Exploring the Decision-Making of OR Nurses: A Qualitative Study

Operating room nurses (ORNs) play a crucial role in ensuring patient safety and surgical efficiency. Their decision-making processes are influenced by protocols, experience, and collaboration with surgical teams. However, little research has described how ORNs navigate these decisions in high-pressure environments. This qualitative study involved semistructured interviews conducted with 11 ORNs from public and private hospitals. Thematic analysis was conducted using an inductive approach to identify key decision-making patterns. Themes included responsibility for patient safety, protocolized and shared decision-making, emergency decision-making, anticipation, and the role of experience. Operating room nurses balance strict adherence to protocols with situational adaptability, often constrained by hierarchical structures. The findings highlight how ORNs develop functional independence through experience, vigilance, and protocol-guided practice, particularly in emergency situations. Training programs should integrate both structured protocols and adaptive decision-making strategies. Future research should explore interventions to enhance ORN decision-making within surgical teams.