5 Things to Know about Surgical Nursing

Do you love anatomy and physiology? Do you want to do important, innovative work as part of a highly disciplined healthcare team? Then surgical nursing may be the right specialty for you.

What Is Medical-Surgical Nursing?

Medical-surgical nursing, also known as perioperative nursing, is a specialized branch of nursing that focuses on the care of adult patients before, during and after surgical procedures. Medical-surgical nurses provide comprehensive care to patients and their families. These nurses collaborate with surgeons, anesthesiologists and the surgical team through all phases of surgical care.

Before surgery, perioperative nurses prepare patients by handling paperwork, administering medications, setting up equipment and addressing patient and family concerns to alleviate fears. During surgery, they assist the surgical team, monitor patient vital signs and ensure compliance with safety and sanitary procedures. After the surgery, medical-surgical nurses provide postoperative care by monitoring for complications, managing wounds and pain, and preparing discharge plans. They also educate patients and their families on recovery expectations, ensuring a smooth transition from hospital to home care.¹

Lori Armbruster, DNP, MSN, RN, is faculty chair at Chamberlain University’s St. Louis campus and a surgical nurse with more than 35 years of experience in the operating room. She explains that surgical, or perioperative, nursing may have a long learning curve, but for nurses who love teamwork and organization, it can make for a very satisfying career. She shares five things to know about the medical-surgical nursing specialty.

Five Things to Know About Being a Medical-Surgical Nurse

1. Scrub or Circulate?

In the operating room, medical-surgical nurses assume distinct roles. Scrub nurses are responsible for setting up the operating room, sterilizing instruments and aiding the surgeon during the procedure. Scrub nurses literally scrub their hands and arms with surgical soap and don a surgical gown and gloves. They anticipate the surgeon’s needs, selecting and passing instruments and supplies.

Circulating nurses oversee the general operation of the room, guaranteeing that all essential supplies and equipment are at hand, and they assist the surgical team as required. There may be just one nurse in each of these roles, or there may be multiple, depending on the complexity of the case. The circulating nurse acts as a runner and helps out wherever they are needed.

“The circulating nurse is the person who walks around the perimeter of the room and is the monitor of everything going on,” explains Dr. Armbruster. “They’re the helper for anesthesia, the help for the scrub person. They answer phones and beepers and bring you supplies. If you drop something, they pick it up and re-sterilize it and bring it back.”

2. Organization Is a Must

Surgical nursing requires a high level of organization and attention to detail. As a medical-surgical nurse, you are part of a well-orchestrated team that also includes staff doctors, anesthesiologists or nurse anesthetists, surgeons, surgery techs and maybe even residents or medical students. Everyone has a job, and everything has a place. That makes surgical nursing a great fit for nurses who love order and organization.

“Surgery is a very controlled, disciplined environment,” says Dr. Armbruster. Complications do arise, but even during those moments, the sense of planning and protocol is palpable. “It’s not like the chaos of the emergency department, where you’re rushing down the hallway with someone who’s not breathing,” she continues. “In the OR, you can say, ‘I gave this drug and I know that in 10 seconds, I’m going to be intubating this patient.’ That’s the difference.”

3. Teamwork Is Crucial

Medical-surgical nursing is a team effort. You’ll collaborate closely with surgeons, anesthesiologists, surgical technicians and other healthcare professionals to provide seamless and coordinated care to patients. For example, if you’re scrubbed in, you can’t go get your supplies out of the other room — you have to depend on the circulating nurse to do that.

“Your team has your back and you have their back,” shares Dr. Armbruster. “You work with a team of people so closely that after a while, you can almost just look at their face and know something’s wrong or they need something, and they don’t need to say a word. That develops when you’re working in a very specialized team and everyone’s on the same page.”

4. There’s a Lot to Learn — but Also a Lot of Places You Can Go

Medical-surgical nursing is a specialty that requires a wide-ranging base of knowledge and skills, but it also offers a diverse array of career opportunities. While nursing school provides a solid foundation, the bulk of what you need to know about the tools and techniques of perioperative nursing comes from one-on-one training with a preceptor.

“You have to put a lot of time into it to learn all the different instruments and procedures,” Dr. Armbruster notes. “I can tell you that it’s probably two years before you feel really comfortable in the operating room.”

But once you’re trained, you have lots of options. “There’s a ton of stuff you can do: outpatient surgery center, OR, be on call on the weekends,” she says.

Perioperative nurses can also choose to specialize even further, in orthopedics, cardiovascular, neurology or other surgical subspecialties. “You can get really good at one service and when they get call-ins, you’ll get called in with that same set of doctors and nurses,” adds Dr. Armbruster. “It’s like a team, like a family.”

5. It’s Not the Easiest Specialty to Break Into, but It’s Not Impossible

Most new nursing school graduates do not start off in medical-surgical nursing. Instead, new nurses gain a few years of experience and then transition into the perioperative specialty. Dr. Armbruster started as a floor nurse in pediatrics. Eventually she was assigned to the recovery room three days a week.

