Five Tips to Choose, Prepare, and Retain New Hires in the OR

Passion for the OR is More Important than Experience

With a 72% retention rate for nurses who take staff positions after completing the Periop 101 program at Morristown Medical Center in New Jersey, Perioperative Educator Arlin Fidellaga, RN, BSN, CNOR, CMH, has discovered several important actions to retain her Periop 101 students.

Surgical personnel reviewing patient file

"Recognizing and cultivating a nurse’s desire to work in the OR is critical to inspiring a love and skill for OR nursing, as well as motivating a preference to stay working with you," Fidellaga says. "Do not disregard a nurse’s passion for the OR, no matter if they are a novice nurse or are coming to you with clinical experience."

In a recent study, Fidellaga compared overall performance of her students entering the Periop 101: A Core Curriculum (Periop 101) course either as a novice or a clinically experienced nurse. The study findings showed that age and experience were not the deciding factors to program success, rather a nurse’s passion to be an OR nurse as he or she entered the program directly correlated to their successful completion of the program.

"There was a perception within the perioperative community that experienced nurses were better for the Periop 101 program because they had already developed critical thinking skills, but we observed that in certain cases our Periop 101 students coming right out of nursing school also excelled in the program so we wanted to verify how previous nursing experience other than in the OR may or may not be a factor in overall program success," she explains. "From conducting this study we found that it’s really up to the individual and their eagerness to learn, regardless of age or experience."

Here are Fidellaga’s tips for identifying, preparing, and retaining newly educated OR nurses.

Tip #1

Carefully Choose Program Candidates

You can’t inspire a love of nursing—it has to be there. Look for this passion, drive and determination. Is the OR a candidate’s first choice for a nursing position? Did they end up in a different nursing specialty because there were no positions available in the OR? These are the questions to start asking once you get a Periop 101 program candidate into an interview so you can dig deeper into their ambitions and goals to get a better understanding on how they see themselves as an OR nurse.

Tip #2

Cultivate a Passion for Perioperative Nursing

Perioperative educators are in a distinctive position to identify a passion for OR nursing and then follow a student through a perioperative training program to support them in cultivating their drive, Fidellaga says. She adds that nurturing this urge could very well mean helping a nurse into a realization that they have the potential to be a great perioperative nurse, or it could mean helping a nurse gain the assertiveness and survival skills to work within any perioperative setting, which can be very stress-inducing.

Tip #3

Build Strong Lines of Communication

Fidellaga describes herself as an involved, proactive educator and she attributes this level of engagement to the successes of her facility’s Periop 101 students.

"It’s so important to be involved with a student from start to finish and it is essential to constantly have the lines of communication open throughout the program. I always ask my interns how they are doing, if they are still liking OR nursing, and how they are getting along with their preceptors,” she says. “We certainly do not want to find out later on that a student is drowning or not getting what they need, whether those unmet needs are a result of the student, a need for additional resources, or the preceptor not being a good fit—anything that can impede the ability to learn."

Fidellaga’s students are placed with carefully chosen preceptors and are also connected with the charge nurses and team coordinators for each specialty OR team they train in. Part of her role as a supervisor for these students is to ensure that all staff members comprehend the importance of sustaining a wholesome learning environment. Fidellaga also maintains close communication with these specialty team coordinators and preceptors to keep tabs on a student’s progress and potential learning needs.

Tip #4

Be Strategic with Staff Placement

Generally, we plan on a student being in our Periop 101 program for a good solid year before putting them on our full time staff to support a strong return on investment with waiting to place a fully functioning, independent OR nurse, Fidellaga says. When a student completes their orientation and is getting near the one-year mark, Fidellaga and her colleagues begin discussing with the student available opportunities for permanent placement. In this process they carefully discuss department needs and preceptor/preceptee preferences with the nurse. Careful deliberation and attention to the intern’s strengths and opportunities are considered as well as the preceptor and team coordinator feedback. Once a new nurse is placed in a full time position, we try not to make it a definite placement, in case the nurse has an urge to learn a different specialty—this is helpful for everyone involved to ensure ongoing opportunities for development and growth, she explains.

Tip #5

Provide Ongoing Tools for Success

Once hired, all staff members at Fidellaga’s facility, including new employees, are provided with the resources to succeed and continue growing through conferences and symposiums. Internal leadership opportunities through a shared governance structure are also made available so a new hire can directly engage with the facility’s cultural ideals for hands-on engagement in decision making, policy review, and improvements through performance and quality work.

Foster the Passion at Every Experience Level

Fidellaga encourages her fellow educators to foster and never disregard a nurse’s desire to be an OR nurse, no matter their age or level of experience.

She encourages students to not relinquish their passion to be an OR nurse. "Don’t abandon your struggle to get a foot in the door, and don’t give up once you get there when you have a bad day with a tough surgeon or a difficult case," Fidellaga stresses. "Give it a chance and keep trying—these are the qualities that make a good OR nurse and these are the attributes that every perioperative team looks for to develop excellence in you."

Additional Resources

Learn more about orienting new nurses with AORN’s Periop 101: A Core Curriculum™.

Bridge the knowledge gap between new hires and current employees with AORN’s Periop Mastery Program. The online learning program keeps the perioperative team current on evidence-based practice.

Recruit experienced perioperative nurses by posting a job listing in AORN’s Career Center.