Navigating the Transition: A Qualitative Inquiry into the Mentorship Role of Trained Nurses in Supporting Novice Nurses

Transitioning into operating room (OR) practice requires skilled mentorship, and trained operating room nurses play a critical role in guiding novices in this high-risk environment. However, little is known about how trained OR nurses manage the challenges of mentoring while fulfilling their clinical responsibilities, particularly in private hospitals in the Philippines. This study explored the experiences of trained nurses in mentoring novice nurses in the OR of a selected private hospital in Pagadian City, Zamboanga del Sur. Using a case study design, face-to-face semi-structured interviews were conducted with five trained OR nurses, two novice OR nurses, and two OR nurse supervisors selected through purposive sampling. Data were analyzed using Yin’s six-stage case study process. The findings revealed four major themes: structured orientation through compliance with OR policies and guidelines, hands-on demonstration and supportive guidance for skill development, challenges in novice nurse engagement and mentorship continuation, and continuation of mentorship and support for novice nurse learning. The study concludes that policy-driven orientation and hands-on, supportive mentorship are the main factors developing competent and confident novice OR nurses but must be reinforced by adequate staffing and organizational support. Strengthening formal OR mentorship structures in private hospital may enhance novice nurses’ adaptation, improve retention, and promote patient safety in the perioperative setting.

mentorship, operating room nursing, novice nurses

1. Acea‐López, L., Pastor‐Bravo, M. D. M., Rubinat‐Arnaldo, E., Bellon, F., Blanco‐Blanco, J., Gea‐Sanchez, M., & Briones‐Vozmediano, E. (2021). Burnout and job satisfaction among nurses in three Spanish regions. Journal of Nursing Management, 29(7), 2208–2215. https://doi.org/10.1111/jonm.13782 [Google Scholar] [Crossref]

2. Afrasiabifar, A., Karimi, Z., & Hassani, P. (2013). Roy's Adaptation Model-Based Patient Education for Promoting the Adaptation of Hemodialysis Patients. Iranian Red Crescent medical journal, 15(7), 566–572. https://doi.org/10.5812/ircmj.12024 [Google Scholar] [Crossref]

3. Alharbi, H. F., Alzahrani, J., Hamed, A., Althagafi, A., & Alkarani, A. S. (2023). The experiences of newly graduated nurses during their first year of practice. Healthcare, 11(14), 2048. https://doi.org/10.3390/healthcare11142048 [Google Scholar] [Crossref]

4. Bagheri, M., Adelmanesh, Y., Alizadeh, A., Sadeghi Meymand, S., Amiri, A., & Khaki, S. (2025). The effect of a combined training program on clinical competence and professional commitment of perioperative nursing students in laparoscopic surgery: A quasi-experimental study. BMC Medical Education, 25, Article 817. https://doi.org/10.1186/s12909-025-07400-7 [Google Scholar] [Crossref]

5. Balabag, R. C., & Guinoo, J. C. (2020). Stress and adaptation of nursing students in clinical exposure: Application of Roy’s Adaptation Model. Philippine Journal of Nursing, 90(1), 45–52. [Google Scholar] [Crossref]

6. Benner, P. E. (2001). From novice to expert: Excellence and power in clinical nursing practice. Prentice Hall. [Google Scholar] [Crossref]

7. Bourke, L., Conway, C., & Abdalla, M. E. (2025). Mentorship in surgical training: A systematic scoping review to inform a mentorship framework for ophthalmology trainees. BMC Medical Education, 25, 373. https://doi.org/10.1186/s12909-025-06901-9 [Google Scholar] [Crossref]

8. Bwanali, R. K., Msiska, G., Urstad, K. H., Bø, B., & Chimwaza, A. (2025). Effect of simulation-based perioperative education on the acquisition of self-competence and knowledge among undergraduate student nurses: A randomised controlled study. BMC Nursing, 24, 1090. https://doi.org/10.1186/s12912-025-03751-0 [Google Scholar] [Crossref]

9. Callis, A. M. B. (2020). Application of the Roy Adaptation Theory to a care program for nurses. Applied Nursing Research, 56, 151340. https://doi.org/10.1016/j.apnr.2020.151340 [Google Scholar] [Crossref]

10. Creswell, J. W., & Poth, C. N. (2016). Qualitative inquiry and research design: Choosing among five approaches (4th ed.). Sage Publications. [Google Scholar] [Crossref]

