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Advanced Practice Nursing

Becoming an OR Nurse May Suture Career Goals

OR nurses fill three critical roles: circulating nurses, who monitor procedure; scrub nurses, who handle surgical instruments; and first assistants, who help with cutting and suturing. Image from Unsplash

Mary Kearl October 30, 2019

If the prospect of working in surgery intrigues rather than terrifies you, you may have what it takes to be an OR nurse. You can start with an associate's degree, but you'll need a master's if you want an honored place at the (operating) table.

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The operating room is sometimes referred to as "the operating theater." Given the level of drama that transpires there, it's an apt descriptor.

For the same reason, operating rooms feature prominently in television dramas. In those, the spotlight is typically on the surgeon, usually impossibly young and impossibly good looking. But in a real operating room, other staff perform essential roles. Among these indispensable professionals are OR nurses (also known as perioperative nurses or surgical nurses).

OR nursing is a challenging job. You'll work long days (and nights), stand for hours at a time, and be on call during holidays and other family events. Through it all, you'll be dealing with high-stakes on-the-job challenges, participating in life-and-death situations nearly every day. You'll need calm, patience, attention to detail, people skills, and a flexible schedule to handle it all.

The U.S. is facing a nursing shortage, so more than ever, hospitals need talented, dedicated nurses to address the growing demand for care.

In this guide, you'll learn how to become an OR nurse. It covers:

Operating room nurse duties and responsibilities
Average salary for OR nurses and where they work
Education and licensure needed to become an OR nurse
Top programs for becoming an OR nurse
Resources for becoming an OR nurse

Operating room nurse duties and responsibilities

What do OR nurses do? What is it like to be an OR nurse?

TV shows like "Nurse Jackie" and "Grey's Anatomy" dramatize what things might be like for RNs working in hospital settings, but what's it really like working in one of the most in-demand medical positions in the country? Here are a few general OR nurse responsibilities:

Caring for patients before, during, and after surgery
Monitoring the vital signs of patients during or after procedures and operations
Directing colleagues, such as surgical technicians and medical assistants, during operations
Informing patients and their loved ones about the process of recovery

Kinds of OR nurse positions

There are three specialized roles for operating room RNs:

Circulating nurses, who focus on making sure the operating environment remains sterile and that the medical team follows procedure.
Scrub nurses, who hand surgeons the instruments needed at every step an operation while also keeping track of patient vitals.
First assistants, who are involved in surgical tasks like cutting into tissue and suturing. They also assist surgeons with tools as needed during the operation. First assistants are typically advanced practice registered nurses (ARPNs), which requires a master's degree.

Skills necessary to become an OR nurse

According to the Bureau of Labor Statistics, the following qualities define effective registered nurses:

Critical-thinking skills
Communication skills
Compassion
Attention to detail
Emotional stability
Organizational skills
Physical stamina

In addition to these qualities, operating room nurses (according to Payscale.com) should also be:

Prepared for fast-paced work
Able to adapt to changing dynamics
Emotionally ready to face a range of health outcomes of their patients without letting it affect their job performance

Average salary for OR nurses and where they work

According to Salary.com, the average salary for an operating room registered nurse is $76,848, with salaries typically ranging from $68,954 to $84,951. Average income by role is:

Where can OR nurses work?

Where a nurse is located can have a significant impact on overall pay, with the following cities offering the highest pay for OR nurses, per PayScale data:

Los Angeles, California: pay may be up to 41 percent higher
New York, New York: pay may be up to 40 percent higher
Houston, Texas: pay may be up to 13 percent higher
Dallas, Texas: pay may be up to 10 percent higher
Chicago, Illinois: pay may be up to 5 percent higher

Education and Licensure needed to become an OR nurse

The minimum educational requirement to become an RN is a two-year Associate Degree in Nursing (ADN). You can become a scrub nurse or circulating nurse with an ADN; to become a first assistant, you will need a Master of Science in Nursing (MSN).

While it is possible to get an OR job with an ADN, you should consider pursuing a four-year Bachelor of Science in Nursing. It will improve your job prospects and will provide you with more options when you look to advance in your career. To improve your options even further, you may continue to a two-year master's in nursing program. An MSN is required to become an advanced practice registered nurse (APRN), a status required to become a first assistant nurse in the OR.

The U.S. Department of Education's Financial Aid offers information about FAFSA and other sources of aid for your OR nursing education and career path.

In the U.S., including all states, D.C., and the territories, registered nurses are required to obtain and maintain a nursing license. To earn your license, you must:

Graduate from an approved nursing program
Pass the National Council Licensure Examination (NCLEX-RN)
Meet additional state requirements, such as having to pass a criminal background check

Additional certifications for nurses

The CNOR certification is held by more than 34,000 perioperative nurses.
The CSSM (Certified Surgical Services Manager) certification confirms managerial knowledge and skills in perioperative practice.
The CNS-CP (Clinical Nurse Specialist Perioperative Certification) provides additional credentialing for advanced practice nurses who have earned a master's or doctoral degree.
Become certified in specialties such as ambulatory care, gerontology, and pediatrics. Specialization is not required but can help nurses gain a competitive advantage when applying for jobs.

Top programs for becoming an OR nurse

What should you look for in a nursing program?

With almost 2,000 nursing schools in the United States, your choices are nearly limitless. Our guide "10 Considerations to Find the Best Nursing School for You," will help you review top criteria to create a short list of good-fit-for-you schools. They should include:

Accreditation: Make sure your picks are all accredited by a national organization.
State board approval: To take the National Council Licensure Examination (NCLEX) to become a licensed nurse, your program will need to be approved by your state board.
How many nurses pass NCLEX? The NCLEX pass rate will help you know whether the program is setting up nurses for success.

Other factors to consider include:

Class schedules
Tuition and other costs
Whether the program offers support for finding clinical site experience
Class size
How much exposure you will get to labs and simulations
How supportive the faculty will be to you as a student

Where are the best OR nursing programs?

U.S. News & World Report ranks the top master's of nursing and doctor of nursing practice programs on an annual basis. For 2020, here are the top three for each: