How to Become a Surgical Nurse

Surgical nurses are trained to care for patients before, during, and after procedures as well as assist surgeons during operations. They ensure adherence to quality protocols, advocate for the patient, and - depending on their role in the surgical center - they might also communicate with the patient’s family before, during, and after the procedure. These nurses are experts at managing all of their responsibilities at once while never losing sight of the empathy and communication required to put the patients and their families at ease.

Remaining calm under pressure and being able to think quickly during potentially difficult situations is second nature to these nurses. Working well with the surgical team and other healthcare team members is also important, due to the necessity of seamless collaboration required in the operating room.

If you’re considering a career as a surgical nurse, learning more about the responsibilities involved, the education required, and the ongoing certification requirements is a good starting point.

 

What Does a Surgical Nurse Do?

Surgical nurses, also known as perioperative nurses or operating room nurses, are the backbone of any surgical team. They’re responsible for managing critical elements of care to ensure surgical procedures are completed safely and successfully.

In doing so, surgical nurses also ensure patients receive the highest quality care before, during, and after their surgical procedures.

Before Surgery

Before a patient goes into surgery, a surgical nurse is responsible for prepping the patient. This involves:

• Educating the patient – Pre-surgical nurses educate patients and their families about the specifics of their procedure, including how long the procedure will take and what will occur. A nurse will also review pre-procedure instructions with the patient, such as not eating or drinking for a certain amount of time before surgery.
• Monitoring patient’s condition – Through history and physical assessment, the nurse monitors the patient for changes and risks related to surgical procedures.
• Prepping the patient – To physically prepare a patient for surgery, a surgical nurse may start intravenous lines, administer medication, and sterilize the incision site.
• Advocating for the patient – Whether witnessing the informed consent, tailoring specific care measures to the patient’s needs or conducting a pre-procedure safety “time-out,” perioperative nurses are constantly looking out for the patient’s best interests.
• Documentation – From accurately documenting a patient’s preoperative vitals to ensuring consent forms and waivers have been signed, surgical nurses ensure an accurate record of care is kept.
• Reassuring the patient – Patients about to undergo surgery can often feel nervous or scared. To help alleviate anxiety—and keep heart and blood pressure rates under control—surgical nurses offer compassion and comfort to their patients, reassuring they’re in safe hands.

During Surgery

While surgical nurses aren’t responsible for performing surgical procedures themselves, they nevertheless play a vital role in the operating room.

During surgery, a surgical nurse will:

• Assess – The nurse will assess the patient’s physiological well-being by monitoring vital signs, and volume of blood loss and track important things like urine output and positioning of the patient.
• Assist the surgeon – Aside from monitoring the patient, a surgical nurse in an RN first assistant (RNFA) role assists the surgeon by handing them the proper surgical instruments and operating any surgical equipment.
• Monitor safety — Perioperative nurses circulate the operating room to complete safety checks to ensure that all equipment is accounted for and used properly.

After Surgery

Following completion of the surgical procedure, patients require tailed care and monitoring. There, a surgical nurse team will:

• Monitor the patient – As patients come out of anesthesia, surgical nurses in the postanesthesia care unit (PACU) are responsible for monitoring their vital signs and neurological status to assess for changes that indicate the need for further intervention as well as provide physical and emotional support as the patient regains consciousness.
• Administer post-operative care – Once the patient has recovered from anesthesia, they may be sent home if the surgical procedure was straightforward, or they may spend several days in the hospital for several days for further monitoring.
  • For patients who have same-day surgery (sent home the day of the procedure), post-operative nurses will provide essential education to the patient and his/their caregiver to ensure the patient follows the necessary care plan at home and seeks care if complications arise.
  • Post-operative patient care for patients who require a hospital stay involves changing dressings, administering medication, and assisting with pain management. As well as patient education before discharging a patient, a nurse will discuss post-operative home care to ensure a successful recovery even after the patient has left the medical facility.
• Advocate for the patient — While the patient recovers from anesthesia to the care in the hours and days after a procedure, surgical nurses advocate for the patient when they are not able to talk for themselves as well as work to make sure the patient receives the necessary care and services form the interdisciplinary team.

Types of Surgical Nurses

To guarantee a wide range of surgical nursing duties are successfully carried out, surgical nursing is broken down into various roles. A nurse’s specific career goals and skill set can help determine which role will best allow them to thrive within the field.

Surgical nursing roles include:

• Circulating nurses – Circulating nurses manage the logistics of the operating room. Think of them “circulating” the room to ensure nothing slips through the cracks to ensure safety. Their responsibilities include assessing surgical equipment, reviewing pre-op information with patients, confirming consent forms are signed, and conducting safety timeouts.
• RN first assistants – RNFAs work closely with the surgeon, acting as a second set of hands and eyes. These surgical nurses are responsible for monitoring signs of patient distress, helping to control bleeding, assisting with suturing, and applying dressings. Due to their more hands-on role, RNFAs require additional education and training.
• Post-anesthesia care unit nurses – These surgical nurses care for patients immediately following surgery. As patients come out from anesthesia, PACU nurses monitor their vital signs, respiratory function, and neurological status to prepare them to move to the medical-surgical unit or ICU once they’re stable.
• Medical-surgical nurses – Medical-surgical nurses assist patients with their recovery once they’ve left the post-anesthesia care unit. These nurses are responsible for administering fluids and medication, assessing for changes and improvement, and educating patients on how to continue managing their recovery from home.
• Operating room directors – Operating room directors are the business managers of the surgical nursing field. Their duties focus on budgeting, staffing, and ordering surgical equipment and supplies.

