Perioperative Nurse

Roles of the Perioperative Nurse

Perioperative NursePerioperative nursing is a specialized area of nursing practice. As a fundamental member of the surgical team, the perioperative registered nurse works in collaboration with other health care professionals which may include the surgeon, circulating nurse, anesthesia provider, surgical assistant, and other assistive personnel. The perioperative registered nurse provides nursing care to surgical patients preoperatively, intra operatively, and postoperatively.

The perioperative nurse plans and directs nursing care for patients undergoing operative and other invasive procedures. Perioperative RNs work in all types of health care facilities, such as hospitals, ambulatory or outpatient surgery centers, and physician offices.

There are several roles that the perioperative nurse fills to ensure quality patient care in the operating room.

Circulator Nurse
The circulator is responsible for managing the nursing care of the patient within the OR and coordinating the needs of the surgical team with other care providers necessary for completion of surgery. The circulator nurse observes the surgery and the surgical team from a broad perspective and assists the team to create and maintain a safe and comfortable environment for the patient. The circulator nurse assesses the patient's condition before, during, and after the operation to ensure an optimal outcome for the patient. Circulating during surgery is a perioperative nursing function. The role of the circulator may not be delegated to a UAP, Licensed Practice Nurse or Licensed Vocational Nurse.

In the operating room, most patients are anesthetized or sedated and are powerless to make decisions on their own behalf during the intraoperative phase. The circulating nurse serves as the patient advocate while the patient is least able to care for him or herself.

OR Director
The OR director manages the business of the facility's ORs. The OR director oversees and is responsible for budgets, staffing, supplies, scheduling, and other areas that keep the OR running.


Scrub Nurse
The scrub nurse works directly with the surgeon within the sterile field, passing instruments, sponges, and other items needed during the procedure. Surgical team members who work within the sterile field have scrubbed their hands and arms with special disinfecting soap and generally wear surgical gowns, caps, eyewear, and gloves. This is a nursing role that may be delegated to a UAP, LPN or LVN.

Registered Nurse First Assistant (RNFA)
The RNFA has gone through additional extensive education and training to deliver surgical care. The RNFA directly assists the surgeon by controlling bleeding, using instruments/medical devices, handling and cutting tissue, and suturing during the procedure. The RNFA may also be involved with patient care before and after surgery.

Patient Educator
The perioperative RN educator works with the patient and assists his or her family members in providing information to enable the patient to make informed decisions regarding surgical care and treatment.