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How to Become a Perioperative Nurse

Janice Monti, Ph.D.
Updated August 9, 2022
Reviewed by
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​​Interested in becoming a perioperative nurse but not sure what it involves? Find out answers about education and licensing requirements, career prospects, and more.
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Perioperative nurses are members of surgical teams. They provide highly specialized care that has a direct impact on the lives of their patients.

The demand for perioperative nurses continues to expand, in response to nursing shortages and the increasing need for surgical services. These registered nurses (RNs), also known as surgical nurses or operating room nurses, can expect promising employment prospects and competitive salaries.

Check out answers to your questions about how to become a perioperative nurse and what it’s like to work in this challenging career.

What Is a Perioperative Nurse?

Perioperative nurses work together with surgeons, anesthesiologists, and other members of the surgical team throughout all phases of surgical care. They prepare patients for operations, work with surgeons during procedures, and monitor patients in recovery.

Before surgery, these RNs get their patients ready for surgery, handle paperwork, administer medicines, and set up medical equipment. They communicate with patients and their families about the procedure by answering questions and calming any fears. During surgery, they work with the doctor and healthcare team, check patient vital signs, and monitor compliance with safety and sanitary procedures.

Following the surgical procedure, these nurses provide postoperative care, checking for signs of complications and tending to wound care and pain management. They also get together discharge plans and educate patients and families about what to expect during recovery.

Perioperative nurses can work in any medical facility that offers surgical services. They find positions in hospitals, outpatient clinics, ambulatory care centers, and physicians’ offices where surgical procedures are performed.

Steps to Becoming a Perioperative Nurse

If you are interested in becoming a perioperative nurse, you must complete a two-year or four-year nursing degree, pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN), and get clinical experience. Because each state sets its own specific licensing regulations, make sure to check with the board of nursing in the state where you intend to practice.

Employers may require you to get certification in basic life support and advanced cardiac life support. RNs working in this field can boost their career and salary prospects by pursuing specialty credentials as certified perioperative nurses, clinical nurse specialists (perioperative), and certified surgical services managers.

  1. 1

    Earn an associate degree in nursing (ADN) or a bachelor of science in nursing (BSN) degree from an accredited program.

    Like all RNs, perioperative nurses must complete a two-year associate of nursing degree or a four-year bachelor of science in nursing from an accredited nursing school. For many perioperative positions, the BSN has become the minimum educational requirement.

    RNs who already hold an ADN degree can enroll in RN-to-BSN degree programs to finish their baccalaureate degree in two years or less. Individuals with bachelors degrees in non-nursing fields can enroll in accelerated BSN degree programs, which prepare them for RN licensure.

  2. 2

    Pass the NCLEX to receive RN licensure

    You must pass the NCLEX-RN to determine whether you are ready to practice in entry-level nursing positions and receive your state license. This computer-adaptive, multiple-choice test covers the fundamentals of nursing practice, infection and disease prevention, and the legal/ethical aspects of nursing.

  3. 3

    Gain experience as a registered nurse

    Before entering the field of perioperative nursing, you will need 1-2 years of clinical experience. RNs should look for jobs in hospital critical care, surgery, or emergency room departments. Physicians offices and clinics that provide surgical services can also offer valuable experience.

    Some hospitals have perioperative internship programs to expose recently graduated RNs to the latest standards of care.

  4. 4

    Consider becoming a certified perioperative nurse

    Nurses who choose to earn a specialty board certification demonstrate their professional accomplishments, boosting their career and salary potential.The Certified Perioperative Nurse (CNOR) credential, administered by the Competency & Credential Institute (CCI), is the only accredited certification for perioperative registered nurses. Candidates for this credential must have an unrestricted RN license and at least two years of experience in a perioperative setting.

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Perioperative Nurse Education

Earning an ADN and passing the NCLEX-RN exam offers the fastest route to a career in perioperative nursing. However, major professional nursing associations and many employers recommend that all practicing RNs earn at least a BSN degree.

Perioperative nurses who pursue nursing specialty board certifications and graduate training in advanced practice can increase their marketability and earning prospects.

