer or require the RN CNOR, or Certified Nurse Operating Room, certification. To become certified, you must have a current, active RN license and be working in the perioperative nursing area, such as perioperative clinical practice, education, research or administration. You must also have a minimum of two years or 2,400 hours of clinical practice, at least half of which is in the operating room setting. A fee is required for the examination, which is computer-based. You must re-certify every five years by completing specific continuing education credits.

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