Elderly people have numerous physical and cognitive changes, which presents a number of challenges in the work of the operating nurse, and for the elderly person there, are many risks in the intraoperative period. The quality of the intra-operative care of an elderly person depends on the level of professional knowledge, competence and self-esteem of the operating nurse. Communication is an important part in every segment of work and organization, even in an intraoperative period, which means transmitting messages, exchanging and processing information, issuing and receiving orders among the operating team participants, and contacts with other professions. All of this makes a special communication system and without it, the operating team could not work. The risk is that there is the possibility of something that can endanger the health of the elderly person, make the disease worse or make some other unnecessary consequences. There are numerous risks in the intraoperative period that can reduce the safety of the elderly people, and the most common are postoperative infections, foreign object (gossypiboma) and damage of the skin integrity caused by many factors. An aseptic technique includes a number of protocols and guidelines, and the most important protocol refers to proper surgical hands washing, which is associated with reduced risk of postoperative infections and the most important intervention for the prevention of intrahospital infections in older persons. The introduction of a surgical checklist should improve the safety of the elderly people in the intraoperative period, and the goal of the list is to reduce the errors and to improve communication and work within the operating team. Presentism has emerged as an important phenomenon within work organizations and is associated with negative outcomes in work, so the operating sister does work which is below it's capabilities. Apsentism is intertwined with presentism, and can simply be explained as not coming to work for various reasons, where the consequence is a reduced quality of intraoperative care for an older person. Operative surgery in older age is associated with morbidity and increased mortality rate. Mortality is significantly increased in elderly people following emergency surgery and even in conditions that usually have a lower mortality rate in older age.