The ability to think on your feet and remain calm are attributes that are a must for anyone with sights on becoming a nurse in the operating room. Perioperative nurses undergo special training for the job.At King Edward VII Memorial Hospital nurses that work in the operating room must have at least two years’ experience working with a registered nurse certification.A special perioperative nursing course must be taken to obtain certification in this area. Although it used to be offered locally the programme is now only available overseas.According to head perioperative nurse Ria Outerbridge, the courses are available at many colleges and last anywhere from nine months to a year."Our nurses come from all parts of the world," she said. "We are all registered with the Association of periOperative Nurses (ApORN). We use their standard which is based in the US."All our nurses are put through competencies which they must pass each year in addition to CEUs [continuing education units]. It's a combination of practical work as well as exams.”Orthopaedic perioperative nurse Michelle Evans said the competencies are important because they ensure that the nurses are kept abreast of the latest developments in the field."The technology age means we're seeing rapid advances in equipment and implants," she said.In fact the OR nurses at KEMH have a book club of sorts to help keep track of change.Ms Outerbridge said: "We have our journals and we meet regularly and discuss matters relating to our area."