Surgical Nursing: Jobs for Nurses in the Operating Room, Surgery and Recovery Room

Surgical nursing jobs (jobs for nurses in the operating room) require skill, motivation and energy and the ability to function well as part of a team.

A successful and safe operating room environment requires coordination and cooperation from the professionals who work there. Nurses in and around the operating room function in many capacities from getting the patient ready for surgery, to assisting in the actual procedure to the recovery of the patient from their surgery and anesthesia. These nurses all deal with stressful situations and must remain composed under pressure.

Prior to going to the actual operating room, a preoperative nurse will see and evaluate you. Your identity and surgical procedure will be identified. The preop nurse will make sure all labs have been done and will alert the doctors to any abnormalities. He or she reviews you medical history and also places an IV to start giving you IV fluids or antibiotics as requested by your surgeon.

If you are having surgery, the circulating nurse also checks the your identity and readiness for surgery. She or he confirms the procedure being performed and makes sure you understand and agree with the procedure being done, just as the preop nurse does.

The circulating nurse accompanies the patient to the operating room. Before the operation starts, the circulating nurse helps the anesthesiologist apply monitors and make sure you are as comfortable as possible. After you are asleep, the circulating nurse helps the surgeon by making sure equipment such as monitors for cameras work properly. This nurse also retrieves additional equipment as requested by the surgeon.

At the end of the operation, the circulating nurse again assists the anesthesiologist as you wake up from the anesthetic and accompany you to the recovery room. The circulating nurse gives report and transfers care to the recovery nurse.

The scrub nurse is so named because he or she is "scrubbed" into the sterile procedure. They handle only sterile instruments and hand instruments to the surgeon. They also help by holding retractors and cutting sutures. Scrub nurses must be conscientious and alert to stay sterile throughout the procedure.

RNFA stands for "registered nurse, first assistant". The RNFA is a nurse who has received special training to assist the surgeon during the operation. He or she helps maintain visualization of the surgical field. Retracting tissue and clearing blood from the field help the surgeon operate more efficiently. During procedures done with scopes (laparascopes inside the abdomen, arthroscopes inside joints), the RNFA may hold the camera for the surgeon.

At the end of the operation, the RNFA may suture or staple the incision. RNFAs have attended both classroom and laboratory courses to learn these advanced skills.

Your anesthesia provider may be either an anesthesiologist (a medical doctor) or a CRNA, a "certified registered nurse anesthetist", or both. In some rural areas, CRNAs work independently and are the sole anesthesia providers. In other areas, one or more CRNAs work in collaboration with an anesthesiologist to provide necessary anesthesia services.

A CRNA or nurse anesthetist is an experienced registered nurse who then goes on to obtain more schooling and training in anesthesia. The AANA (American Association of Nurse Anesthetists) states that there are over 100 instructional programs for nurse anesthetists.

After the operation, a recovery room nurse takes over care. He or she helps you transition out of your anesthesia. Monitoring vital signs, administering medications and giving post-operative instruction all fall under the scope of practice of a recovery nurse.

Many institutions require recovery nurses to have experience in critical care. The postoperative nurse must be able to identify and begin treating problems that may arise after surgery. This includes problems related to surgery like increased bleeding and anesthesia or patient related issues such as low oxygen levels and changes in heart rate or rhythm.