Perioperative nursing is a nursing specialty that works with patients who are having operative or other invasive procedures. Perioperative nurses work closely with surgeons, anesthesiologists, nurse anesthetists, surgical technologists, and nurse practitioners. They perform preoperative, intraoperative, and postoperative care primarily in the operating theatre. The circulating nurse is a perioperative nurse who assists in managing the nursing care of a patient during surgery. The circulating nurse observes for breaches in surgical asepsis and coordinates the needs of the surgical team. The circulating nurse is not scrubbed in the case, but rather manages the care and environment during surgery. An instrument (scrub) nurse is a perioperative nurse who works directly with the surgeon within the sterile field. The instrument nurse manages the sterile equipment, anticipates the surgeon's needs, and passes instruments and other items required during the procedure. Other duties include surgical site skin preparation, sterile draping, suctioning, irrigation, and retraction. The title comes from the requirement to scrub their hands and arms with special disinfecting solutions. An RNFA is the surgeon's assistant and is extremely qualified in providing extended perioperative nursing care. The role also includes preoperative, intraoperative, and postoperative care of the patient. The perianaesthesia nurse (recovery nurse) provides intensive nursing care to patients after they wake from anesthesia. This nurse cares for and monitors patients to make sure they are not nauseated or disoriented.