8 Things to Know to Become a Surgical Nurse

Surgical nurses play a vital role in healthcare today. They work closely with surgeons, anesthesiologists, and other operating room personnel to ensure safe patient care before, during, and after surgical procedures. 

With the aging population and rise in chronic diseases, the demand for nurses is higher than ever. So, becoming a surgical nurse is an excellent option for those interested in a rewarding nursing career at the forefront of healthcare. 

However, to be successful as a surgical nurse, there are several key things to know about this specialty.

  1. Earn a Nursing Degree

The first educational step to becoming a surgical nurse is earning an Associate’s Degree in Nursing or a Bachelor of Science in Nursing. 

An ADN degree is a great way to start a career in nursing. It requires two years to finish and provides the fundamentals of nursing care. A BSN is a more in-depth 4-year program with additional leadership, research, and community health courses. While an ADN is sufficient to become an RN, employers increasingly seek out nurses with a BSN or higher.

Earning a BSN is recommended for those pursuing specialty nursing roles like surgical nursing. When researching nursing schools, look for programs offering robust clinical rotations in the operating and perioperative units. Getting hands-on surgical experience during nursing school will help reinforce the skills and knowledge needed for this field. 

Some nurses may also pursue a Master of Science in Nursing degree after gaining experience to take on more advanced nursing and leadership positions. Fortunately, many universities now offer online MSN degrees to help accommodate working students, making it easier to pursue advanced training without compromising their professional duties.

  1. Obtain Licensure

After graduating from an accredited nursing program, candidates must pass the National Council Licensure Examination (NCLEX-RN) to obtain registered nursing licensure. The NCLEX-RN is a comprehensive exam that tests the essential knowledge and clinical judgment required for entry-level nursing practice across all specialty areas. 

Upon passing the NCLEX-RN, nurses must apply for licensure in the state where they wish to practice. Nursing licensure must be renewed every 1-2 years by completing continuing education courses and clinical practice requirements.

  1. Gain Clinical Experience

Once licensed, most hospitals require registered nurses to have 1-2 years of medical/surgical nursing experience before transitioning into a specialty area like the operating room. Working on a medical-surgical unit, progressive care unit, or in a specialty such as labor & delivery or the emergency department helps build fundamental nursing competencies. These include patient assessment, communication, clinical decision-making, and managing unstable patients. 

During this time, nurses interested in surgical nursing should express their interest to unit managers and network with surgical services staff. 

  1. Complete Specialized Surgical Training

After getting experience in an initial nursing role, the next step is to complete a perioperative training program to transition into surgical nursing. Many large hospitals provide these specialized orientations ranging from 6 weeks to 6 months. 

Training covers surgical instruments and equipment, various surgical procedures, sterile techniques, patient positioning, surgical complications, and safety protocols. Nurses get hands-on practice in the OR setting while learning the circulator and scrub roles. 

Some facilities require nurses to scrub in and observe dozens of cases alongside an experienced preceptor before being cleared to work independently. Perioperative training gives nurses the tools to thrive in a complex surgical environment.

  1. Understand Surgical Roles

Surgical nurses take on different roles within the operating room, including circulator or scrub nurse. 

Circulating nurses oversee the big picture during surgery by coordinating room preparation, patient transportation, surgical equipment, specimen handling, and communications between team members. In contrast, scrub nurses work directly with the surgeon by passing instruments, preparing sutures, handling surgical specimens, and maintaining the sterile field at the surgical table. 

Both roles require extensive knowledge and preparation for surgical procedures to ensure smooth workflow. Nurses in each role must collaborate closely and anticipate each other’s needs throughout the case.

  1. Master Surgical Procedures

To provide safe patient care, surgical nurses must have in-depth knowledge of their facility’s most common operations, including general surgery, orthopedic, neurologic, cardiac, plastic, and other specialty procedures. 

Nurses should understand the standard procedural steps, instruments, and supplies needed for each surgery type, patient positioning, specimen handling, and potential complications. Reading procedure manuals, watching surgery videos, reviewing care guidelines, and studying textbooks help nurses gain expertise. The more exposure nurses have to observing and participating in procedures, the more adept they will become at anticipating needs and performing their role.

  1. Know Anesthesia Methods

Surgical nurses must have knowledge of different anesthesia types, including general anesthesia, regional anesthesia such as spinal blocks, local anesthesia, and sedation. Nurses must be able to monitor patients under anesthesia by tracking vital signs, airway patency, and other parameters. They need to quickly recognize any changes in patient status related to anesthesia and alert the anesthesia care team. Smooth coordination between surgical nurses and anesthesia is crucial for positive patient outcomes.

  1. Have Strong Communication Skills

Communication is vital for teamwork and patient safety in the fast-paced OR environment. Surgical nurses must communicate clearly, listen attentively, and provide direct instructions to surgical technologists and other staff. They need to concisely relay important information to the surgeon and anesthesia providers, ask clarifying questions when unsure, and speak up immediately if issues arise. Nurses must advocate firmly for patient safety if any concerns are noted. Maintaining open lines of communication fosters collaboration between all OR team members.


Pursuing a career as a surgical nurse allows nurses to play an integral role during surgery while advancing their knowledge and technical skills. By following the steps above – earning a nursing degree, obtaining licensure, gaining experience, completing perioperative training, mastering surgical practices, and honing critical thinking – nurses can successfully transition into this dynamic specialty. With its fast pace, cutting-edge technology, and need for precision, surgical nursing offers endless opportunities for dedicated nursing professionals seeking to take their careers to the next level.

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