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How to become a surgical nurse

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When a patient undergoes surgery, they entrust their health and well-being to a skilled surgical team. This includes the surgeon, or in some cases a team of surgeons, as well as technicians and anesthesiologists. Surgical nurses also play a crucial role in ensuring a positive surgical experience.


Becoming a surgical nurse is a promising path for anyone who wishes to make a difference for their patients. But what does a surgical nurse do specifically? What steps are required to become a surgical nurse? And what can aspiring surgical nurses expect regarding salary and job outlook?


The best way for you to prepare for this kind of nursing career is to seek a formal education that cultivates the right skills.

What does a surgical nurse do? 

If you’re interested in pursuing surgical nursing as a profession, consider the job’s basic duties and responsibilities.

Surgical nurse job description

Surgical nurses, also known as perioperative nurses, are typically registered nurses (RNs) who receive specialty training to assist in surgical procedures. Their role may involve promoting patient safety, comfort, and well-being before, during, and after surgery. A surgical nurse may assist in any kind of procedure, from emergency interventions and life-saving surgeries to elective or cosmetic ones.

Surgical nurse duties and responsibilities

What does a surgical nurse do from day to day? Duties vary depending on the nature of the surgical environment the nurse works in, and also on the nurse’s specific surgical subspecialty. Surgical nurses fill a number of roles, and they all have their own unique responsibilities. Some examples include:

  •  Scrub nurses. Scrub nurses work in the sterile environment of the operating room (OR). Their job is to make sure the room is properly set up not only for the patient’s comfort but also to make sure the surgeons have easy access to the necessary tools. Scrub nurses may be present during the surgery to hand surgeons tools and supplies as needed.
  • Circulating nurses. Circulating nurses work outside the sterile part of the OR, but play a vital role in managing activity throughout the surgical facility. Their duties may involve sterilizing instruments, obtaining signatures on patient consent forms, and performing preoperative assessments to ensure patient safety.
  • RN first assistants (RNFA). This role is given to RNs who work closely with the surgeon to perform suturing, keep bleeding under control, apply bandages, and monitor the patient for any signs of complication. This is a highly significant role for promoting the safety of the patient.
  • Post-anesthesia care nurses. These nurses will usually be with the patient in the recovery room following their procedure, closely monitoring them as they stabilize and as they shake off the effects of the anesthesia. Additionally, these nurses can help prepare patients either to go home or to be transferred to another unit of the hospital.
  • Medical-surgical nurses. The role of med-surg nurses is to care for patients post-procedure, helping promote a safe and expedient recovery. Nurses in this role may monitor vital signs and apply different medical techniques to help guard their patients against infection, excessive bleeding, swelling, and intense pain.

Surgical nurse work environments

While many people may assume that surgical nursing professionals work strictly in hospital settings, they practice in a number of environments. Some examples include:

  •  Ambulatory surgery centers
  • Day surgery centers
  • Clinics
  • Private practices with their own OR facilities
  • Hospitals (including in operating rooms and recovery rooms)

Steps to becoming a surgical nurse

If you’re interested in any kind of surgical nursing role, important first steps include seeking the right education, the right credentials, and the necessary portfolio of skills and technical competencies.

Education and experience requirements

To become a surgical nurse, you must first become a registered nurse, or RN. Earning an RN designation requires the completion of either a two-year associate's degree in nursing, a four-year Bachelor of Science in Nursing, or a nursing diploma program. (Note that diploma programs are increasingly rare.) While any of these three options is sufficient for earning an RN certification, many hospitals and medical practices favor four-year degrees when it comes to surgical nursing hires. Completing a BSN is the optimal step for those who wish to maximize their career prospects in the surgical nursing field.


No degree program is specifically geared toward surgical nursing, but most nursing programs offer continuing education courses that can help nurses hone their surgical skills, such as courses in sterilization and emergency procedures.


Many organizations prefer that their surgical nurses have at least some experience caring for patients in the emergency room or on critical care floors. Though not strictly necessary, this level of experience can benefit your career prospects.


To become an RN, nurses must pass the NCLEX-RN, a national exam administered by the National Council of State Boards of Nursing. Nurses who want to work in surgical settings are not always required to obtain further certification, but many organizations ask that they earn certification through the Medical-Surgical Nursing Certification Board (MSNCB).


MSNCB certification requirements include:

  • A current RN license
  • At least two years’ medical-surgical experience
  • At least 2,000 hours of medical-surgical practice experience within the previous three years

Core skills for a surgical nurse

The ultimate goal of these education, experience, and certification requirements is to hone the skills necessary to deliver the highest standard of patient care. A number of skills are essential for anyone in the surgical nurse role.

  • Communication skills. To maintain patient safety and well-being, surgical nurses often need to clearly communicate with their patients before and after a procedure, letting them know what preparations they need to make and what follow-up they need to do. Additionally, nurses must communicate calmly and clearly with the surgeon and technicians, even in tense environments.
  • Physical and emotional strength. The surgical nursing profession may require you to be on your feet for long stretches at a time, which can call for great physical stamina. Additionally, the operating room setting can be very fast-paced and intense, and in some cases, unwanted outcomes can include a patient’s death. Dealing with these circumstances calls for great emotional fortitude.
  • Flexibility. With surgery, things can change very quickly and abruptly. Surgical nurses may have to deal with a lot of last-minute modifications to their schedules and work assignments. Flexibility is essential for the job.
  • Organizational skills. For nurses working in the surgical setting, organization is crucial. Surgical nurses must have a disciplined and detail-oriented approach to organizing tools and surgical implements, paperwork, and beyond. Also, surgical nurses should be prepared to diligently update patient charts and files.
  • Time management. As they gain more experience in surgical settings, nurses will learn to identify which requests are urgent, and which can wait a few minutes. Being able to prioritize and manage time effectively are crucial for the position.
  • Alertness and observational skills. Surgical nurses need to be keenly aware of what is happening in the sterile field, or with their patient. For example, if a physician is running low on certain supplies, the surgical nurse should see that additional supplies are brought in as quickly as possible. And if any changes to the patient’s condition arise, the nurse should respond with urgency.

