Perioperative Nurse

Each year, 40 to 50 million surgeries are performed in the US. Surgeons are often seen as the central figures in operation rooms, responsible for performing complex procedures that can save lives. However, they do not work alone. A team of dedicated professionals assists them, ensuring the safety and well-being of patients before, during, and after surgery. This team comprises anesthesiologists, surgical technologists, nurse anesthetists, and notably, perioperative nurses. 

Perioperative nurses are vital in maintaining a sterile operating environment, caring for patients, and supporting surgeons throughout the surgical process. However, they also have many responsibilities that extend beyond the operating room. They conduct preoperative patient interviews, help prepare patients for surgery, and provide postoperative education and serve as patient advocates, often being the primary point of contact between the surgical team and the patient’s family. 

As for the education required to become a perioperative nurse, the first step is to become a registered nurse (RN) by earning a bachelor’s or associate’s degree in nursing, passing the National Council Licensure Examination (NCLEX), and applying for licensure from their state’s board of nursing. Once licensed, nurses typically gain surgical nursing experience before specializing in perioperative care. Many then obtain certification through the Competency & Credentialing Institute, which offers the Certified Perioperative Nurse (CNOR) credential. To gain hands-on skills, many aspiring perioperative nurses will complete a fellowship or residency offered at hospitals and medical centers

Keep reading to discover more about how to start a career as a perioperative nurse, including education programs, accreditation, and steps for certification and licensure. 

Perioperative nursing is a specialization within the field of nursing. All perioperative nurses must complete an accredited nursing program and earn an associate’s or bachelor’s degree. Nurses who wish to complete additional education in perioperative nursing can choose to complete a residency or fellowship in this field. These programs are structured for recent nursing graduates to provide them the opportunity to gain hands-on experience, enhance clinical skills, and transition smoothly into a new role. They often include classroom learning, simulations, and on-the-job training, supervised by experienced mentors.

Admission requirements to perioperative nursing residencies and fellowships will vary. Still, they will often include completion of an accredited nursing program, an unencumbered RN license, letters of recommendation, and a statement of purpose. Some programs may require clinical experience, while others are designed for new graduates.

All perioperative nurses must complete a nursing education program that is accredited by the 

Commission on Collegiate Nursing Education (CCNE) and the Accreditation Commission for Education in Nursing (ACEN). Attending an accredited program is a requirement for licensure in most states. It demonstrates to employers and students that a program has met a high standard for quality in facilities, faculty, and curriculum. 

Post-nursing school, RNs may choose to complete a perioperative nursing residency or fellowship program to gain hands-on skills in a structured environment. These fellowships can be accredited by the Practice Transition Program by the American Nurses Credentialing Center’s Commission on Accreditation in Practice Transition Programs. 

Mayo Clinic – College of Medicine and Science 

The perioperative RN fellowship program at the Mayo Clinic College of Medicine and Science is a comprehensive 30-week training course designed for registered nurses looking to venture into the operating room setting. The program kicks off with a week of hospital induction, followed by three weeks of theoretical and simulation-based learning to familiarize nurses with the operating room environment. The ensuing three weeks involve one-on-one guidance from a preceptor to further acquaint nurses with surgical procedures and standards.

Next, nurses will complete a 15-week rotation across various specialty services like general surgery, vascular, neurology, cardiac, urology, GYN, and robotics. The program encompasses instruction on state-of-the-art, specialized machines like lasers, and electrosurgical and laparoscopic equipment, and introduces basic scrub principles. All admitted students receive a full scholarship and a stipend to participate in this program. 

• Location: Phoenix/Scottsdale, AZ 
• Duration: Four months
• Accreditation: Higher Learning Commission (HLC)

University of Pittsburgh Medical Center

The University of Pittsburgh Medical Center offers a perioperative nursing fellowship program designed to provide comprehensive training in the recommended practices of the Association of Operating Room Nurses (AORN). The program’s primary goal is to prepare students to practice safely and confidently as members of a fast-paced perioperative team. Throughout the fellowship, participants will gain clinical experience and participate in ongoing educational opportunities to enhance OR skills and didactic knowledge.

To further support professional development, the program includes courses and workshops approved for continuing education credit. Participants will also receive ongoing support from staff development instructors, who will monitor progress and provide guidance. Students will work in various settings, including laparoscopy, transplant, gynecology, neurology, podiatry, and more.

• Location: Pittsburg, PA 
• Duration: Eight months
• Accreditation: Commission on Collegiate Nursing Education (CCNE)

University of Maryland Medical Center 

New nursing graduates and individuals without prior work experience in a perioperative setting can complete the OR nurse fellowship program at the University of Maryland Medical Center. This program is designed to equip them with the necessary skills to fulfill the responsibilities of a registered nurse in the operating room. It is customized to cater to each participant’s unique training requirements, considering their educational and professional background.

