Nurses In The Operating Room

(Ebbs, 2008)
(Ebbs, 2008)
Nurses play an important role in maintaining the health and well-being of patients. One type of nurse in particular is the perioperative nurse, which is commonly referred to as the operating room nurse. They are registered nurses who take care of patients before, after and during surgery (Lewis, Heitkemper & Dirksen, 2006). The following will provide a description of the roles and responsibilities of perioperative nurses, the hazards and safety precautions they face and the qualifications needed to practice this branch of nursing.

This video summarizes the nursing career. The Basics

Perioperative Nurses

Perioperative nurses, also known as O.R. nurses are one of the many types of nurses (Nurses for a Healthier Tomorrow). Perioperative nurses are known for their professional judgment and critical thinking skills (Nurses for a Healthier Tomorrow). They help plan, implement and evaluate treatment for patients by monitoring patients physical and emotional well-being (Nurses for a Healthier Tomorrow). Providing care in a safe manner is one of the priorities of nursing, and perioperative nurses keep this in mind when performing their jobs. It is vital that a sterile environment is created and maintained by perioperative nurses and the health care team when treating patients (Nurses for a Healthier Tomorrow); having a sterile environment will promote health for nurses and affect the health of patients positively. Educating a client is one of the most important aspects to nursing. Clients should know about their treatment, illness, and anything regarding their health. As a perioperative nurse, it is vital that patients are educated about their health before and after surgery (Nurses for a Healtheir Tomorrow).

Roles and Responsibilities

Perioperative nurses assume many roles within the operating room that involve both sterile and unsterile activities (Lewis et al., 2006). Perioperative nurses can be divided into three main groups according to their roles and resposibilities within the operating room. The three main groups are circulating nurses, scrub nurses, and registered nurse first assistants (Lewis et al., 2006).

Circulating Nurses
In the operating room, circulating nurses remain in the unsterile field (Lewis et al., 2006). These nurses are not scrubbed, and do not wear gloves or a gown (Lewis et al., 2006). Their role is to monitor and document the procedures taken during the operation (Lewis et al., 2006). Circulating nurses also function to promote the sterility of the operating room (Smith, 2009). They inform operating room staff of anything that may cause contamination (Smith, 2009). They are also responsible for opening autoclaved packages, which are packages that hold sterile objects, so that the operating room staff may easily access the sterile equipment (Smith, 2009).

Scrub Nurses
Scrub nurses remain in the sterile field of the operating room and follow the designated scrub procedure, wear gloves, a mask and gown (Lewis et al., 2006). Scrub nurses aid surgeons by handing them equipment, sponges and other necessary instruments needed during the operation (AORN, 2009). They also help the surgeon by monitoring the patient’s condition during the procedure (AORN, 2009).

This video provides a brief description and outline of the O.R. room and the tasks scrub nurses perform.

Registered Nurse First Assistant (RNFA)
RNFA nurses have had additional education and training in surgical care (AORN, 2009). These nurses have more responsibilities within the operating room and work directly with surgeons (AORN, 2009). Their job is to help surgeons by controlling patient bleeding, use instruments and medical devices during the operation, perform invasive procedures such as cutting tissue, and suture the patient when the operation has finished (AORN, 2009).

Safety Precautions and Hazards of Nursing in the O.R

Operating nurses utilize a variety of different equipment to assist in medical procedures. Unfortunately, this entails coming into contact with dangerous medical tools and substances. This includes sharp objects such as scalpels and syringes, which can stab, scratch or cut nurses. Anesthetic gases, drugs, and sterilizing chemicals that can adversely affect the skin or respiratory tract. Other hazards include physical injury or conditions from the ambulation of larger patients, radiation, electrical injuries and psychological issues such as burnouts.

Safety Preventions
There are a variety of safety precautions nurses and institutions use in the O.R. to prevent injuries. Basic methods include comfortable non-slip shoes to prevent back pain and falls, handling sharp objects with caution, and having equipment routinely monitored for signs of breakdown or unsafe conditions. Assessing equipment is essential in preventing electrical or radiation related accidents; it ensures that the machines are properly grounded and no radiation escapes. Thus proper ventilation is also important in an O.R. setting to ensure that the anesthetic gases and other airborne substances are not trapped in the room.


The qualifications to be a perioperative nurse is no different from a registered nurse. Perioperative nurses must be able to work in a fast-paced, stressful environment (Nurses for a Healthier Tomorrow).This includes interacting with various types of people, having emotional stability, and being accountable for his or her actions (Nurses for a Healthier Tomorrow). Communicating effectively will help a perioperative nurse be able to work as team with other health care professionals to coordinate a patient's health care plan (Nurses for a Healthier Tomorrow).

Registered Nurse First Assistant Qualification (RNFA)
RNFA require more education and experience as they have increased responsibilities within the operating room. In Canada, becoming an RNFA requires a registered nurse to have a minimum of 5 years experience in perioperative nursing, basic cardiaclife support (BCLS) or advance cardiac life support (ACLS) certification and certification with the Canadian Nursing Association -Perioperative specialty (Operating Room Nurses Association of Canada, n.d.). They must also complete an intensive education program that includes 175 hours of hospital clinical internship with a surgeon mentor (ORNAC, n.d.).

More information regarding nurses in the operating room can be found in the Operating Room Nurses Association of Canada website .