Specialties

Surgical Scrub Nurse: Nursing Specialties Breakdown

  • Understand the different titles and roles that make up the surgical team in an operating room setting.
  • Learn the specific responsibilities of a scrub nurse and what skills are beneficial.
  • Identify information regarding salary and how to become a scrub nurse for current Registered Nurses and potential nurses.

Tracey Long

PhD, MS, MSN, RN, APRN-BC, CCRN, CDCES, CNE

September 08, 2023
Simmons University

Many of you may have watched popular drama television shows about the operating room or the comedy sitcom “Scrubs” and are now intrigued by what a “real” scrub nurse does on a daily basis. In this blog, we will explore the real world of scrub nurses and become more aware of the important roles they play.

A scrub nurse, also known as a surgical nurse or operating room nurse, plays a crucial and vital part in the surgical process. The entire surgical area is often known as the interoperative process, which includes preoperative (pre-op), surgical, and post-operative (PACU) areas.

Nurses work in all areas and indeed, they all wear scrubs, but their roles are much more important than the scrubs they wear. A scrub nurse is responsible for maintaining the sterile field during operations, and acting as a bridge between the sterile and non-sterile areas of the operating room.

While wearing sterile attire or “scrubs,” the scrub nurse assists the surgeon, surgical technologists (known as surgical techs), and other healthcare professionals in delivering optimal patient care. Scrub nurses are the unsung heroes of the operating room, working diligently alongside the surgical team to ensure safe and successful procedures.

 

 

 

 

Who are the Team Members that Work in an Operating Room?

The operating room (OR) is a complex and highly coordinated environment where various healthcare professionals work together as a team to ensure safe and efficient surgical procedures. Here are some of the key individuals that work in an operating room:

 

Surgeon

The surgeon is a highly skilled physician who performs the surgical procedure. They are responsible for diagnosing the patient, determining the appropriate surgical approach, and leading the surgical team during the procedure.

 

Anesthesiologist

The anesthesiologist is a medical doctor who specializes in administering anesthesia to patients before, during, and after surgery. They monitor the patient’s vital signs, manage pain control, and ensure the patient’s safety and comfort are maintained throughout the procedure.

 

Scrub Nurse

The scrub nurse is responsible for maintaining the sterile field during the surgery. They assist the surgeon by handing sterile instruments, sutures, and supplies. They are knowledgeable about surgical instruments and maintain a vigilant eye on the patient’s safety during the procedure.

 

Circulating Nurse

The circulating nurse is a registered nurse (RN) who manages the overall nursing care and coordinates activities in the operating room. They ensure patient safety, manage documentation, monitor the surgical environment, and act as a liaison between the surgical team and other areas of the hospital.

 

Surgical Technologist

Surgical Technologists, also known as surgical techs, work alongside the surgical team to prepare the operating room and assist during surgical procedures. They handle instruments, sterilize equipment, set up surgical trays, and ensure a sterile environment. The surgical techs may also assist with wound closure and patient transport.

 

Anesthesia Technician

An anesthesia technician assists the anesthesiologist in preparing and maintaining anesthesia equipment. They ensure that the anesthesia machines, monitors, and other devices are functioning properly.

 

Perfusionist

Perfusionists operate the heart-lung machines during cardiac surgeries. They are responsible for managing blood flow and oxygenation while the patient’s heart is temporarily stopped during cardiac surgery.

 

Surgical Assistant

A surgical assistant works closely with the surgeon to aid during the surgical procedure. They may suture incisions, assist with exposure, and perform other tasks under the direction of the surgeon.

 

Sterile Processing Technician

Sterile processing technicians are responsible for cleaning, sterilizing, and maintaining the surgical instruments and equipment.

 

It is important to note that the specific roles and titles may vary depending on the healthcare institution. While the above roles are common, there may be additional specialized roles or variations in different surgical specialties.

 

 

 

 

What Responsibilities Does a Scrub Nurse Have?

A scrub nurse serves as a critical part of the surgical team and has unique responsibilities as outlined below:

 

Preparing the Operating Room

Scrub nurses are responsible for ensuring the operating room is appropriately set up before each procedure. They gather and arrange all necessary surgical instruments and equipment and they collaborate closely with the circulating nurse to ensure a sterile and organized environment.

 

Sterile Technique Management

Maintaining a sterile field is of utmost importance during surgery to prevent infection and promote patient safety. Scrub nurses are experts in sterile technique, performing meticulous hand hygiene and donning sterile gloves and gowns. They assist the surgeon by handling sterile instruments, sutures, and other supplies during the procedure.

