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Entry to Perioperative Nursing: An Explanatory Mixed Methods Study.

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  • 1School of Nursing, University of Tasmania, Alexandria, New South Wales, Australia.

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|October 8, 2025
PubMed
Summary

Entry into perioperative nursing faces relational and structural barriers, often treated as a staffing issue rather than a supported transition. Policy and organizational changes are needed to improve access, learning, and support for nurses in this essential specialty.

Keywords:
critical realismentry to practicehealth workforcemixed methodsnursing educationontological insecurityperioperative nursing

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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.