Differences Between an OR Nurse and a Surgical Tech

Operating rooms (ORs) are critical environments where precision, skill, and teamwork come together to ensure successful surgical outcomes.  

Within surgical settings, two key roles stand out: the OR nurse and the surgical technologist, also known as surgical tech. While both professionals are integral to the surgical team, their roles, educational pathways, and day-to-day duties differ significantly.  

Here’s a look at the specifics of the two roles:  

OR nurse 

OR nurses, also known as perioperative nurses, are RNs who specialize in the care of patients before, during, and after surgery. Their role is multifaceted, encompassing patient advocacy, preparation, and post-operative care. OR nurses ensure the surgical environment is safe and that patients receive the highest standard of care. 

Surgical tech 

Surgical techs, often referred to as operating room techs, are healthcare professionals trained to assist during surgical procedures. Their primary responsibility is to maintain the sterile field and assist the surgical team by providing the necessary instruments and supplies during surgery. 

Educational pathways 

For an OR nurse, there are four steps to attaining their role.  

Nursing degree: To become an OR nurse, one must first obtain a nursing degree. This can be an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). The BSN is increasingly preferred by employers and is required for advanced roles. 

Licensure: After completing the nursing degree, candidates must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to become licensed RNs. 

Specialized training: OR nurses often undergo additional specialized training in perioperative nursing. This can be through on-the-job training, certification programs, or continuing education courses. 

Certification: While not always required, certification can enhance an OR nurse’s credentials. The Certified Nurse Operating Room (CNOR) certification, offered by the Competency & Credentialing Institute (CCI), is a recognized certification for perioperative nurses. The Association of perioperative Registered Nurses highlights multiple certifications on its website.  

Surgical techs, meanwhile, have three important steps to take for advancement into the profession.  

Surgical technology program: To become a surgical tech, one must complete a surgical technology program, which can be a certificate, diploma, or associate degree. These programs are offered by community colleges, vocational schools, and some universities and typically take from nine to 24 months to complete. 

Certification: This step is not always required, but it is highly recommended. The Certified Surgical Technologist (CST) credential, offered by the National Board of Surgical Technology and Surgical Assisting (NBSTSA), is a common certification that enhances job prospects and credibility.  

Clinical training: Surgical tech programs include clinical training, providing hands-on experience in the operating room under the supervision of experienced professionals. 

Day-of-surgery duties 

The responsibilities of an OR nurse and a surgical tech vary during procedures.  

OR nurse duties include: 

Preoperative duties: On the day of surgery, OR nurses are responsible for preparing the patient and the operating room. This includes verifying patient identity, reviewing medical history, , and ensuring all preoperative instructions have been followed. OR nurses also conduct preoperative assessments, which may involve checking vital signs and administering preoperative medications. 

Intraoperative duties: During surgery, OR nurses play a crucial role in maintaining a safe and sterile environment. They are responsible for monitoring the patient’s condition, documenting the procedure, and ensuring the surgical team has everything they need. OR nurses can function as scrub nurses, who directly assist the surgeon by handling instruments, or circulating nurses, who manage the overall environment, retrieve additional supplies, and assist with non-sterile tasks. 

Postoperative duties: After surgery, OR nurses are involved in transferring the patient to the recovery area. They update the post-operative unit nurse how the surgery went and any specific monitoring needs.  

Surgical tech duties: 

Preoperative duties: Surgical techs are responsible for preparing the operating room for surgery. This includes sterilizing instruments and equipment, arranging the surgical tools, and ensuring that all necessary supplies are available. Surgical techs also help position the patient and prepare the surgical site by applying antiseptic solutions. 

Intraoperative duties: During surgery, surgical techs play a critical role in maintaining the sterile field. They pass instruments and supplies to the surgeon and surgical assistants, hold retractors, cut sutures, and manage surgical specimens. Surgical techs must anticipate the needs of the surgical team and ensure that all instruments are accounted for. 

Postop duties: After the surgery is completed, surgical techs assist with cleaning and sterilizing the operating room, ensuring all instruments are properly decontaminated and stored. They also prepare the OR for the next procedure. 

Key differences in roles, responsibilities 

The roles and responsibilities of an OR nurse and a surgical tech not only differ during procedures, but throughout their daily work. Here’s how: 

Patient interaction 

OR nurses have a more direct role in patient care compared to surgical techs. They may interact with patients before, during, and after surgery, providing emotional support, education, and advocacy.  

Surgical techs, on the other hand, have limited direct interaction with patients. Their primary focus is on the technical and procedural aspects of surgery, ensuring that the surgical environment is prepared and maintained. 

Scope of practice 

The scope of practice for OR nurses is broader than that of surgical techs. OR nurses are involved in patient assessment, care planning, and postoperative care, in addition to their intraoperative responsibilities. They must use critical thinking and clinical judgment to respond to changes in the patient’s condition and make decisions about care. 

Surgical techs have a more focused scope, concentrating on the technical and mechanical aspects of surgery. They ensure that the surgical team has the instruments and supplies needed and that the sterile field is maintained. 

Decision-making and leadership 

OR nurses are involved in decision-making and leadership within the surgical team. They coordinate care, communicate with other healthcare providers, and ensure that the surgical procedure follows the established plan. OR nurses are responsible for managing the overall environment and addressing any issues that arise during surgery. 

Surgical techs play a supportive role, following the direction of the surgeon and OR nurse. Their decision-making is more limited. 

Collaborative relationship 

Despite their different roles and responsibilities, OR nurses and surgical techs work closely together as part of the surgical team. Their collaboration is essential for ensuring patient safety and the success of the surgical procedure. 

OR nurses rely on surgical techs to maintain the sterile field and provide the necessary instruments and supplies efficiently. Surgical techs depend on OR nurses to manage patient care and coordinate the surgical team’s activities. This interdependence fosters a collaborative environment where each team member’s skills and expertise are utilized to provide the highest standard of care. 

The roles are distinct yet complementary, each bringing valuable skills and expertise to the operating room.  

Understanding the differences highlights the importance of each role in the surgical team and the need for effective collaboration to achieve successful surgical outcomes. By working together, OR nurses and surgical techs contribute to the safe, efficient, and compassionate care of patients undergoing surgical procedures.