Surgeons rely on nurses to keep the operating room clean and sterile, hand them surgical tools during the operation and monitor patients’ vital signs for signs of complications. These nurses, referred to as perioperative nurses, fall into three categories: scrub nurse, circulating nurse and RN first assistant. While each plays a different role, they work together to make the surgeon’s job easier and ensure the patient’s safety.

All surgical nurses need an associate or bachelor’s degree in nursing and a registered nurse license. While there’s no degree program just for perioperative nursing, most universities offer elective courses in various aspects of surgical procedures. After nurses enter the field, they can pursue continuing-education credits in perioperative nursing. Hospitals often prefer that nurses have experience in emergency or critical care nursing before applying for surgical roles. Many surgical nurses also pursue certification, offered by professional associations such as the Medical-Surgical Nursing Certification Board.

Scrub Nurse

A scrub nurse inspects the operating room prior to surgery, ensuring that it’s clean, sterile and ready for the patient. She also sets up the surgical tools, counting all sponges, needles and other instruments before and after the operation. After “scrubbing in,” she helps the rest of the surgical team wash their hands and put on the sterile gowns, gloves and masks they wear to protect themselves and the patient. During the surgery, she hands the surgeon tools and other instruments and must often anticipate when he’s ready for the next tool and what he needs. After the operation, she removes the surgical tools and helps prepare the patient for transport to the recovery room.

Circulating Nurse

Instead of participating directly in the operation, the circulating nurse oversees the procedure and ensures it follows hospital policy and safety guidelines. She begins by inspecting surgical equipment to determine everything is in working order. She also confirms the patient’s identity and verifies that he or his family have completed the necessary consent forms. She then discusses with the surgeon the type of procedure and any special concerns, such as allergies or other health conditions, that could impact the patient’s care. In addition, she assists the anesthesiologist as he puts the patient under. During the operation, she retrieves any additional supplies or tools the team needs.

RN First Assistant

Surgeons often depend most heavily on the RN first assistant, who provides direct patient care. She watches for possible complications by monitoring a patient’s vital signs, including heart rate, pulse and respiration. If she sees signs of trouble, she immediately alerts the surgeon so he can halt the surgery. She takes direction from the surgeon and also performs emergency care such as CPR and controlling bleeding. After the operation, she sutures wounds and the incision site and applies dressings and bandages. She also participates in assessing the patient before surgery and before discharge. Nurses need several years of surgical nursing experience before taking on an RN first assistant role.