How to Become an Operating Room (OR) Nurse

What Is an Operating Room (OR) Nurse?

Operating Room (OR) nurses are Registered Nurses who assist during surgeries. They work in conjunction with surgeons and other healthcare professionals to help patients needing surgical procedures. 

OR nurses care for patients before, during, and after surgical procedures and work on everything from life-saving procedures to elective ones. They work in hospitals, surgery centers, and clinics and care for patients throughout the surgical process. 

In this guide, we'll explain what an OR nurse does, how much they make, how to become one, and more!

What Do OR Nurses Do?

The main job duties of an OR nurse include:

• Assisting in surgical procedures
• Making sure that all paperwork has been signed
• Prepping patients for operations
• Taking care of patients postoperatively
• Monitoring patients as they come out of anesthesia
• Offering pain management
• Prepping equipment for operations
• Ensuring operating rooms are sterile
• Developing a nursing care plan for the assigned patient
• Educating patients and their families pre/post operatively
• Passing surgical instruments to the surgeon
• Starting IVs and inserting Foley catheters

How to Become an OR Nurse

To become an OR nurse you'll need to complete the following steps:

1.) Attend an Accredited Nursing Program

To become a registered nurse you'll need to graduate from a two-year program for an Associate’s degree in nursing, or a four-year college or university program leading to a Bachelor’s degree in nursing.

2.) Pass the NCLEX-RN

You'll then need to take the RN licensing exam after graduation, also known as the NCLEX (National Council Licensure Examination). The NCLEX is a nationwide examination for the licensing of nurses in the United States and Canada.

3.) Get Additional Training and Experience

Once you pass the NCLEX, you may apply for your first nursing job.

The Association of peri-Operative Registered Nurses (AORN) also offers an online program, “Periop101: A Core Curriculum.” This course provides content coupled with lab and clinical experience and includes coursework in anesthesia, surgical draping, patient and equipment safety, and many other topics.

4.) Get Certified

Once you have experience in OR, you can advance your knowledge and salary potential by becoming certified. Two certifications are offered for OR nurses: CNOR and CNAMB. Both are provided by the Competency and Credentialing Institute (CCI).

CNOR Certification

According to CCI, CNOR is a definition, not an acronym. It means meeting identified standards of practice for providing nursing care to patients before, during, and after surgery.

CNAMB Certification

CCI offers the Certified Ambulatory Surgery Nurse (CNAMB) certification that is designed for perioperative nurses working in the ambulatory surgery setting who are seeking to improve and validate their professional competencies.

OR Nurse Salary

According to the U.S. Bureau of Labor Statistics (BLS), the median salary for a registered nurse in 2021 is $77,600 per year or $37.31 per hour, but conditions in your area may vary.

However, BLS reports don't differentiate between different specialties of nursing. Other salary reporting entities estimate that OR nurses make significantly higher salaries. For example, Glassdoor reports OR nurse salaries of $108,352 per year, and Payscale estimates they make around $76,567 or $34.58 per hour.

You can also increase your OR nurse salary by gaining experience:

• Less than 1 year of experience earns an average hourly salary of $29.03
• 1-4 years of experience earn an average hourly salary of $31.05
• 5-9 years of experience earns an average hourly salary of $33.97
• 10-19 years of experience earns an average hourly salary of $37.38
• 20+ years of experience earns an average hourly salary of $40

Via Payscale

OR Nurse Benefits

Regardless of the workplace setting, full-time and part-time nurses enjoy similar benefits. While actual benefits may vary depending on the institution, most include the following:

• Attendance at nursing conferences
• Maternity, paternity, or bereavement leave      
• Tuition Reimbursement      
• Childcare
• Health, vision, dental, and life insurance
• Discounts on extracurricular activities      
• Family Leave of Absence
• Paid time off & holidays
• Relocation packages & assistance
• Retirement Options

Where Can OR Nurses Work?

Operating Room nurses can work in a variety of locations as long as there is an Operating Room. Most work in hospitals, but they can also work in the following locations, 

• Ambulatory Surgery Centers
• Day Surgery Centers
• Clinics
• Physician’s Offices
• Cancer centers 

What is the Career Outlook for OR Nurses?

The Bureau of Labor Statistics predicts that nursing employment will grow at a rate of 6% percent through 2032, which is faster than the average for all jobs.

However, the need for OR nurses may be steadier, considering the high volume of ambulatory care visits in the US. According to the CDC, 48.3 million surgical and nonsurgical procedures were conducted in 28.6 million ambulatory surgery visits in 2010 alone.

Additionally, OR nurses have upward career mobility. They can attend RNFA programs to become registered nurse first assistants, increasing their responsibilities and salary expectations.

Continuing Education Requirements for OR Nurses

OR nurses do not necessarily have specific requirements beyond state-mandated continuing education. However, advanced certification does require CEUs.

All surgical nurses are required to maintain an RN license.

Continuing education requirements for the license differ for each state. Monetary fees and other state-specific criteria are also associated with all license and certification renewals.  

Examples of continuing education requirements for RNs are as follows:

• California - 30 CEUs every two years
• Florida - 24 CEUs every two years
• Hawaii - 30 CEUs every two years
• Oklahoma - 24 CEUs every two years
• Pennsylvania - 30 CEUs every two years

Some states do not require CEUs to maintain an RN license. Examples include Arizona, Colorado, Connecticut, Maine, Maryland, and Indiana. Several states also require HIV/AIDS education such as Florida or mandatory child abuse such as Pennsylvania. It is important for nurses to check their state’s RN credentialing body for exact CEU requirements.  A comprehensive list can be found here.  

Where Can I Learn More About OR Nurses?

The following organizations can provide more information about OR nursing:

• Association of periOperative Registered Nurses
• American Nurses Association
• American Society of Plastic Surgical Nurses (ASPSN)
• American Society of Plastic Surgical Nurses (ASPSN)
• American Society of PeriAnesthesia Nurses
• International Federation of Perioperative Nurses

FAQs about OR Nurses

• What is the role of an operating room nurse?

  • OR can perform several jobs during OR cases including being a scrub nurse, circulating nurse, or registered nurse first assistant.

• Do OR nurses assist in surgery?

  • OR nurses can assist in surgery; however, this depends on the healthcare institution. For example, large teaching hospitals will utilize surgical residents and fellows to assist attending surgeons instead of nurses. Smaller hospitals, as well as outpatient surgical centers, will most likely utilize OR nurses. For OR nurses to assist directly in surgery, they must have a CNFA certification.

• Is operating room nursing stressful?

  • The OR can be stressful at times, but so are most nursing positions within the healthcare industry. The most important thing to remember is to communicate with the surgeons as well as the rest of the OR team.

• Are OR nurses in demand?

  • OR nurses are VERY in demand right now. In fact, all nurses are in demand.

• What is the OR in a hospital?

  • The OR is the Operating Room where the medical team performs surgical procedures. Surgeries vary depending on the healthcare institution but include, orthopedic, cardiovascular, neurologic, gynecologic, and pulmonary.