Perioperative nurses take care of patients undergoing operative or other invasive procedures and work closely with surgeons and anaesthesiologists.  It’s fast-paced and unpredictable, but is it a career that will have you running for the door or wanting more?

ACORN’s Education Manager Edwina Blannin-Ferguson says perioperative nursing is a career shrouded in mystery – but for those who venture into the theatre, challenge, diversity and life-long bonds await.

“The variety and diversity of every day is one of the reasons perioperative nursing is so engaging and fulfilling for nurses.

“Perioperative nursing is often seen as a mystical area of nursing, behind locked doors, that impacts a large portion of the patient cohort within a hospital setting.

“It is a fast-paced, diverse environment that allows nurses to extend their knowledge, experience technical expertise, and have a deep understanding of the patient journey.

“No two days are the same. Within the same day, you could be scrubbing for a craniotomy and finish your day assisting in delivering a newborn child.

“There is a strong bond between the multidisciplinary perioperative team – bonds that will last a lifetime.”

The camaraderie and educational opportunities within the perioperative environment are what drives excellent retention rates, explains Ms Blannin-Ferguson.

“Those perioperative departments that support ongoing professional development are often those departments with the highest retention rates.

“Everybody has something to learn, and everybody has something to teach. The wide variety of specialty areas and roles available within the perioperative suite allows for career progression, specialisation and diversification.

“There are multiple opportunities to upskill in a wide range of clinical and non-clinical areas, offering exciting, challenging and diverse career options for nursing staff.”

However, it does take a special individual to be a successful perioperative nurse with three main qualities required: ¬ – flexibility, resilience and a team player.

“The acuity of patients, and theatre schedules, often change rapidly, and perioperative nurses need to be flexible.

“When dealing with any critical or acutely unwell patient, stress or anxiety can build.

“It’s important that perioperative nurses are resilient, continue to be proactive and take initiative.

“Perioperative staff depend on each other daily – no singular person, of any discipline, can operate on a patient independently.

“You work together as a team, and therefore qualities of coordination and collaboration are essential.”

A cohesive and supportive team is at the heart of perioperative nursing, as is the ability to adapt and communicate well.  

“There is no denying that some days feel long, some extremely exciting, and some feel very challenging.

“What gets you through is your team – your admitting nurses, anaesthetic nurses, anaesthetists, circulating or instrument nurses, surgeons, registrars, theatre technicians, medical device specialists, PACU recovery staff, educators and floor coordinators.

“With all of these people in mind, the most important soft skill is adaptability. The nature of surgical procedures, and no two patients being the same, brings the phrase ‘ever-changing environment’ to the forefront.

“As a perioperative nurse, your adaptability will afford you amazing experiences, enhanced learning opportunities and a diverse career path.

“Communication is key in such a diverse clinical environment – clear, direct, and closed-loop is the communication style of necessity in the perioperative environment.”

It’s an exciting time to be a perioperative nurse in Australia, says Ms Blannin-Ferguson, and the future looks bright.

“Throughout the COVID-19 pandemic, there have been challenges in processes and operating theatre activity levels. However, perioperative services are always required.

“There were multiple opportunities for perioperative nurses to upskill in critical care areas to assist their colleagues, which large numbers of nurses undertook. “This reinforces the value of working together as a team that is so important for perioperative nurses.

“Whether it’s your theatre or the nursing profession as a whole, perioperative nurses are there for each other and the patients.”

The future of surgery is one of technological advancement and unlimited learning opportunities for perioperative nurses.

“The modernisation and development of new surgical techniques and technologies are growing at such a rapid rate there is so much to learn at any one time.

“The increasing prevalence of multidisciplinary training opportunities allow for remarkable education advancements to occur.

“The Perioperative Surgical Nurse Assistant role is becoming more common in perioperative suites across the country.

“The education and roles for nurses are expanding rapidly, and with more surgeries occurring than ever before, the opportunities are endless!

“The clinical and non-clinical skills that you perfect during your perioperative experience are invaluable to whatever avenue of nursing you choose to pursue.”

How to become a perioperative nurse

Registered and enrolled nurses can work in perioperative settings. It is recommended that enrolled nurses complete a Diploma of Nursing that includes medications administration up to intravenous medications. The Nursing and Midwifery Board of Australia (NMBA) fact sheet Enrolled nurses and medicine administration provides more information.


What are the roles in perioperative nursing?

Anaesthetic nurse
An anaesthetic nurse helps the anaesthetist prepare the environment and equipment for the patient to receive an anaesthetic. They are essential in ensuring a patient’s safety, comfort and warmth before, during and after surgery and assist with monitoring.

Circulating nurse
Also known as a ‘scout nurse’, a circulating nurse is a non-sterile member of the team responsible for coordinating the operating room, including implementing a nursing care plan. They are also an influential advocate for the patient and monitor the intra-operative environment.

Instrument nurse 
The instrument nurse, colloquially known as a ‘scrub nurse’, is a sterile team member who scrubs, gowns and gloves for the surgical procedure and maintains an accurate count of accountable items throughout an operation.

Post-Anaesthesia Care Unity (PACU) nurse
This nursing role involves receiving the patient into the PACU (also known as the recovery unit). They undertake assessment and monitoring as the patient recovers and monitor emergence from anaesthesia, dressings, intravenous lines and drainage tubes and implement pain management.

Pre-admission and day surgery nurse
These nurses work in day surgery units and pre-admission departments, working with doctors to assess patients’ health care needs for the planned procedure or operation.
This nursing role has one of the highest levels of patient contact in the perioperative field and involves teamwork and autonomy, which many nurses find both appealing and rewarding.

Perioperative Nurse Surgeons Assistant (PNSA)
PNSA is an advanced practice role that provides a continuum of care and optimal outcome for patients undergoing surgical procedures in collaboration with and under the direction of a surgeon.

There are many other roles in management, research and education in the perioperative nursing field, and the opportunity to become a Nurse Practitioner (Perioperative).