American nurses developed the profession of the perioperative RN. Lasting personnel shortages led to the creation of the position of surgical technologist, however, and the necessity of having an RN in the OR has been under scrutiny in the United States and United Kingdom. The Netherlands had a different historical development of perioperative professions, resulting in ORs largely staffed by technicians. The differences in staffing practices have consequences not only for functionality but also for perioperative staff members job satisfaction. An examination of the historical differences in staffing may support the hypothesis that both disciplines may be needed for the OR to function most effectively.