“Perioperative nurses are patient advocates who are committed to providing safe patient care following current guidelines and best practices.”
Melanie Perry, BSN, Founder and Chief Nursing Officer of First Case Media, LLC
Each year, one in nine people in the US undergo surgery. Surgeons are often seen as the central figures in operating rooms, responsible for performing complex procedures that can save lives. But they do not work alone. A team of dedicated professionals assists them, ensuring patients’ safety and well-being before, during, and after surgery. This team comprises anesthesiologists, surgical technologists, nurse anesthetists, and notably, perioperative nurses.
Perioperative nurses are vital in maintaining a sterile operating environment, caring for patients, and supporting surgeons throughout the surgical process. However, they also have many responsibilities that extend beyond the operating room. They conduct preoperative patient interviews, help prepare patients for surgery, and provide postoperative education and serve as patient advocates, often being the primary point of contact between the surgical team and the patient’s family.
As for the education required to become a perioperative nurse, the first step is to earn a registered nurse (RN) license by completing a bachelor’s or associate’s degree in nursing, passing the National Council Licensure Examination (NCLEX), and applying for licensure with their state’s board of nursing. Once licensed, nurses typically gain surgical nursing experience before specializing in perioperative care. Many then obtain certification through the Competency & Credentialing Institute, which offers the Certified Perioperative Nurse (CNOR) credential. To gain hands-on skills, many aspiring perioperative nurses will complete a fellowship or residency offered at hospitals and medical centers
Keep reading to discover more about how to start a career as a perioperative nurse, including education programs, accreditation, and steps for certification and licensure.
Meet the Expert: Melanie Perry, BSN, RN, CNOR, CSSM

Melanie Perry is a perioperative nurse, educator, and healthcare leader specializing in operating room practice and professional development. She is the founder and chief nursing officer of First Case Media, LLC, and has worked extensively as an OR circulator and in leadership roles, including charge nurse, team lead, and OR manager.
With more than two decades of nursing experience, she is a recognized voice in perioperative education and social media engagement. Perry is also the creator of “The Circulating Life” and co-founder of the “First Case Podcast,” platforms dedicated to supporting and educating OR nurses. Additionally, she has contributed to professional nursing organizations such as the Association of periOperative Registered Nurses (AORN), serving on committees and contributing to industry education and thought leadership.
HealthcareDegree.com: What do you wish the public understood about perioperative nursing?
Perry: Perioperative nursing is a specialized field of nursing that focuses on patient care before, during, and after surgery or invasive procedures. Perioperative nursing encompasses the continuum of care for the surgical patient, and doesn’t just occur in the operating room.
Perioperative nurses work in the preoperative, intraoperative (operating room), and postoperative areas, and each area has a unique set of skills required for optimal patient care. Perioperative nurses are patient advocates committed to providing safe patient care in accordance with current guidelines and best practices.
HealthcareDegree.com: What advice would you give to aspiring perioperative nurses?
Perry: Surgical Services can seem daunting. It’s a fast-paced environment that requires clear communication, critical thinking, and the ability to prioritize the plethora of requests, needs, and tasks that are required for every surgical case. But it’s doable! The best advice I can give is to ask for opportunities during nursing school to shadow in the different departments—preop, operating room, and postop.
If you have the opportunity to do a clinical in perioperative nursing, take advantage of that, too. Every bit of exposure you get to the department will help you understand our processes and make it feel less overwhelming.
HealthcareDegree.com: What is your favorite thing about working in perioperative nursing?
Perry: My favorite things about perioperative nursing are the 1:1 patient care, the camaraderie of our perioperative team, and the variety of cases and surgical specialties that I am exposed to.
I am a perioperative nurse who works in the operating room, primarily in orthopedics. But even orthopedics is a big specialty, so I get to see a variety of cases each day. And while I mostly do orthopedics, I still see my fair share of general, ENT, GYN, and plastics cases. The variety keeps things exciting, and it keeps me learning. And, at the end of the day, no matter what case I may be doing, every case is an opportunity to make a difference in the lives of my patients and to provide the best care that I possibly can. It’s a big responsibility, but it’s also very satisfying.