She recalls, “It was a very small hospital, and you could watch through the windows in recovery and watch surgeries going on — that’s how close we were,” she said. “I was always watching surgery and thinking, ‘If they need help, come and get me. I want to help.’ ”

Eventually, a position opened in the OR, and the rest is history.

If you’re a nurse who is interested in making a similar transition into the operating room, Dr. Armbruster suggests you take a few steps. First, she says, “Express the interest. If you say it enough times, people might hear you and there might be a possibility out there.”

Next, prove to others that you have the right stuff: a collaborative personality and a can-do attitude. “Do everything and anything they ask you to do in your current job,” she advises. “If they tell you to assist in this or that, go do it. Never say ‘no’ to anything. The more willing you are to do things, the more they’ll see that you’re willing and able to be trained in a whole other nursing area.”

The History of Medical-Surgical Nursing

If you become a medical-surgical nurse, you’re joining a specialty with a long history: Surgical nursing is believed to be the first nursing specialization. The evolution of perioperative nursing began in the late 19th century with Florence Nightingale, who emphasized the importance of sanitary conditions in hospitals to prevent infection. As hospitals became safer environments for surgery, the demand for skilled nurses grew, leading to the development of specialized nursing roles in surgical care.

The first dedicated operating room nurse was employed in the United States in 1889. Over the years, the role of the surgical nurse expanded from preparing patients and assisting in surgeries to providing comprehensive preoperative and postoperative care. Scientific advancements, such as the development of anesthesia, further cemented the importance of surgical nursing. Today, perioperative nurses play a critical role in the surgical team, ensuring patient safety and promoting recovery through meticulous care and innovative practice.²

The Scope of Practice for Perioperative Nurses

Medical-surgical nurses offer comprehensive care to patients before, during and after surgery. Their responsibilities include:

• Preoperative care: Assess the patient’s overall health, provide education about the surgery and prepare the patient physically and emotionally for the procedure.
• Intraoperative care: Assist the surgical team during the procedure, ensure patient safety and monitor vital signs.
• Postoperative care: Monitor pain management, watch for complications, administer medications and promote recovery.
• Patient education: Provide information about postoperative care, wound care and medication management.
• Emotional support: Comfort and reassure patients and their families during challenging times.³

Skills and Competencies Needed for Medical-Surgical Nurses

Med-surg nurses possess a unique combination of clinical expertise, technical skills and interpersonal qualities that enable them to provide exceptional patient care. Here are three of the most important skills perioperative nurses need:

1. Clinical expertise and decision-making: Medical-surgical nurses use their clinical judgment and decision-making skills to evaluate patients’ conditions, recognize potential complications and implement suitable interventions. They must remain current with the latest evidence-based practices and guidelines to deliver optimal care.
2. Technical skills: Surgical nurses are adept at a range of technical procedures, from monitoring anesthesia to using software to document patient care.
3. Emotional resilience and stress management: Surgical nursing can be physically and emotionally demanding. Successful perioperative nurses possess emotional resilience and utilize effective stress management strategies to cope with the high-pressure environment and provide compassionate care to patients and their families.⁴

How to Become a Medical-Surgical Nurse

To embark on this exciting nursing career, you must complete a nursing school program and obtain a registered nurse (RN) license. While there are diploma and associate nursing degree programs, most perioperative nursing positions require a Bachelor of Science in Nursing (BSN) degree. Chamberlain offers campus-based and online BSN degree programs, as well as an RN to BSN option. A Master of Science in Nursing (MSN) degree can provide additional nursing education and offer a pathway to licensure as a nurse practitioner.

Once you have your BSN or MSN degree and your RN license, you can choose to specialize in medical-surgical nursing. After you’ve gained at least two years of nursing experience as an RN, completed 30 hours of continuing education in medical-surgical nursing, and completed 2,000 hours of practice, you can seek a certification in med-surg nursing — however, a certification is not always required to work in a surgical unit.^5,6

Medical-surgical nursing is a dynamic and rewarding specialty that offers diverse opportunities for career growth and specialization. By combining clinical expertise, technical skills and compassionate care, medical-surgical nurses play a vital role in ensuring the safety and well-being of patients undergoing surgical procedures.

Chamberlain University, an HLC-accredited institution, offers bachelor’s, master’s, doctoral and certificate programs in nursing and healthcare professions. With a growing network of campuses and robust online programs, Chamberlain continues to build on more than 130 years of excellence in preparing extraordinary healthcare professionals.
 

¹Source: nursejournal.org/careers/perioperative-nurse/how-to-become

²Source: www.journal.acorn.org.au/cgi/viewcontent.cgi?article=1107&context=jpn

³Source: ca.indeed.com/career-advice/finding-a-job/perioperative-nursing

⁴Source: totalnursesnetwork.com/the-essential-skills-every-surgical-nurse-needs

⁵Source: nursejournal.org/careers/surgical-nurse

⁶Source: www.nursingworld.org/our-certifications/medical-surgical-nurse/

By Chamberlain University