Surgical Nursing Specialties

Aside from focusing on a specific role, surgical nurses can also choose to specialize in a specific area of healthcare.

Specializations can include:

• Neurosurgery
• Cardiac surgery
• Emergency surgery
• Pediatrics
• Oncology
• Urology
• Ophthalmology
• Orthopedics
• Dental surgery
• Plastic and reconstructive surgery
• Transplant surgery

What is the Average Salary of a Surgical Nurse?

A career as a surgical nurse isn’t only personally rewarding; it’s also financially rewarding. In 2019, the average annual salary of a surgical nurse was reported at $73,300. However, the exact salary is impacted by factors such as level of education and years of experience in the field.

Surgical nurses who advance their education with a master’s degree, doctorate degree, or additional certifications can expect to earn a higher annual salary than those who only hold bachelor’s degrees.

The state where you work can also play a role in the amount of money you earn. For instance, the average annual salary of surgical nurses in California stands at $113,240. Other top-paying states include Hawaii, the District of Columbia, Massachusetts, and Oregon.

What is the Job Outlook for Surgical Nursing?

As nurses of the baby boomer generation are reaching retirement age, the amount of working nurses in the U.S. is declining. This has resulted in a demand for nurses in every field, including surgical nursing.

In fact, nursing employment is projected to grow by a rate of twelve percent through 2028—a higher-than-average job rate growth. And with millions of surgeries performed every year in the U.S., the need for surgical nurses shows no signs of slowing down.

How to Become a Surgical Nurse

Specific character traits can guarantee increased success in this dynamic position regardless of which role a surgical nurse plays or their specialty.

For instance, as members of surgical teams, surgical nurses must work well with others. In fact, the success of an operation depends largely on a surgical nurse’s ability to collaborate and communicate effectively with surgeons and other nursing staff.

Successful surgical nurses should also be:

• Detail-oriented
• Attentive
• Analytical
• Empathetic

Along with these qualities, surgical nurses need to receive the proper education and training to execute their roles effectively.

Step #1: Enroll in a nursing degree program

The first step to becoming a surgical nurse is to complete the required education. In the vast majority of clinical settings today, surgical nurses must be a registered nurse (RN). To qualify to sit for the RN licensure exam, you need to complete an accredited nursing program. You can enter the profession of professional nursing as an RN via one of the following options:

• Associate Degree in Nursing (ADN). The ADN is an entry-level degree program for students who don’t have any previous nursing experience. The program takes up to 24 months to complete.
• Bachelor of Science in Nursing (BSN). The BSN takes up to four years to complete, depending on whether you have prior college credits or a degree outside of nursing. Students with a bachelor’s degree in another area can complete an accelerated BSN in as little as 16 months, depending on the selected program. An online ABSN program is also available for those looking for a hybrid — in-person and online — education. Why get a BSN instead of an ADN? The ANA currently recommends the BSN degree as the minimum level of education for RNs, while several studies have noted a correlation between BSN-educated nurses to improved patient outcomes. BSN-prepared nurses also enjoy more job opportunities than ADN-prepared nurses, as advanced nursing positions often require a minimum of a BSN degree.
• Direct-entry masters. For individuals who already hold a bachelor's degree and want to pivot to the nursing profession, a graduate entry option allows students to meet the requirements for the NCLEX-RN without needing to start over completely.

Keep in mind that many programs today offer online or hybrid options. Most work is completed online, and many programs don’t have mandatory login times, allowing you some degree of flexibility to plan your study schedule.

Step #2. Pass the NCLEX exam to become an RN

Completing a nursing program will prepare you to take the NCLEX-RN exam. This exam is required in all 50 states, and passing this exam is a prerequisite for receiving licensure.

The test is computerized and includes mostly multiple-choice questions, some fill-in-the-blank questions, and some drag-and-drop questions. The test assesses your knowledge in areas such as safe and effective care, health promotion and maintenance, psychosocial integrity, and physiological integrity. Once you have passed the exam and met board requirements in your state, you will be a licensed registered nurse. You will need to follow the state rules for maintaining and renewing your RN licensure, which commonly consists of continuing education requirements.

Step #3: Seek specialized training and experience

After you complete your nursing degree, pass the NCLEX-RN exam, and obtain your RN licensure, you can elect to specialize in surgical nursing by completing additional education or experience.

One option is entering a perioperative nurse training program, which is typically a two-year program. Alternatively, you can complete a master’s degree in nursing with a surgical nursing specialization.

Step #4: Earn certification

Employers may require surgical nurse candidates to be formally certified. Most certification programs require nurses to have relevant experience, which can be earned during perioperative nurse training, on-the-job experience, or a master’s program.

A few of those certification options for nurses include Certified Registered Nurse First Assistant (CRNFA) and Certified Perioperative Nurse (CNOR).

Certifications typically require that you have a current and unencumbered license in your state, work as a surgical nurse, and have completed a minimum number of hours of surgical experience. Certification will require regular renewal and potentially ongoing continuing education.

Find the Key to Unlocking Your Potential

If you’re looking for an in-demand career that allows you to positively impact countless lives, choose a career as a surgical nurse. In this exhilarating field, you can assist with life-saving surgical procedures while also providing patients the invaluable compassion, support, and education they need for a truly successful surgery.

To begin your journey toward a fulfilling career in nursing, consider an accelerated bachelor’s of science nursing program. To help you find your perfect fit, we’ve compiled a list of high-quality, accredited online ABSN programs. Simply enter your Zip code to find which program(s) are available in your area.