This program includes unit-based training, a five-day perioperative nursing course, and simulation training in a lab setting. Trainees receive an orientation to both the RN circulator and scrub roles, and they work closely with experienced preceptors in each role. While with an OR centric program, students will rotate through perioperative areas to ensure they are prepared for all potential workplaces and assignments. 

• Location: Baltimore, MD 
• Duration: Varies
• Accreditation: Commission on Collegiate Nursing Education (CCNE)

Cleveland Clinic

The perioperative nurse residency program at the Cleveland Clinic is designed to equip nurses who are new to the operating room with the necessary skills and knowledge to succeed in this dynamic setting. This program utilizes an innovative approach that focuses on competency and simulation-based training. Nurses can apply newly acquired skills and concepts in the operating room under the guidance of experienced preceptors. 

In addition to learning operating room skills, students in this program will develop strong critical thinking skills and the ability to work on a team. Communication skills are also emphasized so students should anticipate learning how to effectively engage with their co-workers and be strong advocates for their patients. 

• Location: Cleveland, OH 
• Duration: One year
• Accreditation: Accreditation with Distinction from the American Nurses Credentialing Center (ANCC)

Dartmouth Hitchcock Medical Center 

Through Dartmouth Hitchcock Medical Center’s perioperative nurse residency program, nurses can acquire the essential knowledge and skills required for a successful nursing career in the operating room. This nine-month program utilizes a combination of didactic learning, specifically AORN’s Periop 101: A Core Curriculum, face-to-face clinical skills labs and hands-on experiences in the operating room. It is designed to support new OR nurses in their journey towards becoming well-rounded and fully competent perioperative registered nurses.

Only a limited number of students are accepted into this program each year. All program participants receive a salary and are eligible for benefits. While the actual program can vary from student to student, most will rotate through a variety of surgical services, including ENT, general, plastics, orthopedic, ophthalmology, oral, and urology. 

• Location: Hanover, NH 
• Duration: Nine months 
• Accreditation: Commission on Collegiate Nursing Education (CCNE)

Columbia Basin College

At Columbia Basin College, the perioperative nursing program is designed to equip students with a comprehensive understanding of the surgical environment. The curriculum is centered on the Association of periOperative Registered Nurses (AORN) Fundamentals of Perioperative Practice, ensuring that students gain a deep understanding of surgical anatomy, operative procedures, surgical instrumentation and supplies, sterilization, and infection control procedures, and technical specialty equipment. 

This intensive program is delivered through online didactic coursework, catering to the needs of working professionals seeking to advance their knowledge and skills without disrupting their professional commitments. Practical skills and hands-on experience are a critical part of the training, with students honing their skills in CBC’s state-of-the-art surgical sciences lab.

• Location: Pasco, WA 
• Duration: Two quarters
• Accreditation: Commission on Collegiate Nursing Education (CCNE)

The Tseng College California State University, Northridge

Nurses can complete a certificate in perioperative nursing at The Tseng College California State University, Northridge. This certificate consists of one course that includes classroom instruction and supervised clinical work. All didactic work is available online, while the clinical work takes place at a healthcare facility that best suits the student’s needs and career goals. Most students complete this program in just eight weeks. 

Students in this program are well supported by faculty, the clinical placement staff, and a personal progress team that is there to ensure students can focus on their classwork and career. To be eligible for admission, nurses must hold a California RN license. All coursework counts as continuing education units for licensure renewal. 

• Location: Northridge, CA
• Duration: 144 hours
• Accreditation: Western Association of Schools and Colleges

Mount Sinai Phillips School of Nursing Perioperative Nursing

In just eight short weeks, nurses can complete the perioperative nursing course offered at Mount Sinai Phillips School of Nursing Perioperative Nursing. Students can complete either the operating room or ambulatory surgery track. They will be required to complete 80 hours of classroom lectures and 50 hours of clinical practice at a hospital or surgery center. 

Course topics include anesthesia coma documentation, environmental sanitation, hemostasis, specimens, and scrubbing, gowning, and gloving. All lectures are delivered live online on Saturdays to accommodate working participants. This program is designed for new nurses, nurses with no OR experience, and experienced nurses.  

• Location: Tampa, FL 
• Duration: Eight weeks 
• Accreditation: Commission on Collegiate Nursing Education (CCNE)

Association of periOperative Registered Nurses

All registered nurses must complete continuing education units to maintain their licenses and certifications. The Association of periOperative Registered Nurses (AORN) offers online continuing education classes to help nurses in this field go beyond basic education and further their skills. 

These classes cover topics essential to ensuring patient safety and optimal outcomes. Topics include aseptic practice, ambulatory surgery, equipment safety, leadership, and even sterilization. Within each topic there are numerous courses nurses can complete. Prices vary, and there is a discount for AORN members.  

