Disclaimer: This article is intended solely for informational and educational purposes only. It does not constitute medical advice.
Operating room (OR) nurses are essential members of the perioperative team, working alongside surgeons, anesthesiologists, and surgical techs to ensure safe and effective surgical care. Their responsibilities extend beyond technical assistance to encompass patient advocacy, infection prevention, surgical preparation, communication, and coordination of care [1,2].
Nurses in the OR generally undertake two principal roles: scrub nursing and circulating nursing. Scrub nurses work within the sterile surgical field, preparing and handling instruments, assisting surgeons, and anticipating procedural requirements. They are also responsible for maintaining sterility and participating in surgical instrument, needle, and sponge counts. Circulating nurses operate outside the sterile field, coordinating personnel, equipment, and supplies while overseeing the broader surgical environment. Both roles require close collaboration to maintain procedural efficiency and safety [2,3].
Preoperative preparation represents a major nursing responsibility. Before surgery, nurses verify patient identity, the planned procedure, surgical site, and relevant clinical information. They also ensure that necessary instruments, equipment, and supplies are available and functioning appropriately. Participation in standardized surgical safety protocols, including sign-in, time-out, and sign-out procedures, helps prevent wrong-site surgery, retained surgical items, and other avoidable errors. Furthermore, nurses are often well-positioned to provide reassurance and emotional support to patients experiencing preoperative anxiety [1,2].
Intraoperative patient safety requires continuous vigilance and teamwork. Nurses assist with patient positioning, ensuring appropriate padding and protection against pressure injuries, nerve damage, and accidental contact with hazardous equipment. They maintain aseptic practices, monitor the integrity of the sterile field, and identify potential contamination. Surgical counts and accurate specimen handling are similarly essential. One study found that patient safety, standardized practices, and preoperative readiness were central themes in OR nursing responsibilities [2].
Effective nursing practice also depends on non-technical skills, particularly situational awareness, communication, teamwork, and stress management. An interview study involving 25 scrub nurses and nine consultant surgeons identified these skills as fundamental to safe surgical performance. Experienced scrub nurses anticipate procedural developments, recognize changes in the surgical environment, and prepare instruments before they are requested. Such awareness facilitates surgical workflow while allowing nurses to identify and communicate emerging safety concerns [3].
Teamwork and communication are especially important in the complex OR environment. Scrub and circulating nurses must coordinate their activities, clarify requests, and share relevant information with surgeons and anesthesia providers. Sonoda et al. found that approximately 30–40% of OR nurses experienced mental stress during surgery, with contributing factors differing between scrub and circulating nurses. These findings highlight the importance of supportive teamwork, appropriate staffing, and effective communication in maintaining safe working conditions [4].
Patient advocacy remains a defining responsibility throughout the perioperative period. Nurses must recognize and raise concerns about unsafe practices, protect patient dignity, and ensure that individual needs are not overlooked. Following surgery, they contribute to accurate documentation and structured handover to the postoperative recovery team, communicating relevant procedural events and ongoing concerns [1,2].
OR nurses have an essential role in the perioperative team, contributing clinical expertise, technical proficiency, vigilance, and interpersonal skills. Highly skilled OR nurses can anticipate needs, coordinate care, prevent errors, and advocate for patients.
References
- Columbia University Department of Surgery. What does an OR nurse do? Columbia Surgery. Available from: https://columbiasurgery.org/news/what-does-or-nurse-do.
- Chellam Singh B, Arulappan J. Operating room nurses’ understanding of their roles and responsibilities for patient care and safety measures in intraoperative practice. SAGE Open Nurs. 2023;9:23779608231186247. doi:10.1177/23779608231186247.
- Mitchell L, Flin R, Yule S, Mitchell J, Coutts K, Youngson G. Thinking ahead of the surgeon. An interview study to identify scrub nurses’ non-technical skills. Int J Nurs Stud. 2011;48(7):818–828. doi:10.1016/j.ijnurstu.2010.11.005.
- Sonoda Y, Onozuka D, Hagihara A. Factors related to teamwork performance and stress of operating room nurses. J Nurs Manag. 2018;26(1):66–73. doi:10.1111/jonm.12522.