Perioperative Nurse Licensure and Certification

Perioperative nurses, like all RNs, must pass the NCLEX-RN and get a license through their state board of nursing. While each state establishes its own RN practice regulations, RNs usually need to renew their license every two years. They must demonstrate that they have kept up with advances in the field by taking continuing education courses for nurses and completing the specified number of practice hours.

While not required by all employers, perioperative nurses often pursue specialty board

certifications to demonstrate higher competency levels and set themselves apart from other job applicants.

The CCI administers several perioperative certification options. The popular CNOR credential requires candidates to hold an unrestricted RN license and current work experience in perioperative nursing, nursing education, administration, or research. It also requires a minimum of 2,400 hours of perioperative experience, with at least 1,200 hours in an intraoperative setting.

Advanced practice registered nurses with a master of science in nursing or doctoral nursing degree may qualify for the Clinical Nurse Specialist Perioperative Certification. The Certified Surgical Services Manager credential is the only certification for perioperative managers, directors, and nurses who oversee personnel, budgets, business departments, or service lines.

Working as a Perioperative Nurse

Working in hospitals and other healthcare facilities that provide surgical procedures can help RNs gain necessary skills in patient assessment and monitoring. They also learn safety and sterilization and recovery coordination.

This experience prepares them for the fast-past and challenging conditions working as perioperative nurses. Some hospitals offer nurse residency programs for recently-graduated RNs designed to strengthen their surgical care skills.

Responsibilities will differ depending on the work setting and assigned role. For example, scrub nurses work in hospital surgery units and emergency rooms, preparing and handing tools to surgeons during procedures. Circulating nurses help maintain sterile conditions and ensure that surgical teams follow safety protocols. Perioperative nurses who are RN first assistants work with physician supervision but perform many surgical procedures independently, from controlling bleeding to suturing incisions and wounds.

As healthcare facilities deal with physician and nursing shortages and increasing surgical volume, employment and salary prospects for perioperative nurses will continue to expand. Although theU.S. Bureau of Labor Statistics does not provide state-specific data for RNs with perioperative specialties, their salaries reflect the average compensation for all RNs which range from $59,450 a year for those in the bottom 10% to $120,250 and over for the top 10%.

Perioperative nurses in advanced nursing roles with board certification can expect to earn much higher than the average annual RN salary of $82,750.

Frequently Asked Questions About Becoming a Perioperative Nurse

question-mark-circleWhat skills does a perioperative nurse need?

Perioperative nurses work in fast-paced, stressful surgical settings. They must develop a full range of fundamental RN skills from their nursing training and clinical practice as well as competency in surgical procedures.

They must also develop “soft skills” for nurses to help them deal with volatile and high-risk working conditions. These include performing under rapidly changing conditions, maintaining patient focus and attention to detail, and committing to teamwork.

question-mark-circleWhat is the quickest way to become a perioperative nurse?

You can enter the field in 24 months by earning an ADN degree and successfully passing the NCLEX-RN exam. If you have previously earned college credits, you may be able to complete an accelerated BSN or bridge program in two years.

question-mark-circleWhat are the legal aspects of a perioperative nurse’s role?

The Association of periOperative Registered Nurse’scode of ethics for perioperative nurses establishes ethical standards for the profession. Perioperative nurses have an obligation to protect, support, and advocate for the moral and legal rights of patients. They must provide safe and professional patient care while also respecting the choices of their patients, including those decisions the nurse does not agree with.

Nurses who do not comply with the Nurse Practice Act in their state may have their licenses revoked or be held legally liable for negligence, malpractice, or breach of patient confidentiality.

question-mark-circleDo perioperative nurses get paid well?

According to Payscale in August 2022, perioperative nurses can earn much more than theaverage annual RN salary of $68,300. In August 2022,RNs with perioperative skills reported average yearly earnings of $76,800. Compensation varies considerably by education level, location, work settings, and experience. Perioperative nurses with 10 or more years of experience earn over $83,300 a year with the highest paid making over $115,000 or more.

Page last reviewed: August 4, 2022

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