• Location: Denver CO
• Duration: Varies
• Accreditation: American Nurses Credentialing Center’s Commission on Accreditation

Curry College

The perioperative 101 certificate at Curry College is a six-month program that combines in-class and online learning to prepare nurses for the Certified Perioperative Nurse (CNOR)  certification exam. With a curriculum designed by AORN, this program meets national standards for perioperative nursing. This program is for new nurses with little to no operating room experience. It is also an excellent option for experienced nurses preparing for their certification exam. 

Pursuing a perioperative certificate offers numerous benefits for career growth and personal development. Nurses gain the necessary knowledge and skills to excel in the dynamic workplace by obtaining this certification. It can open up new career opportunities and allow for advancement within the nursing field. Nurses will gain additional critical-thinking abilities specific to this field and be allowed to showcase mastery of nationally recognized nursing standards and evidence-based practices. 

• Location: Milton, MA 
• Duration: 68 instructional weeks
• Accreditation: Commission on Collegiate Nursing Education (CCNE)

Perioperative Nurses typically must complete bachelor’s and master’s of nursing degrees. This takes about six years of education post-high school. However, this time can vary depending on the work experience required and the length of the master’s program.  

Step 1: Graduate from High School or Complete a GED (Four Years)

The foundational knowledge and skills students gain in high school or while earning their GED are crucial for their nursing education. Biology and chemistry are particularly beneficial as they lay the groundwork for understanding the human body and medical treatments.

Step 2: Complete a Nursing Program (Two to Four Years)

After completing high school or a GED, aspiring perioperative nurses must complete a nursing program. This can be an associate degree in nursing (ADN) or a bachelor of science in nursing (BSN) program. An ADN typically takes two years, while a BSN usually takes four years. Both programs provide the necessary clinical experience and coursework in anatomy, pharmacology, and nursing practice to equip students with the skills and knowledge to work as entry-level nurses.

Step 3: Pass State NCLEX Exam (Timelines Vary)

Upon completing a nursing program, the next step is passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN). This standardized exam is required to obtain a license as a registered nurse in the United States. It measures competency to perform as an entry-level nurse and assesses understanding of nursing principles, patient care and safety, infection control, and health promotion and maintenance.

Step 4: Apply for State Licensure (Timelines Varies)

After successfully passing the NCLEX-RN exam, the next milestone is to apply for state licensure. This process involves applying to the state nursing board, and the requirements may vary slightly depending on the state you reside in. This license legally authorizes nurses to practice as registered nurses and is a prerequisite to pursuinga specialization in perioperative nursing. More details on licensure can be found below.

Step 5: Complete a Perioperative Nurse Fellowship or Residency (Optional, Timelines Vary)

Though not mandatory, completing a perioperative nurse fellowship can provide valuable practical experience and specialized knowledge in the field. These fellowship programs offer a unique opportunity for registered nurses to gain direct, hands-on experience in the surgical environment under the guidance of experienced mentors. The duration of the fellowship programs varies, but they typically last from six to 24 months. 

Through a blend of didactic learning, case reviews, and clinical practice, fellows acquire the skills to deliver safe and effective patient care before, during, and after surgery. These programs often enhance employability, demonstrating a commitment to the specialty and providing a competitive edge in the job market.

Step 6: Obtain Perioperative Nurse Certification (Optional, Timelines Vary)

Although optional, securing a perioperative nurse certification can significantly enhance credibility and job prospects within the field. The primary credential obtained is the Certified Perioperative Nurse (CNOR) certification from the Competency & Credentialing Institute. More details on certification can be found below.

Perioperative nurses work primarily in surgical departments and operating rooms. Day-to-day duties will vary but will typically include:

• Preparing patients for surgery by assessing their medical history, and current health status, and ensuring they are properly informed and consented
• Collaborating with the surgical team to develop and implement a comprehensive plan of care for each patient
• Assisting in the setup and maintenance of the operating room
• Monitoring patients’ vital signs, anesthesia administration, and overall condition during surgery
• Managing and administering medications, intravenous fluids, and blood products as needed during surgery
• Monitoring patients’ responses and maintaining accurate documentation during surgery
• Anticipating and responding to potential complications or emergencies during surgery
• Working alongside the surgical team to provide immediate intervention and stabilize patients when necessary
• Communicating and coordinating with other healthcare professionals
• Educating patients and their families on post-operative care instructions, including wound care, pain management, and any necessary lifestyle modification
• Advocating for patient safety and promoting infection control measures in the perioperative setting
• Following strict protocols and guidelines to minimize the risk of surgical site infections.
• Updating their knowledge and skills through professional development activities

