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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 incollaboration 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 NurseThe 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 broadperspective and assists the team to create and maintain a safe and comfortable environment forthe 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 aperioperative 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 makedecisions 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.

Scrub NurseThe 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.

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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 beinvolved with patient care before and after surgery