How to Become a Scrub Nurse
Scrub nurses - one branch of nurses commonly called operating room (OR) or perioperative nurses - care for patients in the fascinating and fast-paced surgical environment. In a setting where every second counts, scrub nurses serve to prepare the operating suite and they work closely with other team members to make each procedure safe and successful.
A scrub nurse prepares the operating area by laying out the necessary instruments and equipment. Before each procedure, nurses “scrub in” by thoroughly disinfecting their hands and arms and then putting on sterile clothing. Under the direction of the surgeon, scrub nurses handle instruments, assist with procedures, and monitor the patient throughout the operation.
For a scrub nurse, every day at work is busy and full of new experiences. Some nurses are generalists who scrub in on many different kinds of surgical cases. Experienced nurses often have greater choices in their cases and they focus on an area of interest, such as orthopedics or cardiac surgery.
Scrub nurses play a vital role in the success of surgical operations and take great satisfaction in supporting people through difficult experiences.
Scrub nurses practice in all types of medical facilities that provide surgical services, including hospitals, physician offices, and ambulatory surgery centers. Additionally, a growing number of scrub nurses work in labor and delivery departments. Surgeons in private practice often employ their own nurses who accompany them and assist throughout their procedures.
Surgical nursing requires constant, high-quality interaction with others. As members of the surgical team, scrub nurses must communicate effectively with physicians, technicians, and other nurses to provide high quality care and to respond to emergencies.
The work of a scrub nurse requires both physical and mental stamina. Some surgical procedures may last many hours, and it is not unusual for these nurses to spend an entire shift on their feet. To keep the operating area sterile, they wear gowns, masks, gloves, and other protective clothing. Before surgeries, nurses wash their arms and hands thoroughly with surgical soap. They must adhere closely to safety procedures when handling sharp instruments, bodily fluids, and chemicals in the operating room.
Scrub nurses typically work eight- to ten-hour shifts. Though most surgical procedures occur during daytime hours, scrub nurses are often called in at night and on weekends and holidays to assist with emergency surgeries. Scrub nurses may work full-time hours in some locations, or they may be employed to work part time, depending on the number of surgical cases available. About 80 percent of registered nurses (including scrub nurses) worked part time in 2010.
Most scrub nurses are certified as registered nurses (RNs). At a minimum, this requires an associate’s degree in nursing (ASN); however, the Association of periOperative Registered Nurses (AORN) highly recommends that scrub nurses hold a bachelor’s degree (BSN). Our nursing degree guide provides lots of useful information about the major differences between these RN degree paths, as well as industry trends that favor the BSN.
Associate’s degree programs take two years to complete and are available through career centers, community colleges, and hospital-based nursing schools. Completion of a bachelor’s degree requires at least four years of full-time study at a college or university. Many nurses enter the workforce with an ASN and take advantage of employee tuition assistance programs to further their studies.
Nursing education covers background courses in subjects such as biology, pharmacology, growth and development, and leadership. All nursing programs also include extensive hands-on training to provide patient care and to practice in hospitals and other clinical settings.
Educational programs for nurses vary greatly in quality. Candidates should be especially wary of for-profit schools, which have come under the scrutiny of the federal government for delivering low-quality education at high cost. The best choices for nursing schools are those programs approved by each state’s Board of Nursing and accredited by the Accreditation Commission for Education in Nursing (ACEN).
A registered nurse may transition into the scrub nurse role after several years of working in acute care settings. To prepare experienced nurses for work in the operating room, AORN offers a course called Periop101. The program provides a thorough introduction to surgical nursing and has been adopted by many hospitals.
To best uphold safety in the surgical environment, AORN also recommends that all scrub nurses maintain certification in Basic Life Support (BLS). Training takes 4.5 hours to complete and covers automated external defibrillation and cardiopulmonary resuscitation in a wide variety of settings and situations.
Scrub nurses who administer moderate sedation or who monitor patients under local anesthesia must be certified in Advanced Cardiovascular Life Support (ACLS). This 10-12 hour course is geared toward resuscitation teams and covers management of cardiac arrest and related emergencies.
Training in BLS and ACLS is usually provided through the nurse’s employer or through outside agencies such as the American Heart Association.
Licensing and/or Certification
Upon graduation from an approved training program, RN candidates can apply to the state board of nursing. Once deemed eligible for licensure, they must next pass the National Council Licensure Exam (NCLEX-RN), a rigorous, computer-based assessment covering safety, health promotion, and physical and psychological care for patients.
Experienced scrub nurses are able to pursue voluntary CNOR certification through the Competency & Credentialing Institute. Candidates must hold an RN license and have at least 2,400 hours of documented perioperative nursing experience. They must also pass an exam covering intraoperative activities, preoperative assessment and diagnosis, instrument care and handling, communication, emergencies, and other relevant topics.
Necessary Skills and Qualities
Above all, scrub nurses need excellent interpersonal and communication skills to work effectively with patients and a team of professionals. Because the job requires strict adherence to safety and sanitary procedures, scrub nurses should be excellent decision makers with a keen eye for detail. These nurses also need energy, stamina, and emotional stability to thrive in the intense, fast-paced operating room environment. A compassionate, empathic nature will help them to put anxious and suffering patients at ease.
Opportunities for Advancement
Experienced scrub nurses may advance to become perioperative care managers. In this role, they supervise the daily activities of OR nurses, technicians, and non-licensed staff. The typical duties of these nurses include scheduling shifts for nurses in the perioperative team, mentoring other staff members, recruiting new nurses to work in the surgical field, and collaborating with other department leaders.
Some scrub nurses also go on to become directors of perioperative care at the organizational level. These professionals are responsible for delivering safe, high-quality surgical services to all patients. In addition to their training in nursing, many directors hold graduate degrees in health care administration, which makes them excellent leaders because of their experience in acute surgical caregiving as well as their background in health management and supervision.
Scrub nurses at larger facilities or health systems have the opportunity to become in-house nurse educators. This involves creating and directing orientation programs for new operating room nurses. Nurse educators also oversee the staff development efforts and continuing education activities of the members of the surgical nursing team.
Nurses who desire greater autonomy in their work should consider studying to become nurse practitioners or certified nurse anesthetists; these roles integrate various areas of medicine with nursing care. A surgical nurse will need a master’s degree or Doctorate of Nursing practice for certification in these fields.
If you would like to gain the necessary education to become a scrub nurse, we highly recommend that you check out our free School Finder Tool located HERE.
Salary and Job Outlook
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According to the U.S. Bureau of Labor Statistics, the annual median salary for registered nurses (including scrub nurses) is $66,640. Eighty percent of RNs make between $45,880 and $98,880. Hospital nurses generally earn the highest salaries, along with nurses who work in outpatient care facilities. Wages typically increase with education level and experience.
According to the U.S. Bureau of Labor Statistics, employment of registered nurses (including scrub nurses) is expected to increase by 19% between 2012 and 2022, which is considered much faster than the average for all occupations.
One reason for this growth is the aging of the U.S. population, which is expected to increase the demand for all types of health care services in the coming years. Another cause is the shift in healthcare toward outpatient surgical care, which is creating new positions in ambulatory surgery centers. Additionally, the growing popularity of elective surgery, including cosmetic surgery, is creating many opportunities for scrub nurses.
Job prospects will be greatest for licensed, experienced professionals. AORN maintains a job board for surgical nurses on its website. There are many other options for scrub nurses to find jobs caring for patients in the perioperative setting.