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Perioperative Nurse Career Guide

Find your purpose in the operating room

Join the fast-paced, team-based, patient-centric perioperative nursing specialty

Video transcript:

0:19
SPEAKER 1: Estelle (Tess) Stansell, BSN, RN Clin II, Circulating Nurse
They told me what a periop nurse does, and I was, like, that’s for me.

0:23
SPEAKER 2: Elizabeth Selden-Bowie, BSN, RN, CNOR, Nurse Professional Development Practitioner
And the main fascination for me—it was the technology, it was the teamwork and the collaboration, how everybody really knew what they were doing. And I'm, like, “Oh, this is so it, I have got to make my way to surgery.”

0:37
SPEAKER 3: Jean-Tyler Scalone, MSN, RN-BC
Nursing is a gift that you get to do every day. And procedural nursing? To me, that's one of the greatest gifts.

0:43
SPEAKER 4: Nokomis Neisz, BSN, RN Clim II
It's so outside the box, it's, it's even hard to describe. It's very fulfilling. Every day is fulfilling. I love my job. I wouldn't change it for anything.

0:54
SPEAKER 5: Colin Mudrick, MD, Orthopedic Surgery
I think people go home and they feel good about what they've done and they can see results directly.

1:02
SPEAKER 6: Charles Blair, RN, Scrub Nurse
That's the most exciting part—just making somebody's life better.

1:07
SPEAKER 7: Fatu Bangura, MD, Pediatric Anesthesiology
Honestly, I think that they really keep the wheels going. I think the perioperative nurse is so critical to everything we do on a day-to-day basis

1:17
Colin Mudrick, MD, Orthopedic Surgery
For the nurses that we work with in the OR every day, there are different roles: We have nurses that work alongside us during surgery. We also have nurses that are circulators, so they are ensuring the cases go smoothly. So it's a big, collaborative team that's all working together in the operating room.

On being a scrub nurse

1:38
Estelle (Tess) Stansell, BSN, RN Clin II, Circulating Nurse
So as a scrub nurse, you're assisting the surgeon in surgery. You're sterile, you're managing all your instruments, making sure everything is organized, you're passing things, and also an emotional support person for your surgeons.

1:51
SPEAKER 8: Raquel (Rocky) Delk, RN, BSN, CNOR, Nurse Professional Development Practitioner
Being able to take care of a room full of people and a whole bunch of equipment that's going simultaneously.

1:56
Charles Blair, RN, Scrub Nurse
You learn how to be at the sterile field and assist surgeons with instrumentation and making sure that we have everything that we possibly need for the procedure.

On being a circulator in the OR

2:08
Charles Blair, RN, Scrub Nurse
I'm the circulator, so that is correct patient, correct positioning, making sure that we have the correct sites, making sure that consents are signed, you have the medications, you're the liaison of communication between yourself, the operating room, and people outside of it.

2:22
Estelle (Tess) Stansell, BSN, RN Clin II, Circulating Nurse
As a circulator, you're doing everything that's not sterile. You're charting, calling family members, opening supplies, taking care of medications and then assisting anesthesia and your surgeon and other staff members in surgery.

2:38
Fatu Bangura, MD, Pediatric Anesthesiology
A timeout is basically a pause and everyone in the room stops what they're doing and listens to the circulator.

2:45
Charles Blair, RN, Scrub Nurse
It's a powerful feeling. It feels really nice just for everybody to stop what they're doing and listen to what you have to say.

On working in the OR

2:56
Charles Blair, RN, Scrub Nurse
Definitely working as a team. Those relationships that I have with members of the team in the operating room is just really awesome.

3:03
Colin Mudrick, MD, Orthopedic Surgery
I think it's very rewarding. It's active, it's fast-paced. I think there's an aura that it's very intense and there's no friendly conversation and that there's not any fun had in the OR and I think the opposite is true.

What are your nursing superpowers?

3:21
Estelle (Tess) Stansell, BSN, RN Clin II, Circulating Nurse
If I were to give myself a superpower, I think it's the superpower of foresight. I like to think ten steps ahead and in different directions—kind of like chess!

3:31
Charles Blair, RN, Scrub Nurse
You build a talent that’s like a superpower: your operating room ears.

3:37
Fatu Bangura, MD, Pediatric Anesthesiology
Being empowered. And being confident in yourself. You're a very important part of this process and without you, we wouldn't be able to get patients safely through surgery.