Perioperative Nurse Specializations & Degree Types
Perioperative nursing is a specialization within nursing. All perioperative nurses must complete an accredited nursing program and earn an associate’s or bachelor’s degree. Nurses who wish to complete additional education in perioperative nursing can choose to complete a residency or fellowship in this field.
These programs are structured for recent nursing graduates to provide them with the opportunity to gain hands-on experience, enhance clinical skills, and transition smoothly into a new role. They often include classroom learning, simulations, and on-the-job training, supervised by experienced mentors.
Admissions Requirements for Perioperative Nurse Programs
Admission requirements to perioperative nursing residencies and fellowships will vary. Still, they will often include completion of an accredited nursing program, an unencumbered RN license, letters of recommendation, and a statement of purpose. Some programs may require clinical experience, while others are designed for new graduates.
Perioperative Nurse Program Accreditation
All perioperative nurses must complete a nursing education program that is accredited by the Commission on Collegiate Nursing Education (CCNE) and the Accreditation Commission for Education in Nursing (ACEN). Attending an accredited program is a requirement for licensure in most states. It demonstrates to employers and students that a program has met high standards of quality in its facilities, faculty, and curriculum.
Post-nursing school, RNs may choose to complete a perioperative nursing residency or fellowship program to gain hands-on skills in a structured environment. These fellowships can be accredited by the Practice Transition Program by the American Nurses Credentialing Center’s Commission on Accreditation in Practice Transition Programs.
On-Campus Perioperative Nurse Fellowship Programs
Mayo Clinic – College of Medicine and Science
The perioperative RN fellowship program at the Mayo Clinic College of Medicine and Science is a comprehensive 30-week training course designed for registered nurses looking to venture into the operating room setting. The program kicks off with a week of hospital induction, followed by three weeks of theoretical and simulation-based learning to familiarize nurses with the operating room environment. The ensuing three weeks involve one-on-one guidance from a preceptor to further acquaint nurses with surgical procedures and standards.
Next, nurses will complete a 15-week rotation across various specialty services, including general surgery, vascular, neurology, cardiology, urology, GYN, and robotics. The program encompasses instruction on state-of-the-art, specialized machines like lasers and electrosurgical and laparoscopic equipment, and introduces basic scrub principles. All admitted students receive a full scholarship and a stipend to participate in this program.
- Location: Phoenix/Scottsdale, AZ
- Duration: Four months
- Accreditation: Higher Learning Commission (HLC)
University of Pittsburgh Medical Center
The University of Pittsburgh Medical Center offers a perioperative nursing fellowship program that provides comprehensive training in the Association of Operating Room Nurses (AORN) recommended practices. The program’s primary goal is to prepare students to practice safely and confidently as members of a fast-paced perioperative team. Throughout the fellowship, participants will gain clinical experience and participate in ongoing educational opportunities to enhance OR skills and didactic knowledge.
To further support professional development, the program includes courses and workshops approved for continuing education credit. Participants will also receive ongoing support from staff development instructors, who will monitor progress and provide guidance. Students will work in various settings, including laparoscopy, transplant, gynecology, neurology, podiatry, and more.
- Location: Pittsburgh, PA
- Duration: Eight months
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
University of Maryland Medical Center
New nursing graduates and individuals without prior work experience in a perioperative setting can complete the OR nurse fellowship program at the University of Maryland Medical Center. This program is designed to equip them with the necessary skills to fulfill the responsibilities of a registered nurse in the operating room. It is tailored to each participant’s unique training requirements, taking into account their educational and professional background.
This program includes unit-based training, a five-day perioperative nursing course, and simulation training in a lab setting. Trainees receive orientation to both the RN circulator and scrub roles and work closely with experienced preceptors in each. With an OR-centric program, students will rotate through perioperative areas to ensure they are prepared for all potential workplaces and assignments.
