Entry to Perioperative Nursing: An Explanatory Mixed Methods Study

Area of Science:

• Nursing Education
• Health Policy
• Surgical Care

Background:

• Perioperative nursing is critical for surgical safety but faces educational and policy marginalization.
• This contributes to workforce shortages and inconsistent pathways for new nurses entering the specialty.
• Existing policies and educational structures do not adequately support nurses transitioning into perioperative roles.

Purpose of the Study:

• To examine the representation of entry into perioperative nursing within Australian policy.
• To understand the lived experiences of nurses entering the perioperative specialty.
• To investigate how policy, education, and organizational factors influence access, learning, and support during this transition.

Main Methods:

• An explanatory concurrent mixed methods design was employed.
• Policy analysis and survey data from 226 perioperative nurses were integrated.
• A critical realist framework underpinned the study, utilizing factor and thematic analysis.

Main Results:

• Relational and structural constraints significantly shape support, opportunity, and recognition for new perioperative nurses.
• Policy analysis revealed that entry is viewed as a local organizational matter, not a structured specialty transition.
• Two constructs, 'Legitimate Learners' and 'Useful Bodies,' emerged, highlighting barriers to exposure, access, and post-entry support.
• Power asymmetry was identified as a common factor causing ontological insecurity among nurses.

Conclusions:

• Perioperative nursing entry is hindered by systemic issues, impacting nurse support and development.
• Current approaches treat perioperative nursing as a staffing solution, neglecting its need for structured specialty transition.
• Structural reforms are essential to establish perioperative nursing as a well-supported specialty pathway, improving workforce stability and quality of care.