Surgical nurse salary and job outlook

If you’re considering a role in surgical nursing, you’ll naturally be interested in pay levels and the job market.

Surgical nurse salary

According to the U.S. Bureau of Labor Statistics (BLS), the median annual salary of RNs was $75,330 in 2020. While the BLS does not offer a distinction for surgical nurses, it does indicate that RNs employed in a hospital setting typically made a bit more than average.


A number of factors can cause variation in surgical nurse salary, including:

  •  Experience. Typically, those with more extensive experience in this profession will earn higher salaries.
  • Education. Level of education is also a deciding factor. RNs with four-year degrees may command higher salaries than those with two-year degrees.
  • Work environment. BLS data shows that the pay rate is a bit higher for nurses working in hospital settings as opposed to private practice.
  • Geographic area. Generally, surgical nurses make more money in metropolitan areas, while nurses in rural settings earn lower salaries.

Ways to increase a surgical nurse salary

If you want to work in surgical nursing and maximize your salary range, these strategies and suggestions can help.

  •  Advanced education. One option is to explore different ways to increase your education level, including enrollment in surgical nurse practitioner programs. Earning a BSN, Master of Science in Nursing (MSN), or continuing education certifications can lead to more competitive salary offers.
  • Pursue a subspecialty. Different subspecialty certifications are available to surgical nurses, and earning one of these credentials can open new job opportunities and boost your pay range. Some examples include certified perioperative nurse (CNOR), certified registered nurse first assistant (CRNFA), and certified medical-surgical registered nurse (CMSRN).
  • Consider travel nursing. For surgical nurses who do not mind spending time on the road, travel nurses, who work in short-term roles to fill nursing gaps rather than being attached to a single facility, tend to earn higher pay than others in the nursing profession.

Job outlook for surgical nurses

In addition to salary, aspiring surgical nurses should also know what to expect in the job market. The good news is that, according to BLS data, the number of jobs for RNs is expected to grow 7% by 2029. This is a higher rate of growth than the average for all professions, which is around 4%.


This high demand is being driven by the aging baby boomer population, which will likely require more specialized care, as well as assistance managing chronic conditions such as obesity and diabetes. Additionally, a shortage of physicians is looming, creating a space for nurses to play an even more central role in treating patients.


It is also worth noting that more surgical procedures are being performed outside of traditional hospital settings, including in clinics and private practices. This is another factor that suggests a growing demand for surgical nursing professionals.

Becoming a surgical nurse practitioner

Another option to consider is a role as a surgical nurse practitioner. Nurse practitioners (NPs) have continuing education and training beyond the basic nursing requirements, empowering them to have a more independent and autonomous role in diagnosing patients, developing care plans, and implementing treatments. Some nurse practitioners may participate in surgical procedures, providing another potential avenue for those who wish to pursue nursing and who are drawn to the surgical setting.

What does a surgical nurse practitioner do?

An SNP combines the traditional NP role with the duties and responsibilities of an RN first assistant. As such, the surgical nurse practitioner may provide an initial diagnosis and treatment plan for a patient. If this treatment plan involves surgery, the NP may help the patient prepare for their procedure, then provide ongoing monitoring and care as the patient recovers, helping the patient to achieve the best surgical outcome. Within the OR, the role of the surgical nurse practitioner may very closely resemble that of the registered nurse first assistant (RNFA).

What is the surgical nurse practitioner job outlook?

According to BLS data, the median annual salary of nurse practitioners is $117,670. Job outlook for NPs is very positive, with an anticipated growth rate of 45% between 2020 and 2030. This favorable surgical nurse practitioner job outlook can be attributed to an aging population, a growing need for chronic disease management, and a physician shortage that is likely to make the NP’s role more essential than ever.

How to become a surgical nurse practitioner

Becoming a nurse practitioner requires completing a few important steps:

  •  Earning a bachelor’s degree, typically a BSN
  • Becoming licensed as an RN
  • Completing either a master’s- or doctorate-level nurse practitioner program
  • Passing a national NP board certification examination

While nursing schools don’t offer formalized surgical nurse practitioner programs, those who obtain NP status and wish to play a more active role in perioperative care may complete continuing education courses that are focused on surgical skills, such as sterilization or emergency response.


Becoming a surgical nurse practitioner may be a valuable way to improve patient outcomes, gain experience in the fast-paced surgical setting, and command a higher salary range than surgical RNs. Both options offer a promising job outlook and ample opportunity to promote patient outcomes in a surgical setting.

Learn more about becoming a surgical nurse

The nursing profession offers a number of avenues for compassionate patient care. If you’re drawn to the high-intensity world of surgery, you should consider becoming a surgical nurse. One of the best ways to pursue success is to hone the right skills to support physicians and promote patient well-being; this all starts with a formal academic background.


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