- Location: Baltimore, MD
- Duration: Varies
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
The nurse residency program at the Cleveland Clinic offers a clinical track in surgical care. This program utilizes an innovative approach focused on competency- and simulation-based training. Nurses can apply newly acquired skills and concepts in the operating room under the guidance of experienced preceptors.
In addition to learning operating room skills, students in this program will develop strong critical-thinking skills and the ability to work as part of a team. Communication skills are also emphasized, so students should anticipate learning to engage effectively with their co-workers and to be strong advocates for their patients.
- Location: Cleveland, OH
- Duration: One year
- Accreditation: Accreditation with Distinction from the American Nurses Credentialing Center (ANCC)
Dartmouth Hitchcock Medical Center
Through Dartmouth Hitchcock Medical Center’s perioperative nurse residency program, nurses can acquire the essential knowledge and skills needed for a successful operating room nursing career. This nine-month program combines didactic instruction, specifically AORN’s Periop 101: A Core Curriculum, face-to-face clinical skills labs, and hands-on experiences in the operating room. It is designed to support new OR nurses on their journey towards becoming well-rounded, fully competent perioperative registered nurses.
Only a limited number of students are accepted into this program each year. All program participants receive a salary and are eligible for benefits. While the actual program can vary by student, most will rotate through a variety of surgical services, including ENT, general surgery, plastics, orthopedics, ophthalmology, oral surgery, and urology.
- Location: Hanover, NH
- Duration: Nine months
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
Online or Hybrid Perioperative Nurse Training Programs
The Tseng College California State University, Northridge
Nurses can complete a certificate in perioperative nursing at The Tseng College California State University, Northridge. This certificate consists of one course that includes classroom instruction and supervised clinical work. All didactic work is available online, while the clinical work takes place at a healthcare facility that best suits the student’s needs and career goals. Most students complete this program in just eight weeks.
Students in this program are well supported by faculty, clinical placement staff, and a personal progress team that ensures students can focus on their classwork and careers. To be eligible for admission, nurses must hold a California RN license. All coursework counts as continuing education units for licensure renewal.
- Location: Northridge, CA
- Duration: 144 hours
- Accreditation: Western Association of Schools and Colleges
Association of periOperative Registered Nurses
All registered nurses must complete continuing education units to maintain their licenses and certifications. The Association of periOperative Registered Nurses (AORN) offers online continuing education classes to help nurses in this field go beyond basic education and further their skills.
These classes cover topics essential to ensuring patient safety and optimal outcomes. Topics include aseptic practice, ambulatory surgery, equipment safety, leadership, and even sterilization. Within each topic, there are numerous courses nurses can complete. Prices vary, and there is a discount for AORN members.
- Location: Denver, CO
- Duration: Varies
- Accreditation: American Nurses Credentialing Center’s Commission on Accreditation
The perioperative 101 certificate at Curry College is a six-month program that combines in-class and online learning to prepare nurses for the Certified Perioperative Nurse (CNOR) certification exam. With a curriculum designed by AORN, this program meets national standards for perioperative nursing. This program is for new nurses with little to no operating room experience. It is also an excellent option for experienced nurses preparing for their certification exam.
Pursuing a perioperative certificate offers numerous benefits for career growth and personal development. Nurses gain the knowledge and skills needed to excel in a dynamic workplace by obtaining this certification. It can open new career opportunities and enable advancement within the nursing field. Nurses will gain additional critical-thinking skills specific to this field and be able to demonstrate mastery of nationally recognized nursing standards and evidence-based practices.
- Location: Milton, MA
- Duration: 68 instructional weeks
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
How Long Does it Take to Become a Perioperative Nurse?
Perioperative Nurses typically must complete bachelor’s and master’s degrees. This takes about six years of post-high school education. However, this timeframe can vary depending on the required work experience and the length of the master’s program.
How To Become a Perioperative Nurse – Step-by-Step Guide
Step 1: Graduate from High School or Complete a GED (Four Years)
The foundational knowledge and skills students gain in high school or while earning their GED are crucial for their nursing education. Biology and chemistry are particularly beneficial as they lay the groundwork for understanding the human body and medical treatments.
