Circulating Nurse

circulating nurseInside the surgery room, the patient is powerless—incapable of making a decision on his or her own, and hence, the circulating nurse acts as the patient advocate while the patient is under the influence of anesthesia. The Nurse Circulator ensures safety of patient within the period of operation. Perioperative nursing is a unique type of nursing specialty and an essential member of the surgery team. The circulating nurse works by collaborating with other members of the team including the anesthesiologist, surgeon, surgical technologist, surgical assistant, and other personnel. They render expert pre-, intra- and post-operative nursing service. 

Perioperative nursing is a nursing specialty requiring a distinct set of skills and knowledge through specialized education and training. The RN Circulator plans and performs all nursing care for patients who will undergo surgery and other invasive procedures. They provide nursing care from assessment to outcome evaluation. With this role, the Perioperative RN is usually the single advocate for patient safety during operative procedures. 

Education Requirements

The circulating nurse needs to be registered by completing a bachelor’s degree in nursing, a relevant diploma, or associate degree. There are a number of post-nursing courses that offer certification for Perioperative nursing. Before one enrolls in a program, make sure a legitimate accrediting body properly accredits it. In this way, it will ensure your diploma/certification will be widely accepted. It can even be used when completing a master’s degree in nursing. Having certification proves commitment to a chosen career, along with having a better understanding of his or her role.

Job Description & Duties

In the operating room, the duties of the circulating nurse are carried out outside the sterile area. The RN Circulator manages all the necessary care inside the surgery room, assisting the team in maintaining and creating a comfortable, safe environment for the patient and observing the team from a wide perspective. He or she must ensure all surgical team members perform in a unified effort. During operation, most patients are sedated or anesthetized and so, they are powerless to decide on their own. By using assessment, diagnosing, critical thinking, and planning skills, the circulating nurse can direct care and the activities of the team for the patient’s best interest.

The role of the Perioperative RN in the surgery setting is important to provide the best patient care. An effective circulating nurse possesses the knowledge, skills, and training to carry out circulating duties during surgery. By using sound judgment, interpersonal communication skills and critical thinking skills, the circulating nurse can check and evaluate the patient’s needs, ensuring positive outcome. To make sure the patient gets the highest standard of care, it is necessary there is a professional Perioperative nurse as the RN Circulator throughout every invasive procedure.

Below is the list of duties and roles of a circulating nurse during perioperative procedure:

  1. Patient Safety – every patient deserves a trained, skilled and knowledgeable RN in the surgery room, assuming the role as patient advocate – the primary spokesperson of the patient
  2. Skillful clinical judgment– observation, knowledge, and assessment skills along with the ability to foresee needs are essential to thesuccess of the operation. This attribute is also an imperative component when making decisions in behalf of the patient.
  3. Informed Monitoring – the circulating nurse serves the welfare of the patient including the team’s success by assuming the role of an active observer, carefully watching any unintended or unanticipated event that could compromise the patient.
  4. Critical thinking –as the patient’s guardian in the operating room, it is the nurse circulator’s job to perform an accurate recording, interpretation and response to the stream of data that is present during the course of operation
  5. Accurate assessment – the education, training, and unwavering commitment to the patient allows the RN circulator to respond appropriately and quickly to the patient’s psychological, social and biological health.
  6. Interpersonal communication skills –possessing a mix of proficiency, perception, and professionalism, these components defines a circulating nurse’s ability to interact and collaborate with all members of the team, which results to high quality level of care provided to the patient.
  7. Expert evaluation –a circulating nurse is trained to perform accurate decision-making and perception, allowing not only sound assessment of the patient’s condition but also capable in planning, implementing, and evaluating patient care. 

Job Outlook and Salary

Given the new breakthrough in the field of surgery, not to mention other factors such as the increasing elderly population that is highly likely to undergo surgery, operating room nurses, both scrub and circulating nurses, can expect a positive job outlook. The salary outlook for these highly skilled nurses will depend on the type, location, and size of the employer, as well as the rank of position. Currently, the average expected yearly salary for operating room staff nurses is about $65,000. Operating room head nurses usually receive an annual salary ranging from $81,000 to $110,000.


  • Association of Perioperative Registered Nurses (