39 - Utilizing Formal Check-Ins to Reduce Transition Shock in New Perioperative Nurses

Description: Transitioning into the operating room (OR) is a high-stakes journey that can define the trajectory of a nurse's career. With the growing complexity of perioperative care, our team — Transition to Practice Manager, OR Educator, and OR Manager — recognized the need for stronger support for new RNs entering this critical environment. Determined to reduce transition shock and enhance onboarding, our team implemented a structured intervention to better prepare these nurses for the challenges ahead.

Our preparation leveraged the foundation of our existing Transition to Practice program, which supports new nurses in other clinical areas. Our team saw an opportunity to adapt these successful strategies specifically for the perioperative setting, where complex workflows and interdisciplinary communication demand extra support. Planning was guided by AORN's position statement on orientation and national transition-to-practice resources emphasizing regular feedback, open communication, and psychological safety. Feedback was also gathered from recent OR nurse graduates, who reported feelings of isolation, uncertainty about progress, and limited structured feedback during orientation.

A targeted assessment, conducted through informal interviews with new hires, preceptors, leadership and educators, confirmed the need for regular, formal opportunities to discuss progress, address concerns, and receive constructive feedback. Preceptors also expressed a desire for more structured support in guiding new nurses through orientation.

In response, our team implemented a formal check-in process where new hire RNs without prior OR experience meet every 2-3 weeks with the OR Educator and perioperative leadership. Sessions cover orientation progress, open discussion of challenges and successes, clarification of expectations, and individualized goal setting. Check-ins are documented to track progression and identify common themes to inform future onboarding improvements.

Since implementation, outcomes include increased new hire satisfaction, improved communication between staff and leadership, and enhanced confidence among new perioperative nurses. Leadership has observed fewer orientation extensions and early signs of better retention.

By embedding regular, structured check-ins into orientation, we are not only reducing transition shock but building psychological safety, continuous growth, and stronger team connection. This approach offers a scalable strategy to improve nurse satisfaction, retention, and success in the high-stakes perioperative environment — an investment that ultimately strengthens patient care and the surgical team.