 

Instrumentation and Equipment

Scrub nurses have an in-depth knowledge of surgical instruments, including their names, uses, and proper handling. They anticipate the surgeon’s needs by having the correct instruments ready and in optimal condition, and they ensure that all surgical equipment such as lights, suction devices, and monitors are functioning properly.

 

Patient Advocacy

Together with the circulating nurse, the scrub nurse serves as an advocate for the patient. They verify the patient’s identity, surgical site, and consent form before the procedure. Scrub nurses maintain a vigilant eye on the patient’s vital signs throughout the procedure and promptly communicate any changes to the surgical team.

 

Documentation and Communication

Scrub nurses are responsible for accurately documenting various aspects of the surgical procedure, including the surgical count of instruments, sponges, and sharps. They communicate with the circulating nurse, anesthesiologist, surgeon, and other team members to ensure open collaboration and patient safety.

What are the Needed Skills of a Scrub Nurse?

A scrub nurse’s day-to-day job can vary depending on their specific role and work area, but the following list outlines the skills and qualities that are needed to become a successful scrub nurse:

 

Sterile Technique Proficiency

Scrub nurses must possess a thorough understanding of aseptic techniques, including sterile gowning and gloving, proper handling of sterile instruments, and maintaining a sterile field throughout the procedure.

 

Attention to Detail

Meticulous attention to detail is crucial to anticipate the surgeon’s needs, recognize potential risks, and ensure that no instruments or sponges are left behind in the patient. There is no room for errors in surgery.

 

Communication and Teamwork

Effective communication and collaboration skills are vital for working in the high-stress environment of the operating room. Scrub nurses must be able to communicate clearly, follow instructions precisely, and coordinate effectively with the surgical team. The greatest medical errors in surgery and medicine have been due to poor communication among team members.

 

Critical Thinking and Problem-Solving

Scrub nurses encounter various challenges during surgeries and must possess the ability to think quickly, adapt to unexpected situations, and troubleshoot any issues that arise.

Show Me the Money

The salary range for a scrub nurse can vary depending on factors such as geographical location, years of experience, educational background, and the specific healthcare setting. Generally, scrub nurses earn competitive salaries due to the specialized nature of their role.

Remember, actual salaries may differ based on individual circumstances. The average salary for a scrub nurse in the United States ranges from $62,000 to $95,000. Entry-level scrub nurses or those with less experience will typically earn salaries at the lower end, while those with advanced skills and experience may earn higher salaries.

How to Become a Scrub Nurse

If you are not yet a Registered Nurse, there are some preliminary steps you need to take first:

  1. Obtain a nursing degree and licensure: The first step towards becoming a scrub nurse is to complete an accredited nursing program and obtain a nursing license in your state. You can pursue an Associate Degree in Nursing (ADN), which may take 1-3 years, or a Bachelor of Science in Nursing (BSN), which may take 3-4 years and includes the nursing school prerequisites.
  2. Pass the NCLEX: After graduation, you must pass the National Council Examination for Registered Nurses (NCLEX-RN) to become a licensed registered nurse (RN) in your state.
  3. Gain Clinical Experience: Clinical experience with direct patient care will develop and strengthen your interpersonal skills and clinical competence. Start by working in a healthcare setting such as a medical-surgical unit where you will work with patients after surgery to understand their post-operative needs. This experience will provide you with a strong foundation in patient care, assessment, and pain management.

 

If you already have a registered nursing license, there are additional steps for you to consider in your journey to specialize as a surgical scrub nurse:

  1. Network and collaborate: Networking is crucial for career advancement in any field, and surgical nursing is similar. Engage with professionals in the field, attend conferences, and join organizations such as the Association of Perioperative Registered Nurses (AORN) to connect with other surgical nurses.
  2. Request a Surgical Position: Surgical nursing is a specialized type of nursing and is generally found in hospitals and surgery centers. After working on a medical-surgical unit, discuss with your manager or human resource department that you are interested in working in the OR setting. You may begin by shadowing in the OR until you are able to fully transfer to the OR for more training. Also, there is a hierarchy of surgical suites within the OR if you are interested in a cardio-thoracic area or other specialized area. If this is one’s desire, you will need more experience in the general surgery setting first. Bottom of Form

 

 

 

 

The Bottom Line

The idea of becoming a scrub nurse is an exciting and rewarding journey! The scrub nurse’s role is indispensable in providing quality surgical care and their expertise in maintaining a sterile field, anticipating the surgeon’s needs, being the key to the team’s communication, and advocating for the patient contributes to the overall success of the surgical procedure. The dedication and skills of a scrub nurse are invaluable, and the specialty is extremely rewarding.

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