Those who enter the field will be able to practice and work in a number of different roles. These nurses work alongside of the surgeon to provide nursing care to the patient undergoing an operative procedure. They are a critical link between the patients’ family and the surgical team. They will meet with the patient on the day of surgery to make a nursing assessment and in addition to the scrub nurse and circulating nurses duties described below they also may provide the patient instructions for recovery at home.
Scrub Nurse or RN Surgical Assistant
The one most commonly seen on TV is the scrub nurse. This is the nurse who assists the surgeon with the operation by insuring all of the necessary supplies and equipment needed for the operation are ready for use during the surgery. The nurse assists with surgeon with placing the sterile drapes to cover the patient in preparation for the surgery; hands the instruments, gauze, sutures and other equipment needed by the surgeon to perform the surgery. The nurse is responsible for maintaining a sterile field in the operating room. The scrub nurse, who in some cases has received additional training, can also be a surgical assistant to the surgeon (RN Surgical Assistant).
The other surgical nurse is the circulator. This nurse provides the surgical team with necessary supplies, equipment, medications, and so forth that may be needed during the surgery. He/she is the professional who may also provide support to the anesthesiologist as necessary. These nurses do not perform a hand washing (scrubbing) that occurs with the scrub nurse. He/she does not wear sterile gloves or gowns. One of their primary responsibilities is to insure the sterility of the operating room. They must inform the surgical team if for some reason any contamination occurs. They open the sterile packages which hold sterilized equipment and supplies needed for the operation.
Along with other members of the surgical team nurses in both of these roles are responsible for continuous assessment of the patient’s condition while in the OR.
Registered Nurse First Assistant (RNFA)
With additional experience and education in surgical care these operating room nurses have more responsibilities than the scrub or circulating nurses. These nurses work directly with the surgeon with responsibilities for assisting with controlling bleeding, cutting tissue, and suturing the patient when the operation is finished. Some RNFA also assist with specialized equipment used during the operation.
Where to These Nurses Work
These nurses are typically found in the surgical suites at hospitals. In addition, many procedures are now performed in ambulatory surgery centers so nurses will also be found in these units. Some nurses gain additional expertise to work with specific surgical patients such as those needing open-heart surgery or hip replacements. They then serve as scrub or circulation nurses for these more complicated patients.
The OR nurse can also move into nursing administration. There are needs for nurse administrators with OR experience to serves as charge nurse and nursing supervisor of the operating room. These positions can be found in both hospitals and ambulatory settings.