OR Nurse Residency Programs: A Literature Review
This literature review examines the growing shortage of operating room (OR) nurses and evaluates nurse residency programs as a primary intervention strategy. Drawing on multiple scholarly sources, the paper explores why undergraduate nursing programs leave new graduates underprepared for perioperative settings, how low job satisfaction drives high turnover among new graduate nurses, and how mass retirement among experienced OR nurses has accelerated staffing crises since the late 1990s. The review argues that structured nurse residency programs offer an evidence-based solution that improves retention, increases job satisfaction, and supports effective novice-to-expert transition in the perioperative nursing specialty.
- Introduction to the OR Nurse Shortage: Overview of the looming OR nursing shortage crisis
- New Graduate Nurses and the Transition Gap: Residency programs improve retention and job satisfaction
- Education and Training as a Staffing Solution: Perioperative education gaps and training-based solutions
- Workforce Retirement and Succession Planning: Retiring OR nurses worsen shortages; residencies aid succession
- References: Full list of cited scholarly sources
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What makes this paper effective
- Integrates multiple authoritative sources to build a cumulative, evidence-based argument rather than relying on a single study.
- Clearly identifies two distinct root causes of the OR nurse shortage — inadequate preparation of new graduates and mass retirement of experienced nurses — then links both to the same proposed solution.
- Uses direct quotations strategically to reinforce key claims without overquoting, allowing the author's synthesis to drive the argument.
Key academic technique demonstrated
The paper demonstrates disciplined thematic synthesis: rather than summarizing sources one by one, it groups them around shared themes (transition, education, retirement) and uses each source to support a specific strand of the central argument. This approach is characteristic of a well-structured literature review.
Structure breakdown
The review opens with an overview of the OR shortage crisis, then moves to the problem of graduate unpreparedness and its link to turnover, followed by the role of ongoing perioperative education, and concludes with the retirement-driven escalation of shortages and the case for residency programs as a succession-planning tool. Each section builds logically on the last, culminating in a call for further examination of residency programs.
Introduction to the OR Nurse Shortage
Previous studies have indicated that in other specialties, nurse residency programs have been largely successful in seeking to stem nursing shortages. However, very few studies have attempted to evaluate or assess the effectiveness and success rate of nurse residency programs in relation to operating room nurses. It is important to note that there is a looming crisis on the horizon regarding the shortage of operating room nurses (Brown, Belgard, Washington, & Grueso, 2017). The effects this continued shortage could have on perioperative nursing may be dire. Toward this end, the importance of assessing the relevance of nurse residency programs as a means of addressing this concern cannot be overstated.
New Graduate Nurses and the Transition Gap
In the words of Zinn, Guglielmi, Davis, and Moses (2012), "as experienced nurses leave the workforce, new graduate nurses are the supply pipeline to acute care hospitals" (p. 653). This assertion is echoed by Finkelman and Kenner (2014). As Zinn et al. (2012) further point out, assuming that perioperative nurses take at least one year to develop proficiency in their role, it would be wrong to assume that graduates fresh from nursing school will "transition into practice without participating in a nurse residency program."
According to Huston (2013), low job satisfaction has been cited as one of the contributors to a high turnover rate among new graduate nurses. Thus, there is a need for a structured transition mechanism — such as graduate residency programs — to enable new operating room nurses to transition effectively. McDonald and Smith (2012) are of the opinion that nurse residency programs are effective, evidence-based graduate nurse retention interventions. In the words of the authors, studies have clearly indicated that "turnover rates among new graduate nurses could be decreased and job satisfaction could be increased by implementing a residency program" (McDonald & Smith, 2012, p. E19).
Education and Training as a Staffing Solution
Sadler (2018) argues that one of the solutions that ought to be explored in addressing the OR nurse shortage is ongoing training and education. The fact that undergraduate programs do not include the principles of perioperative practice has been a significant challenge in operating room nurse staffing (Sadler, 2018). In the words of Bakewell (as cited in Sadler, 2018), "this makes it difficult to hire new nursing school graduates into the perioperative setting." The proposed solution, according to Sadler (2018), includes the implementation of ongoing perioperative training and education opportunities such as residencies.
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