Step 2: Complete a Nursing Program (Two to Four Years)
After completing high school or a GED, aspiring perioperative nurses must complete a nursing program. This can be an associate degree in nursing (ADN) or a bachelor of science in nursing (BSN) program. An ADN typically takes two years, while a BSN usually takes four years. Both programs provide the necessary clinical experience and coursework in anatomy, pharmacology, and nursing practice to equip students with the skills and knowledge to work as entry-level nurses.
Step 3: Pass State NCLEX Exam (Timelines Vary)
Upon completing a nursing program, the next step is passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN). This standardized exam is required to obtain a license as a registered nurse in the United States. It measures competency to perform as an entry-level nurse and assesses understanding of nursing principles, patient care and safety, infection control, and health promotion and maintenance.
Step 4: Apply for State Licensure (Timelines Vary)
After successfully passing the NCLEX-RN exam, the next milestone is to apply for state licensure. This process involves applying to the state nursing board, and the requirements may vary slightly by state. This license legally authorizes nurses to practice as registered nurses and is a prerequisite to pursuing a specialization in perioperative nursing. More details on licensure are available below.
Step 5: Complete a Perioperative Nurse Fellowship or Residency (Optional, Timelines Vary)
Though not mandatory, completing a perioperative nurse fellowship can provide valuable practical experience and specialized knowledge in the field. These fellowship programs offer a unique opportunity for registered nurses to gain direct, hands-on experience in the surgical environment under the guidance of experienced mentors. The duration of the fellowship programs varies, but they typically last from six to 24 months.
Through a blend of didactic learning, case reviews, and clinical practice, fellows acquire the skills to deliver safe and effective patient care before, during, and after surgery. These programs often enhance employability, demonstrate a commitment to the specialty, and provide a competitive edge in the job market.
Step 6: Obtain Perioperative Nurse Certification (Optional, Timelines Vary)
Although optional, obtaining a perioperative nursing certification can significantly enhance credibility and job prospects. The primary credential obtained is the Certified Perioperative Nurse (CNOR) certification from the Competency & Credentialing Institute. More details on certification are available below.
What Do Perioperative Nurses Do?
Perioperative nurses work primarily in surgical departments and operating rooms. Day-to-day duties will vary but will typically include:
- Preparing patients for surgery by assessing their medical history and current health status, and ensuring they are properly informed and consented
- Collaborating with the surgical team to develop and implement a comprehensive plan of care for each patient
- Assisting in the setup and maintenance of the operating room
- Monitoring patients’ vital signs, anesthesia administration, and overall condition during surgery
- Managing and administering medications, intravenous fluids, and blood products as needed during surgery
- Monitoring patients’ responses and maintaining accurate documentation during surgery
- Anticipating and responding to potential complications or emergencies during surgery
- Working alongside the surgical team to provide immediate intervention and stabilize patients when necessary
- Communicating and coordinating with other healthcare professionals
- Educating patients and their families on post-operative care instructions, including wound care, pain management, and any necessary lifestyle modifications
- Advocating for patient safety and promoting infection control measures in the perioperative setting
- Following strict protocols and guidelines to minimize the risk of surgical site infections.
- Updating their knowledge and skills through professional development activities
Perioperative Nurse Certifications & Licensure
All perioperative nurses must be licensed RNs in the state where they are working. Licensing requirements will vary by state, but will typically include:
- Graduate from an accredited nursing education program (ADN or BSN), or meet equivalent military nursing education requirements
- Complete a fingerprint-based background check
- Pass the NCLEX-RN exam
Certification as a perioperative nurse is a voluntary step that RNs can take to demonstrate their competency in this field. The primary certification perioperative nurses earn is the Certified Perioperative Nurse (CNOR) credential through the Competency & Credentialing Institute (CCI). Currently, over 40,000 nurses hold this valuable certification. To be eligible, RNs must:
- Hold a current, valid, and unrestricted RN license
- Currently working full- or part-time in perioperative nursing clinical practice, nursing education, administration, or research
- Have a minimum of two years and 2,400 hours of experience in perioperative nursing, with a minimum of 1,200 hours in the intraoperative setting
Nurses who meet the minimum qualifications can apply to take the CNOR exam. This three-hour-and-45-minute exam consists of 200 questions. Topics covered include pre/postoperative patient assessment and diagnosis, individualized plan of care development and expected outcome identification, management of intraoperative activities, patient care and safety, management of personnel, services and materials, communication and documentation, infection prevention and control of environment, instrumentation and supplies, emergency situations, and professional accountabilities.
