How to become an OR nurse

As the name suggests, an operating room (OR) nurse is a registered nurse (RN) who works in the operating room. These professionals care for patients before, during and after surgery. You may also hear them called surgical nurses, perioperative nurses or OR nurses. They collaborate with the entire surgical team — surgeon, anesthesiologist, surgical technicians and other nurses — to ensure patient safety.

But what do they actually do? That depends on the type of operating room RN they are. Typically, they assist in preparing the patient for surgery, assist the surgeon during surgery, assess and monitor the patient’s status intraoperatively, manage surgical tools and equipment, complete documentation and administer medications.

A surgery involves a lot of moving pieces, from checking a patient’s medical history for allergies to counting the gauze pads removed from a patient’s abdomen before closing the incision. Surgery is very much a team effort, in other words, with each healthcare member responsible for a specific set of tasks. Everyone needs to know who is responsible for what so they can work together smoothly.

While technically anyone on the surgical team can call a “time-out”  before surgery begins, it’s often the operating room nurse’s responsibility. This is when everyone on the surgical team confirms the patient’s name, date of birth, reason for the surgery and the surgical site (body location that is to be operated on). This important step helps to prevent mistakes, such as performing the wrong procedure or documenting something incorrectly in the patient’s chart.

For efficiency and patient safety, collaboration is key and can potentially lead to better patient outcomes. In fact, studies show that adverse events and complications during surgery  may be connected to poor teamwork. Likewise, ambiguity around the roles within the healthcare team can lead to discord on authority, delegation and duties. 

OR nursing is a specialized field of nursing. Many skills you learn will apply only to the OR, while other things you may have learned in nursing school won’t be needed in the operating room. Similarly, there are some skills you will use only during certain types of surgeries.

Specialization opportunities exist on a wide spectrum, including orthopedic surgery, cardiovascular surgery, neurosurgery, plastic surgery, cardiothoracic surgery, vascular surgery and trauma surgery.

OR nurses typically work in the operating rooms of hospitals. They can also work in surgical centers and ambulatory care centers.

The type of surgery may determine the workplace setting. For example, a nurse who works in plastic surgery will likely work in a specialty surgery center. A nurse working in trauma surgery will likely work in a hospital. 

How much do nurses make while working in the operating room? It depends on their specialty, location and facility. The U.S. Bureau of Labor Statistics (BLS) does not report specifically on operating room nurse salaries, but they do provide a range of income for RNs. As of May 2023, RNs earned between $63,720 and $132,680 , with a median wage of $86,070, according to BLS.

Salary ranges are not specific to students or graduates of University of Phoenix. Actual outcomes vary based on multiple factors, including prior work experience, geographic location and other factors specific to the individual. University of Phoenix does not guarantee employment, salary level or career advancement. BLS data is geographically based. Information for a specific state/city can be researched on the BLS website.

Nursing experience is often required before working in the OR. It’s a great idea to gain experience in a nursing unit that cares for surgical patients, either before or after surgery. This could be on a med-surg floor, in an orthopedic or neuro unit, in telemetry or in an intensive care unit. High-volume surgical centers and trauma hospitals often require specialized OR nurse training.

If you already know the surgical specialty you’d like to work in, you could start out as a bedside nurse in that field. For example, if you want to work in cardiothoracic surgery, you could first work as a telemetry nurse for a few years.

Many hospitals offer and even require nurses to complete a surgical residency program prior to working as an OR nurse. These programs typically last 6 to 12 months and include a combination of classroom lecture and hands-on clinical training.

Some nurses may choose to pursue certification in an OR specialty as well. While not required, it can be a good opportunity to demonstrate your dedication to that specialization while deepening your skill set.

As a nurse working in surgery, you can find a wealth of resources from professional organizations and associations. For example, the Competency & Credentialing Institute  offers multiple surgical nursing certifications, like the CNOR certification, as well as handbooks for studying and preparing for the exams .

You can also become a member of the American Nurses Association (ANA) to gain access to continuing education courses and stay current on nursing news. Consider continuing education courses relevant to surgical nursing, like operating room inventory management, medical error prevention, sterile technique best practices, bariatric surgery and procedural sedation.