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The Roles and Responsibilities of a Surgical Nurse

Being a nurse is personally rewarding, allowing you to do meaningful work while enjoying job security and financial stability. Another benefit of pursuing the nursing career path is the opportunity to choose a specialty that aligns with your interests and strengths.

There are over 100 nursing specialties to choose from. Among these, surgical or perioperative nursing is one of the fastest-growing fields. It is also one of the most popular among aspiring nurses and registered nurses (RNs) seeking career growth alike.

This article explores the various aspects of being a surgical nurse, illustrating the responsibilities and environments in which they work. It also includes an overview of the requirements before one can become a surgical nurse.


What Is a Surgical Nurse?

A surgical nurse, also known as a perioperative nurse, is an RN who specializes in the care of patients throughout all stages of surgical procedures: preoperative (before), intraoperative (during), and postoperative (after). Surgical nurses play a crucial role in the success of surgeries by assisting surgeons, providing patient education, administering medication and monitoring vital signs to ensure that patients remain stable.

Surgical RNs typically play one of the following roles, depending on their employer and the facility in which they work:


Scrub Nurse

A scrub nurse prepares the operating room for the surgery, ensuring all necessary tools and supplies are available. They set up surgical drapes, sterilize and hand surgical tools to the surgeon, and monitor the patient’s health and safety during the procedure. Additionally, they may perform other tasks such as applying sponges, marking incision sites and preparing to move the patient to the recovery room after the surgery.  


Circulating Nurse

This type of nurse performs many of the tasks of a scrub nurse, but, as the name implies, they “circulate” between all phases of care, from pre-op to post-op. Circulating nurses serve as patient advocates, and their responsibilities typically include going over consent forms with the patient and their family, educating them on surgery aftercare and delivering additional supplies or equipment to the operating room.


RN First Assistant

This type of nurse works directly alongside the surgeon during surgical procedures. Their responsibilities may include:

  • Monitoring a patient’s vital signs.
  • Controlling bleeding.
  • Applying dressings and suturing wounds under the supervision of the surgeon.

To become an RN first assistant, an RN must undergo additional training and certification.  

PACU Nurse

A postoperative care unit (PACU) nurse is a critical care nurse whose primary responsibility is to look after the health and well-being of patients after they’ve received anesthesia. PACU nurses are also sometimes called recovery room nurses. Their tasks may include:

  • Helping stabilize patients as they come out of anesthesia.
  • Monitoring patients for changes in electrocardiogram patterns.
  • Watching for signs of oversedation.
  • Administering medication to relieve post-op symptoms .
  • Speaking to patients and their families about postoperative care.  

In addition to these four primary roles, surgical nurses may choose to further specialize in a specific area of surgery, such as:


  • Cardiovascular surgery: Nurses in this specialty provide care during heart and vascular surgeries, such as coronary bypass, valve replacements, and aortic aneurysm repairs.
  • Orthopedic surgery: This specialty involves the treatment of musculoskeletal conditions, including joint replacements, spinal surgeries, and fracture repairs.
  • Neurosurgery: Neurosurgical nurses assist with procedures involving the brain and nervous system, such as brain tumor removals, spinal cord decompressions, and aneurysm clippings.
  • Gynecologic surgery: Nurses in this specialty care for patients undergoing procedures related to reproductive health, such as hysterectomies, tubal ligations, and cesarean sections.
  • Oncology surgery: Oncology nurses are involved in cancer-related surgical procedures, including tumor removals, biopsies, and reconstructive surgeries.

Where Do Surgical Nurses Work?

Generally, perioperative nurses can work in healthcare facilities and environments where surgeries are performed. These include the following:

  • Hospital operating rooms
  • Specialty surgical units within hospitals
  • Ambulatory surgery centers (ASCs)
  • Specialty clinics
  • Outpatient and inpatient surgery centers
  • Recovery rooms
  • Military hospitals
  • Teaching hospitals

How to Become a Surgical Nurse

1. Earn a Nursing Degree

To start your journey toward becoming a surgical nurse, you must first earn a nursing degree. There are different paths to obtaining the necessary education, which may include pursuing one of the following:

  • An Associate Degree in Nursing (ADN)
  • A Bachelor of Science in Nursing (BSN)
  • A direct entry nursing program (for those with a non-nursing bachelor’s degree)
  • A Licensed Vocational Nurse (LVN) to Associate Degree in Nursing (ADN) program

Each program type has advantages, but the ultimate goal is to prepare you to meet nursing licensure requirements. Remember that some employers may prefer hiring surgical nurses with a BSN.

2. Pass the National Council Licensure Examination (NCLEX-RN®)

After completing your nursing program, you must pass the NCLEX-RN® to obtain your RN license. The exam measures your competency to provide safe and effective patient care.

3. Gain Work Experience as an RN

Once you have your license, the next step is to work as an RN. It’s essential to gain experience as an RN in various healthcare settings, such as hospitals, clinics, and long-term care facilities. Many surgical nurses start by working in medical-surgical settings, which helps them develop critical thinking skills, time management abilities and a better understanding of the patient care system.

4. Complete a Perioperative Nurse Certification Program

Consider enrolling in a perioperative nurse certification program to further specialize in surgical nursing. These programs are available through various institutions, such as the Academy of Medical-Surgical Nurses and the Competency & Credentialing Institute. Most of them require RNs to have at least two years of work experience before they can apply.

The following are some examples of surgical nurse certification programs:

  • Certified Medical-Surgical Registered Nurse (CMSRN®)
  • Certified Perioperative Nurse (CNOR®)
  • Certified Foundational Perioperative Nurse (CFPN®)
  • Certified Ambulatory Surgery Nurse (CNAMB®)

Before choosing a program, ensure it aligns with your interests and career goals. It should also be accredited and recognized by your state’s board of nursing.

Job Outlook for Surgical Nurses

There are over 500,000 surgical RNs currently employed in the US. However, that number is expected to increase as there continues to be a strong demand for perioperative nurses. The projected growth rate for this nursing field is 6% from 2018 to 2028.

Start Your Journey Toward a Fulfilling Nursing Career

Becoming a surgical nurse means undergoing years of studying, gaining work experience, earning professional credentials and developing specialized skills. While the journey toward becoming a surgical nurse can be challenging, this career is professionally and personally fulfilling. 

Take the first step to transform your nursing career and enroll at Texas Health School. We offer a vocational nursing program that prepares you to become a licensed vocational nurse (LVN). 

Additionally, our LVN-to-ADN pre-licensure program prepares currently licensed LVNs to transition to a career as an RN. After graduating from our LVN-to-ADN program, you’ll earn an Associate of Applied Science in Nursing degree and become eligible to sit for the NCLEX-RN®.


View our programs today, or contact us for more information. 

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