Operating Room Registered Nurse

Job Description

Job Description

POSITION SUMMARY

The Operating Room Registered Nurse plans, delivers, and evaluates perioperative nursing care for patients undergoing outpatient surgical procedures. The role primarily functions as the circulating nurse, coordinating the surgical team, maintaining a safe environment, and advocating for the patient from entry into the operating room through handoff to the Post-Anesthesia Care Unit (PACU).

The Operating Room Registered Nurse practices under the state Nurse Practice Act, AORN Guidelines for Perioperative Practice, accreditation standards, and Center policy.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Pre-Procedure Preparation

• Reviews each patient's record before the case, verifying consent, history and physical, site marking, allergies, laboratory results, and implant or equipment needs, and resolves discrepancies before the patient enters the operating room.
• Prepares the operating room with instruments, supplies, equipment, and implants per the surgeon's preference card; confirms sterility indicators and equipment function.
• Assesses the patient on arrival to the operating room, confirming identity, procedure, and site, and communicates relevant findings to the surgical team.

Intraoperative Care

• Leads the surgical safety checklist, including the time-out and sign-out, and halts the procedure for any unresolved discrepancy.
• Positions, preps, and protects the patient, including pressure-point padding, electrosurgical dispersive pad placement, and thermal management.
• Maintains and monitors sterile technique and corrects breaks in sterility.
• Performs and documents surgical counts of sponges, sharps, and instruments with the scrub person per Center policy.
• Labels, documents, and tracks specimens, implants, and explants per Center policy and tissue-tracking requirements.
• Prepares and administers medications and solutions within scope of practice as ordered, and ensures all medications on and off the sterile field are labeled.
• Assists anesthesia during induction and emergence, and responds to intraoperative emergencies, including malignant hyperthermia, airway, and cardiac events, per Center protocol.
• Performs the scrub role when competency has been validated and staffing requires.

Documentation and Handoff

• Documents intraoperative care accurately and in real time in the electronic medical record.
• Provides a structured handoff report to the PACU registered nurse.

Safety, Quality, and Teamwork

• Follows infection prevention, fire safety, radiation safety, and OSHA bloodborne pathogen standards.
• Directs Surgical Technologists and Operating Room Aides within the room, within scope of practice.
• Participates in quality improvement activities, annual competencies, and accreditation readiness.
• Precepts new staff as assigned.
• Assists with room turnover and restocking, and reports supply and equipment issues.
• Performs other duties as assigned.

QUALIFICATIONS

Required

• Graduate of an accredited nursing program (ADN or BSN).
• 1–2 years of prior perioperative nursing experience.
• Current, unrestricted RN license valid in the state where the Center is located; a multistate compact license is accepted where the state participates in the Nurse Licensure Compact.
• Current BLS (CPR) certification.
• Working knowledge of aseptic technique, surgical instrumentation, and AORN guidelines.
• Proficiency with electronic medical records.

Preferred

• Bachelor of Science in Nursing (BSN).
• Ambulatory surgery center experience.
• CNOR certification.

PHYSICAL REQUIREMENTS

Must be able to perform the essential functions of this position with or without reasonable accommodation.

• Stand and walk for extended periods, up to 10 or more hours per shift.
• Lift and carry up to 50 lbs; assist with patient transfers and positioning using appropriate equipment and assistance.
• Push and pull stretchers, beds, and equipment carts.
• Bend, stoop, reach, and twist repeatedly; fine motor dexterity to handle instruments, equipment, and medications.
• Visual and auditory acuity sufficient to monitor patients, read equipment displays, and hear alarms.
• Respond quickly and calmly in emergency situations.
• Wear personal protective equipment, including lead aprons, for extended periods.

WORKING CONDITIONS

• OSHA Bloodborne Pathogen Exposure Category I: tasks routinely involve potential exposure to blood, body fluids, and other potentially infectious materials.
• Possible exposure to sterilants and disinfectants, anesthetic gases, surgical smoke, ionizing radiation (fluoroscopy), latex, sharps, and noise.
• Personal protective equipment is required in restricted and semi-restricted areas.
• Works the Center's operating hours, including early starts and late cases; overtime, call, and floating between departments may be required based on patient volume.