Why become an OR nurse?

3:51
Elizabeth Selden-Bowie, BSN, RN, CNOR, Nurse Professional Development Practitioner
It's amazing. It's a wonderful journey. It's something everyone should experience. I will always recommend the OR. There’s no career like it.

4:00
Charles Blair, RN, Scrub Nurse
It's an incredible place to be. It's going to be amazing.

4:04
Raquel (Rocky) Delk, RN, BSN, CNOR, Nurse Professional Development Practitioner
What I will say is give yourself grace, be patient with yourself. Things are going to fall into place over time.

4:11
Colin Mudrick, MD, Orthopedic Surgery
The operating room is a fun, fast-paced environment where you see tangible results and work as a team. What are you waiting for?

4:23
SPEAKER 9: Debbie Smith, MSN, RN CNOR, Senior Clinical Program Manager, AORN
Now is the time to become a perioperative nurse.

Perioperative nursing—also referred to as operating room (OR) or surgical nursing—specializes in patient care before, during, and after surgical and invasive procedures. Perioperative nursing is a dynamic, team-based, highly rewarding patient-centric career within nursing that is in high demand, offering a variety of development opportunities and career paths. All nurses within this specialty are also Registered Nurses (RNs).

Explore a career in perioperative nursing

HIGH DEMAND
There is significant demand for perioperative nurses. While there are over 539,000 perioperative nurses currently employed in the U.S., that number is expected to grow by more than 6% between 2018-2028.
Map of USA with pin cartoon graphic
Getting Started: Perioperative Nurse FAQs
As a perioperative nurse, you’ll be a vital member of the surgical team.

How do I become a perioperative nurse?

If you are interested in becoming a perioperative nurse, like all RNs, you must complete a two-year associate of nursing degree or four-year Bachelor of Science in nursing degree (BSN) from an accredited nursing school program. For many perioperative positions, the BSN has become the minimum educational requirement. RNs who already hold an ADN degree can enroll in RN-to-BSN degree programs to finish their baccalaureate degree in 2 years or less. Individuals with bachelors’ degrees in non-nursing fields can enroll in accelerated BSN degree programs, which prepare them for RN licensure. In addition you must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN), and get clinical experience. Because each state sets its own specific licensing regulations, make sure to check with the board of nursing in the state.1

What is the demand for perioperative nurses?

There is significant demand for perioperative nurses. While there are 539,000 perioperative nurses currently employed in the U.S., that number is expected to grow by more than 6% between 2019-2028.2, 3 To help meet this demand schools, employers, and professional organizations are innovating ways to facilitate entry into the field of perioperative nursing, such as AORN's Introduction to Perioperative Nursing an undergraduate course for nursing students that provides essential knowledge of pre-, intra-, and post-operative practices through the continuum of care for surgical patients. Nursing schools can integrate the course into their curriculum as an introduction to perioperative specialty.

In addition, AORN offers Periop 101: A Core Curriculum™ , designed specifically to onboard RNs entering the perioperative specialty.

Where do perioperative nurses work?

Perioperative nurses can be found providing essential care roles in hospital surgical departments, day-surgery units, ambulatory surgery centers, and in clinics or physician offices that perform invasive procedures. Their skills and care are essential pre- and post-op as well as in intraoperative settings.

What are some opportunities to advance my career as a perioperative nurse?

Surgical nursing is a unique and flexible specialty that provides lifelong learning experiences as changes in surgery are always occurring. Perioperative nursing is a diverse and varied career path that offers opportunities to grow and work in over 14 specialties such as general surgery, orthopedics, cardiothoracic, gynecology, and more. Perioperative nurses can advance in their career by becoming charge nurses, nurse managers, and advanced practice nurses such as nurse practitioners and clinical nurse specialists. They also often serve as leaders in the profession and advocates for their fellow nurses.

What are some sub-specialties for perioperative nurses?

There are three phases to the perioperative experience: preoperative, intraoperative, and postoperative, which begins in the postanesthesia care unit (PACU). Most patients will go through the three phases of the perioperative experience. Depending on the size of the facility, nurses may work in a single phase or may span across all phases of the surgical care continuum. Most commonly, nurses trained for the pre/post-op phase will cross-cover roles and nurses trained for the intraoperative phase will cross-cover roles.4,5

Learn more about the roles and responsibilities of perioperative nurses in the continuum of care here.

