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As surgical care advances, so does the scope of nurses’ responsibilities. O.R. nurses are now referred to as Perioperative Registered Nurses to more accurately reflect their duties immediately before, during, and after surgery. 

Perioperative registered nurses are relied upon for their professional judgment and critical thinking skills. They may work closely with the surgical patient, family members, and other health care professionals. They help plan, implement, and evaluate treatment of the patient. 


Perioperative registered nurses provide surgical patient care by assessing, planning, and implementing the nursing care patients receive before, during and after surgery. These activities include patient assessment, creating and maintaining a sterile and safe surgical environment, pre- and post-operative patient education, monitoring the patient’s physical and emotional well-being, and integrating and coordinating patient care throughout the surgical care continuum. 

During surgery, the perioperative registered nurse may assume any of the following responsibilities:

  • Scrub nurse – works directly with the surgeon within the sterile field by passing instruments, sponges, and other items needed during the surgical procedure.
  • Circulating nurse – works outside the sterile field. Responsible for managing the nursing care within the O.R. by observing the surgical team from a broad perspective and assisting the team in creating and maintaining a safe, comfortable environment.
  • RN First Assistant – after completing extensive additional education and training to deliver direct surgical care, the RN First Assistant may directly assist the surgeon by controlling bleeding and by providing wound exposure and suturing during the actual procedure..

Perioperative registered nurses also may work as an O.R. Director, managing budgets, staffing, and other business aspects of the operating room. Some perioperative registered nurses may later consider a career in business as a management consultant, clinical educator, researcher, or medical sales professional.


Surgical subspecialties include neurosurgery, cardiac surgery, trauma, pediatrics, oncology, general surgery, urology, ophthalmology, otorhinolaryngology (ear, nose, and throat), dental, plastic and reconstructive, and orthopedic.

Practice Settings:

Perioperative registered nurses work in a wide array of urban and rural settings, such as:

  • Hospital surgical departments 
  • Ambulatory surgery centers (also known as Day Surgery units)
  • Clinics 
  • Physicians’ offices


Generally, registered nurses obtain general nursing experience before entering the specialty area of Perioperative Nursing. Two areas that can provide applicable experience are critical care and emergency room care. They are fast-paced, sometimes stressful environments where life-saving decisions that make a difference in a patient’s life are routinely made. 

Perioperative registered nurses must be able to interact well with all kinds of people in difficult situations. They need emotional stability to cope with human suffering and frequent emergencies. They must be able to accept responsibility, provide direction to others, coordinate a patient’s health care plan, and collaborate with other health care professionals. 


RN license with a Bachelor’s of Science degree in nursing (BSN), associate degree in nursing (ADN), or hospital diploma. 

Salary Range: 

The median annual wage for registered nurses in 1997 was $41,400 and the median hourly wage was $18.88, according to the U.S. Bureau of Labor Statistics. However, some 30 percent of all registered nurses earn between $40,000 and $50,000 and another 16 percent earn from $50,000 to $89,000. 


Association of periOperative Registered Nurses
2170 South Parker Road, Suite 300
Denver, CO 80231-5711
FAX: (303) 755-6300
Web site:

American Association of Critical-Care Nurses
101 Columbia, Suite 200
Aliso Viejo, CA 92656
FAX: (949) 362-2020
Web site:

American Association of Nurse Anesthetists
222 South Prospect Avenue
Park Ridge, IL 60068
FAX: (847) 692-6968
Web site:

American Nurses Association
600 Maryland Avenue, SW
Suite 100 West
Washington, DC 20024
FAX: (202) 651-7001
Web site:

Emergency Nurses Association
915 Lee Street
Des Plaines, IL 60016-6569
(847) 460-4000
FAX: (847) 460-4001
Web site:

National Student Nurses Association
555 West 57th Street
New York, NY 10019
FAX: (212) 581-2368
Web site:


AORN Journal (