All perioperative nurses must be licensed RNs in the state where they are working. Licensing requirements will vary by state but will typically include:

• Graduate from an accredited associate’s level nursing program or higher or have completed military nursing coursework
• Complete a fingerprint-based background check
• Pass the NCLEX-RN exam

Certification as a perioperative nurse is a voluntary step that RNs can take to demonstrate their competency in this field. The primary certification perioperative nurses earn is the Certified Perioperative Nurse (CNOR) credential through the Competency & Credentialing Institute (CCI). Currently, over 40,000 nurses hold this valuable certification. To be eligible, RNs must:

• Hold a current, valid, and unrestricted RN license
• Currently working full- or part-time in perioperative nursing clinical practice, nursing education, administration, or research
• Have a minimum of two years and 2,400 hours of experience in perioperative nursing, with a minimum of 1,200 hours in the intraoperative setting

Nurses who meet the minimum qualification can apply to take the CNOR exam. This three-hour and 45-minute exam consists of 200 questions. Topics covered include pre/postoperative patient assessment and diagnosis, individualized plan of care development and expected outcome identification, management of intraoperative activities, patient care and safety, management of personnel, services and materials, communication and documentation, infection prevention and control of environment, instrumentation and supplies, emergency situations, and professional accountabilities.

The Bureau of Labor Statistics doesn’t differentiate between nursing specializations. Registered nurses, including perioperative nurses, earn $89,010 per year on average. Here are the percentiles:

• 10th percentile: $61,250
• 25th percentile: $66,680
• 50th  percentile (median): $81,220
• 75th percentile: $101,100
• 90th percentile: $129,400

For more targeted salary information, Salary.com (2023), a salary aggregating website, estimates that staff nurses who work in operating rooms earn $85,626 per year on average. 

Here are a few alternatives to a career as a perioperative nurse. 

Become a Surgical Technologist

Surgical technologists, also known as surgical technicians, assist surgeons during surgical procedures by preparing the operating room, sterilizing and arranging surgical instruments, and ensuring all necessary supplies are readily available. During surgery, they pass instruments to the surgeon, handle specimens, and assist with suturing and wound closure. They also play a vital role in maintaining a sterile environment, operating and maintaining surgical equipment, and providing patient care. 

• Typical Education: Certificate or associate’s 
• Licensing or Certifying Organization: National Board of Surgical Technology and the National Center for Competency Testing (NCCT)

Become a Nurse Practitioner

With advanced training and education, nurse practitioners provide comprehensive and personalized care to patients. They play a crucial role in diagnosing and treating various health conditions, ordering and interpreting diagnostic tests, prescribing medications, and managing chronic illnesses. Nurse practitioners also focus on preventive care, health promotion, and patient education, empowering individuals to take control of their own health. 

• Typical Education: Master’s of science in nursing or doctor of nursing practice
• Licensing or Certifying Organization: American Academy of Nurse Practitioners (AANP), American Nurses Credentialing Center (ANCC), American Association of Critical-Care Nurses (AACN), National Certification Corporation (NCC), Pediatric Nursing Certification Board (PNCB), American Midwifery Certification Board (AMCB), Dermatology Nursing Certification Board (DNCB), Nephrology Nursing Certification Commission (NNCC), Orthopaedic Nurses Certification Board (ONCB), and Oncology Nursing Certification Corporation (ONCC) 

Become an ER and Critical Care Nurse

ER (emergency room) and critical care nurses provide specialized care to patients in critical conditions. Their duties will include assessing, monitoring, and treating patients who require immediate medical attention. In the fast-paced and unpredictable emergency room or critical care unit environment, these nurses excel at triaging patients, administering life-saving interventions, and ensuring their overall well-being. They are highly skilled in handling trauma cases, cardiac emergencies, and other critical situations, utilizing their extensive knowledge and expertise to stabilize patients and make split-second decisions. 

• Typical Education: Associate or bachelor’s degree
• Licensing or Certifying Organization: American Association of Critical-Care Nurses (AACN), American Nurses Credentialing Center (ANCC), National Certification Corporation (NCC)

Kimmy Gustafson

Writer

At HealthcareDegree.com, Kimmy Gustafson has delivered in-depth and insightful articles since 2019, aiding prospective students to navigate the complexities of choosing the right healthcare degree. Her recent work includes topics such as the ethics of gene editing and physician assistant’s fight for autonomy.

Kimmy has been a freelance writer for more than a decade, writing hundreds of articles on a wide variety of topics such as startups, nonprofits, healthcare, kiteboarding, the outdoors, and higher education. She is passionate about seeing the world and has traveled to over 27 countries. She holds a bachelor’s degree in journalism from the University of Oregon. When not working, she can be found outdoors, parenting, kiteboarding, or cooking.