How much does a perioperative nurse make?

According to Payscale.com, the average annual salary range for perioperative nurses in the U.S. is $60K - 108K.6

What skills do perioperative nurses need?

Perioperative nurses work in a patient-facing role, working hands-on with patients as well as their care teams. As such, the job requires resiliency, patience, flexibility, compassion, a sense of humor, and calmness in pressure situations. Perioperative nurses need to be adaptable and ready for the unexpected, taking on different tasks, patients, and situations every day. With changing clinical circumstances on a daily basis, perioperative nurses should be highly organized and be able to follow a routine that allows them to anticipate and prepare for every situation.7

Click here to learn more about the skills you need as an perioperative nurse.
Why Become an OR Nurse?
The main fascination for me was the technology, the teamwork, and the collaboration—how everybody really knew what they were doing. And I'm, like, 'Oh, this is so it, I have got to make my way to surgery.'
Elizabeth Selden-Bowie, BSN, RN, CNOR, Nurse Professional Development Practitioner
Perioperative nursing is a high-demand nursing speciality. There are over 539,000 perioperative nurses currently employed in the U.S., with that number expected to grow by more than 12% between 2018-2028. The growth in demand is expected to continue as current perioperative RNs reach retirement age.
perioperative nurse and surgical care team in surgery

What's the Difference Between a Perioperative Nurse and an Operating Room (OR) Nurse?

Perioperative nurses care for patients throughout the surgical continuum of care from before surgery to during and after surgery. Operating room (OR) nurses are perioperative nurses, but have a specialized role focusing on the surgical phase and assisting the surgeon during surgery.

OR nurse with surgical team in PPE

Responsibilities at-a-glance

There are three phases to the perioperative experience: preoperative, intraoperative, and postoperative, which begins in the postanesthesia care unit (PACU). Most patients will go through the three phases of the perioperative experience.

Preoperative or Pre-op phase

  • Pre-op nurses perform pre-operative assessments, help obtain the necessary consents for surgery, answer patient questions, and administer preoperative medications such as antibiotics.

Intraoperative phase

  • Involves caring for patients from the time the patient enters the operating/procedure room, through the procedure, and until the patient is transferred to the postanesthesia care unit (PACU)
  • Scrub nurses prepare the operating room for surgery ensuring the necessary equipment is available and ready for use, assisting surgeons in donning sterile surgical attire, setting up the sterile surgical field with drapes, monitoring patient safety, and tracking all equipment used during surgery. Scrub nursing requires technical knowledge of surgical procedures in order to be able to anticipate the needs of the surgical teams.
  • Circulating nurses will perform a lot of the same surgical preparation duties as a scrub nurse, but will 'circulate' between all phases coordinating the many phases of the surgical care continuum: ensuring patients are ready to go to surgery, OR rooms are set up for surgery, bringing additional equipment to active surgeries if needed, providing breaks to staff if a surgery is prolonged, and ensuring beds are available for patients coming out of surgery.

What's the role of a scrub nurse in the OR?

In surgical settings, scrub nurses are responsible for:

  • Setting up the operating room for the patient
  • Choosing and managing the instruments for procedures
  • Ensuring all equipment and tools are sterile and ready to go
  • Working closely with the surgeon and handing tools to the surgeon during surgery

What's the role of a circulating nurse in the OR?

In surgical settings, circulating nurses are responsible for:

  • Managing the overall nursing care in the OR and helping to maintain a safe, comfortable environment
  • Acting as an advocate for the patient before, during, and after surgery
  • Conducting “time out”—the last chance for team members to review patient and procedure details and speak up with any concerns

Postoperative or Post-op/PACU phase

  • Post-op/PACU (post anesthesia care unit) nurses monitor patients as they wake from anesthesia, monitoring vital signs and managing side effects of anesthesia and post-operative pain. PACU nurses also provide patient education for surgical wound care and how to monitor for infections.
HOW MUCH DO PERIOPERATIVE NURSES MAKE?
The average annual salary range for perioperative nurses in the U.S. is $58K-$106K, according to Payscale.com.
Female nurse holding up chest X-ray cartoon graphic
  • What Special Traits Does a Perioperative Nurse Need?

