How To Become a Scrub Nurse in the USA

By ShiftMed Team//Nursing Profession
Scrub nurse standing in the operating room

Scrub nurses, sometimes called surgical nurses, are vital to any surgical team. These nurses work to maintain a sterile environment within the operating room. In addition, they assist the surgeon and help minimize complications during surgery.

While scrub nurses usually work the day shift, they’re often on-call for emergency surgeries that can happen at any time. That means they may be called in on weekends, holidays, or the middle of the night. 

Here, we’ll discuss how to become a scrub nurse, what certifications are available, opportunities for advancement as a scrub nurse, and how much money scrub nurses make.

What are the steps to becoming a scrub nurse?

What are the educational requirements for becoming a scrub nurse? Do you have to take an exam? What certifications and specialties are available? These are the questions answered in the sections below.

Earn a nursing degree

The first step to becoming a scrub nurse is to become a registered nurse (RN). Next, you’ll need to earn either an associate’s degree in nursing or a bachelor’s degree in nursing (BSN). A bachelor’s degree takes four years.

While the ADN requires less time, some employers require a BSN. You’ll also need a BSN for some certifications and advancement opportunities. 

Pass the NCLEX-RN nursing exam

Once you’ve completed your education requirements, you must pass an exam to become an RN. The National Council of State Boards of Nursing administers the NCLEX-RN. You’ll need one to two months to study for this exam. 

Gain work experience

Now that you’re an RN, you must go to work. Finding a job won’t be hard. Elderly Americans are one of the fastest-growing population groups. With an aging population, demand across the healthcare sector is higher than ever before. Experts expect a 9% growth in demand for scrub nurses through 2030. 

It’s best to work in an operating room, as certifications for scrub nurses require a certain amount of surgical experience.

Consider specialty qualifications

As a scrub nurse, you have several opportunities for certifications, including critical care RN (CCRN), certified nurse operating room (CNOR), and Certified Medical-Surgical Registered Nurse (CMSRN).


The American Association of Critical Care Nurses (AACN) provides several CCRN certifications, including

  • CCRN (Adult)

  • CCRN (Pediatric)

  • CCRN (Neonatal)

  • CCRN-K (Adult)

  • CCRN-K (Pediatric)

  • CCRN-K (Neonatal)

  • CCRN-E (Adult)

The CCRN-Ks are for “knowledge professionals.” These RNs influence patients' care but do not provide direct care. The CCRN-E is for RNs working remotely via video. Next, we’ll focus on CCRNs that provide direct care to adults.

The first step to becoming a CCRN (Adult) is, of course, to become an RN. We’ve already covered that, so let’s jump to the experience requirements. You have two options: the two-year option or the five-year option. 

For the two-year option, you must have completed 1,750 hours of direct care to acutely/critically ill adults while an RN or advanced practice RN (APRN) within the last two years. At least 875 of those hours must have accrued within the previous year. 

For the five-year option, you must have completed 2,000 hours of direct care to acutely/critically ill adults while an RN or APRN within the last five years. At least 144 of those hours must have accrued within the last year. 

Once you have met the experience requirements, you’re eligible to take the exam. After you pass the exam, you’re a CCRN.


As an RN, you can take the CNOR exam after completing at least two years and 2,400 hours in a perioperative setting. You will need 1,200 hours of experience in an intraoperative environment. At the time you take the exam, you will need to work either full-time or part-time in one of the following settings:

  • Perioperative nursing clinical practice

  • Nursing Education

  • Nursing Administration

  • Research


The Medical Surgical Nursing Certification Board (MSNCB) offers the CMSRN credential. You need two years as an RN in a medical-surgical setting and 2,000 hours practicing as an RN within the last three years to qualify for this exam. Pass the exam, and you’ll have this certification.

Apply for scrub nurse jobs

As mentioned, scrub nurses are in heavy demand. A few years ago, a few studies showed having too many choices makes people unhappy. You know a great deal about nursing. But do you know as much about potential employers? How are you going to decide? That is where working with experts can help you find the right fit for you.

Can you become a scrub nurse online?

There are several options for taking online classes for ADN and BSN degrees. So, yes, you can qualify for the NCLEX-RN with online courses. But you’re not a scrub nurse until you’re an RN working as a scrub nurse. So before considering online classes, ensure you’re dealing with a reputable school

What is the difference between a scrub nurse and a registered nurse?

Scrub nurses, sometimes called surgical nurses or perioperative nurses, are RNs that specialize in keeping the surgical environment sterile and assisting the surgeon.

What positions can you progress to from being a scrub nurse?

