This study describes the perioperative nursing experience on a patient with traumatic trimalleolar fracture waiting for undergoing Open Reduction Internal Fixation (ORIF) at the ER. During the nursing period from February 20 to February 26, 2016, the researcher adopted methods of observation, listening, interviews, physical evaluation, and medical chart review. Data were collected before, during, and after the surgery. In addition, perioperative nursing care model was used as the evaluation framework to confirm that the patient experienced health issues, such as anxiety, potential risk for operative injury, and potentially dangerous peripheral neurovascular dysfunction. During the perioperative nursing, the researcher proactively listened to and cared for the patient at the ER waiting for undergoing the surgery by understanding the patient's needs, providing surgery-related information, increasing the patient's understanding of fracture surgery and anesthesia, and reducing the perioperative anxiety. During the surgery, the researcher provided correct positioning and adequate protection information to the patient, in order to prevent the occurrence of irreversible surgical risk. Moreover, for patients undergoing orthopedic surgery, the researcher provided them with individualized health education and potential risk of postoperative neurovascular injury to enable the patient to be discharged from hospital in a safe and comfortable state. Because patients waiting for undergoing surgery at the ER are unable to obtain complete information on surgery and anesthesia, thus may trigger anxiety problems, nursing personnel are advised to use perioperative health education short films or health education leaflet to assist patients waiting for undergoing surgery at the ER in mentally adapt themselves to the surgery and reduce pressure as early as possible to further improve surgical care quality.