Scrub Nursing

Scrub nursing is a specialty where the nurse is an expert in operative nursing and works closely with surgeons and other surgical staff to ensure a smooth procedure, minimize complications, and continuously assist with maintaining a sterile field.  Surgical nurses are known as scrub nurses and work in the surgical suite to assist with surgery while maintaining a sterile field.  Scrub nurses work in clinical facilities like hospitals and surgery centers. Scrub nurses assist surgeons with surgical procedures on patients throughout the lifespan and with a large variety of surgical conditions including gallbladder removal, cardiac surgery, joint replacements, and hysterectomy .    

Scrub nurses typically work during the day shift during the typical work week in both the hospital and the outpatient surgery center.  Hospital scrub nurses are often required to be "on call" during the evenings, weekends, holidays, and nights for emergency surgery, which can occur 24 hours a day and seven days a week.  In large facilities, scrub nurses may specialize in a particular type of surgery, like cardiac, orthopedic, or general. Scrub nurses have a meaningful role in saving lives and improving patient health through surgery. Scrub nursing is an incredibly important and satisfying nurse specialization.

Scrub nurses have the very important role in preparing the operating room and the surgical instruments for the operation.  A Scrub nurse must be organized and prepared for the surgery and possible complications.  Being detail oriented ensures patient safety because small mistakes can mean the difference between life and death.  A Scrub nurse must have excellent communication skills to be aware of the needs of the surgeon and convey them to the surgical team.  Once a scrub nurse is sterile, he or she can not break sterile procedure until the operation is over, so they need to communicate their needs to the circulating nurse.   Scrub nurses must be excellent team players because the collaboration of a surgical team keeps patients alive.  Scrub nurses should have excellent problem solving and critical thinking skills.  While they work under the supervision of a surgeon, a scrub nurse should be able to anticipate complications and plan for the next steps.

Scrub nurses that work in the operating room may mean working long hours for surgical cases, which can be physically and emotionally draining.  No two days in the operating room are the same, which may be exhilarating or stressful.  Scrub nursing is a challenging and exciting career

Education Requirements

In order to become a Scrub nurse, you must first obtain a nursing degree from an accredited nursing program to successfully become a Registered Nurse (RN).  In order to become an RN, you can attend an Associate Degree program or choose to obtain your Bachelor of Science in Nursing.  After obtaining the registered nursing degree, you can sit for your NCLEX-RN to become certified.  Finally, you will apply to the Board of Nursing in your state to become a Registered Nurse.  Most Scrub nurses have been trained in advanced surgical scrub techniques by their hospital or other accrediting bodies. Scrub nurses may choose to further their training and become a Registered Nurse First Assist (RNFA) to remain in the intraoperative setting with more responsibility and higher pay.

Certification

Scrub nurses have the option to pursue an operative nurse certification that directly impacts their field.  There is the Certified Nurse Operating Room (CNOR) that is a perioperative nursing exam that can be taken three months after applying to sit for the test. The CNOR certification is accredited by two agencies, the National Commission for Certifying Agencies and the American Board for Specialty Nursing Certifications.

To sit for the CNOR exam, you must have:

  • a current and unencumbered RN license,
  • be a current perioperative nurse in the areas of nursing education, administration, research, or clinical practice,
  • have a minimum of two years of perioperative nursing experience and 2400 hours in perioperative nursing,
  • and have spent at least 1200 hours in the intraoperative nursing role.

Typically, scrub nurses spend two to three months studying for the exam with CNOR approved study materials. The exam takes approximately three hours and 45 minutes.

Job Description & Duties

The following are a list of basic duties that scrub nurses should be expected to perform.  Scrub nurses are also known as operating room or perioperative nurses.  The description varies based on the facility for which you work.

  • Properly disinfect oneself, scrub in, and dress and gown by sterile procedure
  • Assist the rest of the surgical team in scrubbing in for surgery.
  • Prepare the operating room by maintaining sterile procedure to set out instruments and set up other surgical equipment.
  • Be able to move quickly and remain organized during complicated procedures.
  • Understand the importance of time-outs and other safety checks.
  • Use critical thinking skills to determine potential surgical complications and the appropriate next steps to take.  
  • Be familiar with all surgical instruments and be comfortable assisting with a variety of surgical procedures.
  • Understand medication dosage, complications, contraindications, and interactions
  • Know how to properly label medication on the surgical field
  • Know when and how to perform proper surgical instrument and sponge counts to ensure patient safety.
  • Collaborate with the surgical team and promote teamwork to ensure patient safety
  • Recognize respiratory and cardiovascular decline and know initial steps to obtain help and to stabilize your patient.

Job Outlook and Salary

The median salary for a perioperative nurse is $67,500 annually, but the range is from $45,000 to $100,000 per year according to the Association for Perioperative Registered Nurses. Salaries for scrub nurses vary significantly based on the surgical specialty, length of nursing experience and geographical location. The career outlook for Scrub nursing is excellent and increasing approximately 19% because of the growth in the nation’s need for health care, particularly in the perioperative area of medicine.

References and Further Reading

Association of perioperative Registered Nurses:
https://www.aorn.org

CNOR Certification and Recertification:
http://www.cc-institute.org/cnor