    A perioperative nurse is a vital member of the surgical team—and is the only one who works with the patient on the surgical journey from beginning to end. Given this scope, perioperative nurses need the following skillset7 to perform their duties successfully:

  • Patience
    In your role as a perioperative nurse, you'll need exceptional patience to navigate the intricacies of patient care and evolving situations.
  • Flexibility & resiliency
    Your resiliency and flexibility will be crucial, as you adapt to the ever-changing demands of the perioperative environment, embracing unforeseen challenges with composure.
  • Sense of humor
    A good sense of humor will not only lighten the atmosphere but also serve as a valuable tool in maintaining a positive and supportive presence for both patients and your care team.
  • Teamwork & communication
    As a key team player and communicator, you'll collaborate seamlessly with your care team, ensuring effective and coordinated patient care through open and clear communication.
  • Calmness under pressure
    Your ability to remain calm under pressure is paramount, allowing you to make sound decisions and provide steady support in high-stress situations.
  • Compassion and integrity
    Upholding a high degree of integrity is integral to your role, fostering trust with patients, colleagues, and the entire healthcare team.
  • Multi-tasking
    Being a multitasker is second nature, as you skillfully manage various tasks, patients, and situations each day, demonstrating your organizational prowess in the dynamic perioperative setting.
Is perioperative nursing for you? Perioperative or operating room (OR) nurses provide patient-focused care in a variety of settings and specialties, with ample opportunities for professional growth. Get the scoop on this fast-paced, team-based, and fulfilling specialty, and find out how health systems and nursing schools are working to strengthen the pipeline of new nurses entering this critical specialty.
Why Become a Perioperative Nurse?
Being able to say, ‘You know Doc, this patient’s going to need something extra. We’re going to have to give them more fluid. We’re going to have to give them some more pain medication.’ Working collaboratively with them makes it all worth it, knowing you did the right thing for that patient.
Kristle, MSN, FNP-C, RN-BC, PACU RN | Nurse Practitioner
Perioperative nurses guide patients through the surgical journey, performing pre- and post-operative assessments, managing post-operative pain and side effects, and providing patient education. Both perioperative and OR nurses are patient advocates, playing a key role in surgical safety, patient comfort, and successful outcomes.
The Life of a Perioperative Nurse
Find out why working in the PACU (Post Anesthesia Care Unit) gives Kristle, MSN, RN, NP, a lot of career satisfaction.
Video still of Kristle Simms in hospital setting

"My Life as a Perioperative Nurse"

As a Family Nurse Practitioner, there’s a lot of subspecialties that I can go into. I can have my own practice. I can work in the hospital. I can work in the clinic setting.

After MedSurg for three years, I transferred to the PACU in critical care. The PACU is the post-anesthesia care unit, or recovery room, so we take care of everyone who’s had surgery and we either discharge them home or keep them in the hospital.

We transfer them to other units and we do a lot of teamwork more so there because we have to. We have a certain criteria that we have to meet. We have patients who are very fragile coming out of the OR and getting them to the stage of feeling [like] “Okay, I feel like I’m myself now” that takes a lot.

And getting them through the rough patches of having postop nausea, having pain, and working with them, and having one-on-one connection or two-to-one connection, that makes it possible to give them the best that I can, as well as advocate for them.

Being able to say, “You know Doc, this patient’s gonna need something extra. We’re gonna have to give them more fluid. We’re gonna have to give them some more pain medication.”

Working collaboratively with them makes it all worth it. You did the right thing for that patient.

Day in the Life of a PeriOp Nurse
Learn more about the day-to-day experiences in the Perioperative Nursing specialty with the videos below.
A Day in the Life - Jennifer (PeriOperative Nurse)
A Day in the Life - (Angela RN, BSN, CNIV, RGN and Sarah - Nurse Mentor)
Learn More About the Profession
AORN logo
Visit the Association of periOperative Registered Nurses (AORN) website to find out more about the profession or become a member to find support, access tools and professional development opportunities.
SEE YOU NOW Podcast
In this episode, we hear the musings of nurses Leslie Oleck, president of the American Psychiatric Nurses Association (APNA), Linda Groah, the CEO/Executive Director of the Association of periOperative Registered Nurses (AORN), and April Kapu, president of the American Association of Nurse Practitioners (AANP) about the unique value their specialties bring to the healthcare system as a whole.

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