66E U.S. Army perioperative nursing: foundation, function, and future in military healthcare

Abstract: The U.S. Army perioperative nurse (66E) plays a pivotal role in delivering surgical care that directly influences battlefield survivability, operational readiness, and overall force health. Rooted in a legacy dating back to the American Revolutionary War, Army perioperative nurses embody a unique blend of clinical precision, operational agility, and leadership excellence. These nurses serve as circulating or scrub personnel in operating rooms, managing sterile technique, surgical equipment, implants, and intraoperative imaging, while coordinating preoperative and postoperative care in both domestic and deployed settings. Their responsibilities extend beyond the surgical suite, encompassing trauma response, setting up field hospitals, managing mass casualties, and providing surgical logistics in austere environments. Specialization in perioperative nursing offers distinct career advancement opportunities and aligns with the Military Health System's goals of maintaining a medically ready force. Through training, mentorship, research dissemination, and advanced academic programs such as the Doctor of Nursing Practice Adult-Gerontology Clinical Nurse Specialist with a perioperative focus at USUHS, 66Es contribute to surgical innovation and quality improvement across the continuum of care. In 2024, 66Es demonstrated significant impact through leadership roles, global deployments, scholarly achievements, and clinical education initiatives. Looking forward, strategic efforts to reintegrate 66Es into forward surgical units and expand CNS authorizations will further strengthen the specialty's influence. Army perioperative nurses remain essential to military surgical capability, shaping the future of combat care and enhancing patient outcomes across operational and humanitarian missions.