Perioperative nursing is a nursing specialty that works with patients who are having operative or other invasive procedures. Perioperative nurses work closely with surgeons, anesthesiologists, nurse anesthetists, surgeon's assistants, surgical technologists, and nurse practitioners. They perform preoperative, intraoperative, and postoperative care primarily in operating theatres, stress test evaluations, cardiac monitoring, vascular monitoring, and health assessments. Perioperative nurses typically have Basic Life Support and Advanced Cardiac Life Support certification.
Perioperative nursing roles
Perioperative nurses in the USA may perform several roles, including Circulating (or Circulator or scout) nurse, Instrument (or scrub) nurse, Pre-operative (or patient reception) nurse, Post Anaesthetic Care Unit or Recovery nurse, Registered Nurse First Assistant (RNFA), and Patient Educator.The roles and functions may have different names or qualifications elsewhere - for instance, Operating Department Practitioner (ODP) in the UK.
The circulating (or circulator or scout) nurse is a perioperative nurse that assists in managing the nursing care of a patient during surgery. The circulator observes for breaches in surgical asepsis and coordinating the needs of the surgical team. The circulator is not scrubbed in the case, but rather manages the care and environment during surgery.
The instrument (scrub) nurse is a perioperative nurse that works directly with the surgeon within the sterile field. The scrub nurse manages the sterile equipment, anticipates the surgeon's needs, and passes instruments and other items required during the procedure. Other duties include surgical site skin preparation, sterile draping, suctioning, irrigation, and retraction. The title comes from the requirement to scrub their hands and arms with special disinfecting solutions.
RN First Assistant
An RNFA is the surgeon's assistant, surgical assistant or assistant surgeon that provides aid in exposure, hemostasis, closure, and other intraoperative technical functions that help the surgeon carry out a safe operation. The duties include a review of the patient's case, assist OR staff in preparing for the operative procedure, assist with positioning, prepping and draping of the patient, provide retraction, maintain hemostasis, performing knot tying, provide closure of tissue layers, help fixate implant devices, drill, ream, cauterize and approximate tissues, and complete the procedure by cleaning and applying dressings, casts, or splints. This role requires additional education and training above and beyond traditional education for becoming a Registered Nurse.