Charge Nurse - Operating Room

Department: Operating Room
Reports To: Director of Nursing
Employment Type: Full-Time
Position Summary

The Charge Nurse is a Registered Nurse who provides direct nursing care and oversees the daily clinical operations of the operating room suite within a multi-specialty ambulatory surgery center. The Charge Nurse coordinates staffing, patient flow, room assignments, and case sequencing across multiple operating rooms and surgical specialties.

This position serves as a clinical and administrative resource to the OR team during each shift and ensures patient care and daily operations are conducted in accordance with recognized standards of practice, applicable state regulations, and organizational policies, procedures, and guidelines.
Essential Duties & Responsibilities
Leadership & OR Operations

• Coordinate and direct daily operating room operations across multiple surgical specialties, including staff assignments, room turnover, and case sequencing.
• Serve as the primary point of contact for physicians, staff, and administration regarding OR scheduling, staffing needs, and case-related issues during the shift.
• Adjust staffing and room assignments in response to add-on cases, cancellations, delays, emergencies, and other changes in the daily schedule.
• Escalate clinical or operational concerns to the Director of Nursing or Administrator as appropriate.
• Facilitate communication and daily huddles among surgeons, anesthesia providers, OR staff, and pre- and post-operative departments.
• Serve as a clinical resource and mentor for OR staff across multiple surgical specialties.
• Provide guidance regarding specialty-specific equipment, positioning, and procedural requirements.
• Assume administrative responsibility for the OR suite in the absence of the Director of Nursing or Nurse Manager.

Direct Patient Care

• Assess patient and family needs and provide quality nursing care to assigned patients across a range of surgical specialties.
• Organize time, equipment, supplies, and personnel to support safe and efficient case management.
• Prepare operating rooms according to patient and procedure-specific requirements.
• Implement the plan of care safely and effectively.
• Ensure appropriate patient positioning, padding of bony prominences, and respiratory and circulatory protection.
• Ensure correct prepping and draping procedures.
• Conduct the surgical time-out process prior to incision to verify the correct patient, procedure, and surgical site.
• Maintain aseptic technique throughout procedures and ensure sterile supplies are properly handled and not expired.
• Account for all sponges, needles, and sharps during and after procedures and document appropriately.
• Promote positive communication and teamwork among all members of the surgical team.
• Anticipate the needs of the surgical team and assist anesthesia personnel in supporting patients during administration of anesthesia.
• Promote cost-effective use of supplies while maintaining quality and patient safety.
• Support efficient room turnover and workflow.

Staff Oversight & Development

• Provide input to the Director of Nursing regarding staff performance, competency, and annual evaluations.
• Orient and precept new OR staff.
• Serve as a role model for current and new employees.
• Monitor staff compliance with organizational policies, safety protocols, and infection control standards.
• Address staff and operational concerns in a timely manner.
• Maintain current professional knowledge, certifications, and licensure.
• Participate in professional development activities and encourage continued development among OR staff.

General & Safety Responsibilities

• Demonstrate professionalism in all interactions with patients, physicians, staff, and other stakeholders.
• Attend required safety and job-related training programs.
• Follow established exposure control plans for blood-borne and airborne pathogens.
• Maintain compliance with applicable safety, infection control, and organizational policies and procedures.
• Perform other duties as assigned.

Required Qualifications

• Current Registered Nurse (RN) license in the applicable state.
• Minimum of 3-5 years of operating room nursing experience, including experience with multiple surgical specialties.
• Minimum of 1 year of charge, lead, or supervisory OR experience, or demonstrated readiness to assume a leadership role.
• Current BLS and ACLS certifications.
• PALS certification as applicable to the center's patient population.

Preferred Qualifications

• Bachelor of Science in Nursing (BSN).
• Previous experience in an Ambulatory Surgery Center (ASC).
• CNOR certification or another related specialty certification.

Knowledge, Skills & Abilities

• Strong knowledge of operating room nursing practices and procedures across multiple surgical specialties.
• Strong clinical judgment and decision-making skills.
• Ability to coordinate multiple operating rooms, surgical cases, and staff assignments simultaneously.
• Strong organizational, communication, and interpersonal skills.
• Ability to work effectively with surgeons, anesthesia providers, nurses, surgical technologists, patients, and administrative staff.
• Ability to prioritize and respond appropriately to changing clinical and operational needs.
• Ability to identify problems, gather information, establish facts, and make sound decisions under time pressure.
• Proficiency with Microsoft Word, email, scheduling/staffing systems, and computerized clinical/EMR systems as applicable.

Physical Requirements

The physical requirements described are representative of those necessary to perform the essential functions of the position. Reasonable accommodations may be made for individuals with disabilities.

• Ability to regularly lift and/or move up to 50 pounds.
• Ability to lift and assist patients and carry or move medical equipment.
• Ability to stand and walk for extended periods.
• Ability to use hands for handling equipment and supplies.
• Ability to reach, bend, stoop, kneel, and crouch as needed.
• Ability to move efficiently between multiple operating rooms and clinical areas.
• Ability to assist and support patients during transfers and movement.
• Requires close vision, peripheral vision, depth perception, and the ability to adjust focus.

Work Environment

The position is performed in a surgical/medical facility and may involve exposure to moving mechanical equipment, fumes or airborne particles, chemicals, electrical equipment, vibration, infectious materials, noise, and odors.

The position carries a Category 1 risk of exposure to infectious diseases. Appropriate training, universal precautions, infection control procedures, and personal protective equipment are provided.

The work environment may include frequent interruptions and the need to oversee activities across multiple operating rooms and surgical specialties simultaneously.
Leadership & Supervisory Responsibilities

This position provides leadership and supervisory oversight of OR staff and surgical teams during the assigned shift. Responsibilities include staff assignments, workflow coordination, operational support, and serving as a clinical resource and escalation point for issues affecting patient care or OR operations.

The Charge Nurse provides input to the Director of Nursing regarding staff performance, competency, and professional development.