Perioperative nurses provide care before, during, and after to patients requiring surgery. Nurses who work in the operating room (OR) and the recovery room, also called PACU (Post-Anesthesia Care Unit), are also perioperative nurses. They are all part of the operative team along with surgeons, anesthesiologists, and nurse anesthetists.
Perioperative nurses keep the operating room functioning like a smooth-running machine. They are in charge of maintaining safety and cleanliness. Perioperative nurses ensure that patients are adequately prepared, pre-operative medication is given, and paperwork is accurately completed. In addition, perioperative nurses actively help the physician perform the surgery by readying the room before and handing the surgeon tools during the procedure.
The PACU nurses receive the patient after surgery. They closely monitor and give pain medication as needed while anesthesia wears off. They report any significant changes to the physician, and when the patient is ready to be released, they will inform and coordinate instructions with the family.
Perioperative nurses often receive advanced training to improve their skills. Some perioperative nurses specialize and only work with physicians who perform a specific type of surgery, such as plastic surgery, pediatrics, or oncology, or they train to become an RN first assistant (RNFA) to actively participate in the surgeries. Others become advanced practice registered nurses (APRNs) either as surgical nurse practitioners or clinical nurse specialists (CNSs).
Scrub nurses
- Scrubs in to assist during surgery
- Works inside the sterile field, setting up the area with sterile tools and equipment
- Hands the surgeon tools during surgery and performs other duties inside the surgical suite
Circulating Nurse
- Greets patients prior to surgery, performs pre-operative assessments, and reviews pre-op paperwork for completeness
- Works outside the sterile field to make sure all equipment is set up before the surgery and arranges for other needed supplies
- Contacts others as needed during surgery
- Keeps family informed as appropriate
RN first assistant (RNFA)
- Assists surgeon in performing the surgical procedure by controlling bleeding and monitoring for complications
- Sutures after surgery is completed and applies dressings
- Performs any task needed during the surgery
Recovery room (PACU) nurse
- Monitors vital signs and assists patients as they come out of anesthesia
- Prepares patients for transfer back to the ward or discharge if same-day surgery
- Communicates to family and patient regarding their status and discharge instructions
- Reviews discharge medications, especially pain medication
Perioperative nurses must be detail-oriented and be excellent communicators. The operating room requires these nurses to be physically strong and have mental agility. Shifts in the OR require long hours of standing, lifting unconscious patients, and moving heavy equipment.
Perioperative nurses must maintain lengthy focus during the surgery but also be flexible. For example, they may start with one surgery and instead be sent to an emergency case instead. Strong communication skills are imperative since there is little time for mistakes. Errors prolong the time the patient is under anesthesia, increasing their risk.
Overall, perioperative nurses must use critical thinking skills and work well with the entire operative team. They must be organized, find medications or tools quickly, and be extremely accurate so that nothing is left inside the patient.