How Much Do Perioperative Nurses Make?
The Bureau of Labor Statistics does not differentiate nurse salaries based on specialization. The 3,282,010 registered nurses in the US earn an average of $98,430 per year (BLS May 2024)—the latest available data as of April 2026. The percentiles for wages are:
- 10th percentile: $66,030
- 25th percentile: $78,610
- 50th percentile (median): $93,600
- 75th percentile: $107,960
- 90th percentile: $135,320
For more targeted salary information,
Salary.com (2026), a salary-aggregating website, estimates that staff nurses working in operating rooms earn $88,944 per year on average.
Perioperative Nurse Career Alternatives
Here are a few alternatives to a career as a perioperative nurse.
Become a Surgical Technologist
Surgical technologists, also known as surgical technicians, assist surgeons during surgical procedures by preparing the operating room, sterilizing and arranging surgical instruments, and ensuring all necessary supplies are readily available. During surgery, they pass instruments to the surgeon, handle specimens, and assist with suturing and wound closure. They also play a vital role in maintaining a sterile environment, operating and maintaining surgical equipment, and providing patient care.
- Typical Education: Certificate or associate’s
- Licensing or Certifying Organization: National Board of Surgical Technology and the National Center for Competency Testing (NCCT)
Become a Nurse Practitioner
With advanced training and education, nurse practitioners provide comprehensive and personalized care to patients. They play a crucial role in diagnosing and treating various health conditions, ordering and interpreting diagnostic tests, prescribing medications, and managing chronic illnesses. Nurse practitioners also focus on preventive care, health promotion, and patient education, empowering individuals to take control of their own health.
- Typical Education: Master’s of science in nursing or doctor of nursing practice
- Licensing or Certifying Organization: American Academy of Nurse Practitioners (AANP), American Nurses Credentialing Center (ANCC), American Association of Critical-Care Nurses (AACN), National Certification Corporation (NCC), Pediatric Nursing Certification Board (PNCB), American Midwifery Certification Board (AMCB), Dermatology Nursing Certification Board (DNCB), Nephrology Nursing Certification Commission (NNCC), Orthopaedic Nurses Certification Board (ONCB), and Oncology Nursing Certification Corporation (ONCC)
Become an ER and Critical Care Nurse
ER (emergency room) and critical care nurses provide specialized care to patients in critical conditions. Their duties will include assessing, monitoring, and treating patients who require immediate medical attention. In the fast-paced and unpredictable emergency room or critical care unit environment, these nurses excel at triaging patients, administering life-saving interventions, and ensuring their overall well-being.
They are highly skilled in handling trauma cases, cardiac emergencies, and other critical situations, utilizing their extensive knowledge and expertise to stabilize patients and make split-second decisions.
- Typical Education: Associate or bachelor’s degree
- Licensing or Certifying Organization: American Association of Critical-Care Nurses (AACN), American Nurses Credentialing Center (ANCC), National Certification Corporation (NCC)
Kimmy Gustafson
WriterAt HealthcareDegree.com, Kimmy Gustafson has delivered in-depth and insightful articles since 2019, aiding prospective students to navigate the complexities of choosing the right healthcare degree. Her recent work includes topics such as the ethics of gene editing and physician assistant’s fight for autonomy.
Kimmy has been a freelance writer for more than a decade, writing hundreds of articles on a wide variety of topics such as startups, nonprofits, healthcare, kiteboarding, the outdoors, and higher education. She is passionate about seeing the world and has traveled to over 27 countries. She holds a bachelor’s degree in journalism from the University of Oregon. When not working, she can be found outdoors, parenting, kiteboarding, or cooking.