How to Become a Circulating Nurse

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Written by Ann Real, BSN, RN Content Writer, IntelyCare
A circulating nurse takes notes before a surgical procedure.

A circulating nurse is a healthcare professional who works in the operating room (OR) and facilitates the seamless flow of surgical procedures by managing logistics and communication between teams. They are not directly involved in the surgery itself; instead, they focus on the behind-the-scenes work, orchestrating the intricate ballet of equipment, personnel, and patient care.

If you are considering a career as a circulator nurse, this article is for you. Read on to learn everything you need to know to kick-start your journey into this dynamic field.

Circulating Nurse: Career Snapshot

  • Mission: Ensure the smooth operation of surgical procedures and optimize patient outcomes.
  • Responsibilities: Coordinating OR logistics, equipment setup, team communication, and patient advocacy.
  • Workplace settings: Operating rooms in hospitals, surgical centers, and outpatient clinics.
  • Career path: Nursing degree followed by specialization in perioperative nursing.
  • Length of study: Approximately 2 to 4 years.

What Is a Circulating Nurse?

A circulator nurse is a specialized registered nurse who works in the operating room outside the sterile field. Unlike scrubbed-in personnel, they do not directly participate in surgery but instead focus on coordinating the logistical aspects of the operating room, such as preparing equipment, recording the progress of the operation, managing communication between surgical teams, and ensuring patient safety and comfort throughout the procedure.

Circulating nurses can be found in various surgical settings, including:

What Does a Circulating Nurse Do?

Picture a circulator nurse as a dual-role specialist: surgical clinician and expert strategizer. For this reason, circulating nurse duties include a variety of tasks, including performing head-to-toe assessments, preparing the operating room for surgery, and troubleshooting various surgical emergencies.

Here’s a quick rundown of the top 10 duties of the circulating nurse:

  1. Verifying the availability and functionality of all the necessary equipment, instruments, and supplies before surgery.
  2. Participating in a surgical safety checklist to confirm patient details, surgical site, and procedure specifics before the operation begins.
  3. Managing the flow of personnel in and out of the operating room, ensuring only essential staff are present during surgery.
  4. Documenting intraoperative details accurately, including surgical counts of sponges, needles, and instruments used during the procedure.
  5. Anticipating the needs of the surgical team during the procedure, proactively providing assistance as required.
  6. Overseeing the adherence to infection control protocols within the operating room.
  7. Monitoring the temperature and humidity levels in the operating room to maintain optimal conditions for both patients and surgical staff.
  8. Managing the flow of specimens collected during surgery, ensuring proper labeling, documentation, and transfer to the laboratory.
  9. Facilitating communication between surgical teams, including CRNAs, PACU nurses, and surgical techs.
  10. Participating in debriefings to identify areas for improvement and enhance patient outcomes in the operating room.

Circulating Nurse Schooling: 4 Steps

Let’s explore the key steps to start your journey into this unique nursing specialty.

1. Get a Nursing Degree

You’ll start by completing prerequisites to enroll in either an associate or bachelor degree program. During your academic journey, you’ll take classes on pharmacology, health assessment, and other relevant subjects, all while gaining practical experience through clinical rotations at healthcare institutions.

2. Obtain Licensure

Following completion of your nursing program, you’ll take the NCLEX-RN — a national certification exam for registered nurses. This comprehensive examination evaluates your readiness to provide safe nursing care. Passing the NCLEX grants you licensure as a registered nurse (RN).

3. Gain Experience

You need to have a solid understanding of surgical settings before stepping into this dynamic role to take on circulating nurse responsibilities with confidence. Consider starting off in these specialties to build a strong knowledge base:

4. Attain Certification (Optional)

The Competency and Credentialing Institute (CCI) offers several certifications that can boost your application and help you earn a pay raise. Certification ensures that nurses have the knowledge and skills to provide high-quality care throughout the perioperative process. Here are some certifications you may want to consider:

  • Certified Perioperative Nurse (CNOR)
  • Certified Surgical Services Manager (CSSM)
  • Certified Foundational Perioperative Nurse (CFPN)
  • Certified Ambulatory Surgery Nurse (NPDA-BC)
  • Clinical Nurse Specialist Perioperative Certification (CNS-CP)

You may also want to consider obtaining credentials from the Certification Board for Sterile Processing and Distribution (CBSPD).

How Much Do Circulating Nurses Make?

The typical circulating nurse salary in the U.S. is about $86,600 per year. You can make more or less, depending on your work experience, education, and geographic location.

If you’re open to nationwide job hunting, here are five states with some of the highest nurse salaries:

Frequently Asked Questions: Circulating Nursing

How is a circulator nurse different from a scrub nurse?

An OR circulating nurse oversees the overall operations of the operating room, ensuring everything runs smoothly, while a scrub nurse directly assists the surgeon during the procedure by handing them instruments, maintaining a sterile field, and anticipating their needs.

Can circulating nurses have a specialty area?

Yes, circulating nurses can specialize in certain areas within perioperative nursing. According to the American College of Surgeons, there are 14 surgical specialties, including:

You can also explore opportunities in minimally invasive procedures, such as interventional radiology and endoscopy nursing.

How can I advance my career in circulating nursing?

You can explore circulating nurse training courses or internships that cover a wide range of topics, including the latest advancements in infection control practices. You can also grow your knowledge by attending nursing conferences, joining professional organizations, and taking continuing education courses.

What are some essential skills needed to excel in this nursing field?

Circulating nurses need a combination of technical and soft skills to excel in this demanding field. Some essential skills you’ll need to develop include:

How do circulating nurses handle emergencies during surgery?

These specialists handle emergencies or unexpected situations during surgery by relying on their training and certifications, such as Advanced Cardiac Life Support (ACLS) and Basic Life Support (BLS). They are trained to recognize signs of distress and initiate appropriate interventions, such as activating codes or providing life-saving measures.

Are there any specific legal or ethical considerations circulating nurses need to be aware of?

Circulating nurses play a key role in preventing sentinel events that lead to serious injury, like amputations of the wrong extremity. In fact, wrong-site surgery is the most common sentinel event, accounting for 13.1% of these incidents. To prevent this, circulating nurses use surgery checklists.

Additionally, nurses in this specialty must also be aware of legal and ethical considerations like patient confidentiality, informed consent, adherence to standards of practice, and accurate documentation to protect patients and healthcare providers from potential legal issues.

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