Emergency Medicine

So you Want to be a Perioperative Nurse

How many people have watched hospital dramas on television like ER or Grey’s Anatomy and wondered what it would be like to work in a high energy hospital setting? Probably most of the people watching the shows, but they are probably thinking about being the doctor or surgeon. The background cast of nurses and orderlies are hardy a blip on the radar. This can even be true when patients are in the operating room or emergency room. Everyone is focused on the physician, but without the nurses just how much would get done?

A perioperative nurse is one who has been specifically trained to work with surgeons and the medical team within the operating room environment. They are an integral part of the surgical team. It is a demanding and rewarding career in a high energy environment. There are several perioperative nursing positions including circulator, scrub, patient educator, and RNFA.

Circulator Nurse

A circulator nurse manages the patient’s care while in the operating room, as well as the needs of the attending surgical team. The circulator nurse maintains overall perspective of the environment and does not usually assist directly with the surgery.

Scrub Nurse

The reason most people call a perioperative nurse a scrub nurse is because they scrub in. He or she uses the same soap and sterile garments as the physicians so they are able to work within the operative field and assist in the surgery. They hand the sterile instruments to the physician as they are called for and may assist in monitoring the condition of the patient.

Patient Educator

A patient educator works with the patient and the family to provide information prior to the surgery to allow them to make informed decisions. This role is filled by a registered nurse with experience in surgical cases.


An RNFA, or Registered Nurse First Assistant, is a nurse who has gone through additional surgical training. The RNFA assists by controlling bleeding during the procedure, using medical devices, cutting tissue, and suturing. An RNFA may also be instrumental in patient care before or after the procedure.


 Perioperative nurses are not relegated to hospital operating rooms. They may also work in outpatient surgery centers or in the office of a physician who performs procedures on site. Other health care facilities such as health departments and emergency care centers may also employ perioperative nurses.

Many nurses find once they begin working in a hospital setting that they want to delve further into a specialty. Surgical nurses are no different. Have you found a home in the OR? Do you love working in a surgical environment? What advice do you wish someone had given you before you became a perioperative nurse? What would you tell a nurse new to this specialty?

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