Evidence Shows Intra-Op Nurses Least Satisfied

New research investigating nurse perceptions of specific perioperative environments shows two important findings.

The good news is that postoperative nurses are more than satisfied with their work environment, including their co-workers and the culture within the post-anesthesia care unit (PACU).

The bad news is that intraoperative nurses working in the OR are the least satisfied, noting the lowest satisfaction with co-workers, communication, and the day to day work environment in the OR, according to study investigators Diane Kay Boyle, PhD, RN, FAAN, and James Stobinski, PhD, RN, CNOR, CSSM(E).

Previous research has shown perioperative nurses in general to be less satisfied with their work environments than nurses in other areas such as pediatrics and intensive care; however, a detailed understanding of perioperative nursing satisfaction within different areas in perioperative care has been less understood.

“With the OR serving as the economic engine in a health care organization, OR staff satisfaction can have a significant impact on how efficiently the OR runs and how teams get along,” Stobinski says. “This new evidence on satisfaction as it compares across perioperative settings, gives leaders new data to focus on the satisfiers that can help them get the best out of their people.”

A Closer Look at Periop RN Satisfaction

For this study, Boyle and Stobinski looked at perioperative nurses’ perception of their respective nursing work unit environments for pre-, intra- and post-operative care, as well as ambulatory care among 284 hospitals using 2017 RN survey data from the National Database of Nursing Quality Indicators® (NDNQI) database.

“We wanted to understand how the nature of the perioperative nursing work environment was perceived by nurses with specific certifications working in specific areas of perioperative care,” Stobinski shares.

Data from a total of 1,550 nurse surveys were analyzed using multilevel mixed regression models fit to each work environment dimension, and using perioperative certification variables (CAPA, CPAN, CNOR/CRNFA), nurse education, the four perioperative unit types and hospital characteristics as predictors. The effect of American Nurses Credentialing Center Magnet accreditation program (ANCC Magnet) status was also evaluated.

Based on differences in ratings between nurses holding these various credentials and in different perioperative work areas examined, nurses with the CAPA certification working in the PACU self-rated the highest satisfaction and nurses with the CNOR or CRNFA certification working in the intraoperative area of the OR self-rated the lowest satisfaction.

Takeaways for Improving Satisfaction

As a longtime perioperative nurse and nurse leader, Stobinski was not surprised by the low ratings intra-operative nurses reported. “OR nurses have worked to move past the ‘captain of the ship mentality’ to collaborate as equals with team members, and find their voice to speak up for patient care—these data show these efforts are still a work in progress.”

However, he says having data that quantify satisfaction within units in perioperative care can be a significant advantage for leaders seeking to improve staff satisfaction.

“The PACU may be a good place to evaluate what is working and why nurses are happier working in that environment and then compare these data to perceptions of those working in the OR,” he suggests. For example, do PACU nurses feel they have more autonomy in decision making? Do they communicate better with other nurses and anesthesia providers in their work area?

Stobinski and Boyle believe that the more research completed to understand factors such as nurse satisfaction in the perioperative setting, the more we can understand what works and what doesn’t to pinpoint cultural and environmental factors that can improve many different aspects of providing perioperative care.

They will be presenting their findings on “An Assessment of Perioperative Nursing Environments” for the first time at AORN’s Global Surgical Conference & Expo in April.

Free Resources for Members

AORN Career Center: Increase your job satisfaction with expert advice and career resources, including a 90-minute career coaching session.

Tool Kits: Create a practice environment of safety and just culture with access to team building exercises and communication tools perioperative nurses can utilize in their practice such as ISBAR handoff tools and a Briefing and Debriefing checklist. 

Guideline Essentials: Improve your team’s job satisfaction by utilizing your easy-to-use Guideline implementation tools on Team Communication and more, including:

• Gap Analysis Tools: Tools to assess areas in which your facility may not be compliant with the guidelines.
• Policy & Procedure Templates: Ready-to-use customizable templates for developing your facility’s policies and procedures
• Competency Verification Tools: Ready-to-use customizable templates for verifying competency to meet facility requirements