Being a scrub nurse sets you up for many other opportunities. We have already touched on  CCRN, CNOR, and CMSRN certifications. Those are just the start. Other areas of opportunity include

  • RNFA

  • Nurse practitioner (NP)

  • CRNA

  • APRN

Frankly, this list doesn’t come close to showing all the opportunities. However, your experience in a surgical setting lays the foundation for multiple paths for advancement. 

You can advance to become an RN first assistant (RNFA). This means you’re the surgeon’s primary assistant. In this role, you’ll perform some tasks that most people believe only surgeons perform. Some of the tasks you will perform:

  • Handling and cutting tissue

  • Suturing the patient

  • Stopping bleeding

  • Preparing the surgical site

  • Using medical devices 

As you can see, RNFA is an important position. You’ll need to complete courses that can require a few days to a few weeks. You may also need a 140-hour internship before you’re an RNFA. To be eligible for the RNFA program, you’ll need to be an RN with a BSN. You must also be a CNOR with two years of perioperative nursing experience. 

Notice that RNFA programs aren’t open to RNs with associate degrees. But it’s worth the extra work to become an RNFA because they earn very high salaries. According to, the average salary for an RNFA in the US is $106,000.

Both CRNAs and NPs make six-figure incomes. You can advance to these jobs with a master’s degree in nursing (MSN), which requires two to three years. RNFAs, NPs, and CRNAs are advanced practice RNs (APRNs). Your work as a scrub nurse can help you reach many other types of APRN positions.

Do your scrub nurse exam qualifications expire?

Yes. The CMSRN expires after five years unless renewed. To be eligible for renewal, you must accrue 90 hours of continuing education over the past five years and 1,000 hours working in a surgical setting.

CNOR certifications expire after five years. You must work in perioperative care to be eligible to recertify. In addition, CCRN certifications require a continuing education requirement. If you cannot meet this requirement, you can take an exam to recertify. 

How much do scrub nurses make?

The median salary for a scrub nurse across the US is $73,366.94. The state with the highest median salary for scrub nurses is Hawaii at $119,905, followed by California at 105,852. Conversely, the states with the lowest median salary for scrub nurses are North Carolina at $57,972, Florida at $57,262, Tennessee at $52,519, and in last place is Mississippi at $52,296.

It’s important to remember that these are median salaries. That means half of the scrub nurses make more than these numbers, and the other half earns less. That’s slightly different from averages since a few higher earners can skew the average. For example, if Bill Gates walks into a bar where 99 other people are all homeless, the average net worth of each person in the bar is $1 billion. 

A few high earners can have a similar effect on income averages. It also matters that you can’t buy near as much with $119,905 in Hawaii as you can in Alabama. Consider the cost of living in a location before moving there to make the highest salary. The federal Bureau of Economic Analysis (BEA) provides good data on how far your money will go in different states.

Entry-level salaries will be on the lower side of the median, while more experienced scrub nurses will make on the higher side of the median. Similarly, scrub nurses with ADNs usually earn less than those with BSNs.

Read more: How long does it take to become a nurse?

How long does it take to become a scrub nurse?

You can become a scrub nurse shortly after becoming an RN. However, since you can complete the educational requirements to become an RN in as little as 18 months with an ADN and allow a couple of months to prepare for the NCLEX-RN, you’re looking at 20 months to become a scrub nurse if your first job is as a scrub nurse. 

Becoming certified takes longer. The first level of certifications requires 2,000 hours of practice or, sometimes, two full years. After that, you will need a BSN to be eligible for some certificates. That’s a four-year degree, though many people complete their BSN in less than four years.

There are ADN to BSN programs, sometimes called RN to BSN, that you can take entirely online. This allows you to get your bachelor’s degree while working as a scrub nurse. 

This may be your best option if you’re in a hurry to reach the hands-on training you can only get in the operating room but would like your BSN too.

Read more: How long does it take to become a nurse?

Extra FAQs about becoming a scrub nurse

This FAQ will answer some fundamental questions many prospective nurses ask.

Is it hard to be a scrub nurse?

This answer depends on you. It’s not easy for anyone. The educational requirements may be quick, but the work experience can be tough on some people. If you enjoy the camaraderie of the high-pressure operating room environment, being a scrub nurse may come easier to you. But on the other hand, some people find this environment too stressful, resulting in burnout.

What’s the difference between a nurse and a scrub nurse?

A nurse is a general term. Nurses work across many fields and settings. For example, scrub nurses are specialists who focus on their surgery team role.

What does a scrub RN do?

A scrub nurse’s primary duty is to maintain a sterile environment in the operating room. But they also may:

  • Hand tools to the surgeon

  • Set up the operating room for the patient

  • Assist the surgical team in other ways

Is a scrub nurse an RN?

Yes, scrub nurses are RNs that specialize in assisting the surgical team. There’s some overlap between what a scrub nurse and a surgical tech do.


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