11. Cross, L., & Kendrick, A. (2024). Notetaking among nursing students. International Journal of Nursing Education Scholarship, 21(1). https://doi.org/10.1515/ijnes-2024-0002 [Google Scholar] [Crossref]

12. Degani, A., & Alkhaled, W. (2024). Psychological safety in students’ clinical learning environments: Medical and nursing students’ perspectives. Journal of Global Medicine, 4(3), 241. https://globalmedicine.co.uk/index.php/jogm/article/view/241/669 [Google Scholar] [Crossref]

13. Dikmen, M., & Şenyuva, E. A. (2024). The relationship between the mentorship skills and professional attitudes of preceptor nurses: A multi-centre study. Clinical and Experimental Health Sciences, 14(1), 87–94. https://doi.org/10.33808/clinexphealthsci.1191515 [Google Scholar] [Crossref]

14. Dobbins, J. (2018). Graduate nurses’ perceived confidence in clinical competence (Doctoral dissertation). ProQuest Dissertations Publishing. https://digitalcommons.gardner-webb.edu/nursing_etd/324 [Google Scholar] [Crossref]

15. Doodlesack, A., Dubosh, N., Grossestreuer, A., de Oliveira, L., & Bilello, L. (2024). A novel nurse-inteRN mentorship program to improve nurse–physician communication and teamwork in the emergency department. International Journal of Emergency Medicine, 17(1), 163. https://doi.org/10.1186/s12245-024-00740-z [Google Scholar] [Crossref]

16. Dracup, K., & Bryan-Brown, C. W. (2004). From novice to expert to mentor: Shaping the future. American Journal of Critical Care, 13(6), 448–450. https://doi.org/10.4037/ajcc2004.13.6.448 [Google Scholar] [Crossref]

17. Eriksson, J., Lindgren, B. M., & Lindahl, E. (2020). Newly trained operating room nurses’ experiences of nursing care in the operating room. Scandinavian Journal of Caring Sciences, 34(4), 1074–1082. https://doi.org/10.1111/scs.12817 [Google Scholar] [Crossref]

18. Ernawaty, E., Hariati, S., & Saleh, A. (2024). Program components, impact, and duration of implementing a new nurse orientation program in hospital contexts: A scoping review. International journal of nursing studies advances, 7, 100214. https://doi.org/10.1016/j.ijnsa.2024.100214 [Google Scholar] [Crossref]

19. Fawcett, J., Aber, C., Haussler, S., Weiss, M., Myers, S. T., Hall, J. L., ... & Silva, V. (2011). Women’s perceptions of caesarean birth: A Roy international study. Nursing Science Quarterly, 24(4), 352–362. https://doi.org/10.1177/0894318411419211 [Google Scholar] [Crossref]

20. Fischer, E. A., Jayana, K., Cunningham, T., Washington, M., Mony, P., Bradley, J., & Moses, S. (2015). Nurse mentors to advance quality improvement in primary health centers: Lessons from a pilot program in Northern Karnataka, India. Global Health: Science and Practice, 3(4), 660–675. https://doi.org/10.9745/GHSP-D-15-00142 [Google Scholar] [Crossref]

21. Ghanmi, N., Bondok, M., Etherington, C., Saddiki, Y., Lefebvre, I., Berthelot, P., Dion, P. M., Raymond, B., Seguin, J., Sekhavati, P., Islam, S., & Boet, S. (2024). Optimizing teamwork in the operating room: A scoping review of actionable teamwork strategies. Cureus, 16(5), e60522. https://doi.org/10.7759/cureus.60522 [Google Scholar] [Crossref]

22. Göras, C., Nilsson, U., Ekstedt, M., Unbeck, M., & Ehrenberg, A. (2020). Managing complexity in the operating room: A group interview study. BMC Health Services Research, 20, 1–12. https://doi.org/10.1186/s12913-020-05192-8 [Google Scholar] [Crossref]

23. Gore, J., & Schrems, B. (2025). Factors influencing the development of patient safety culture in the undergraduate nursing student population—An integrative review. Journal of Advanced Nursing, 81(12), 8529–8563. https://doi.org/10.1111/jan.16880 [Google Scholar] [Crossref]

24. Gularte-Rinaldo, J., Baumgardner, R., Tilton, T., & Brailoff, V. (2023). Mentorship ReSPeCT study: A nurse mentorship program’s impact on transition to practice and decision to remain in nursing for newly graduated nurses. Nurse Leader, 21(2), 262–267. https://doi.org/10.1016/j.mnl.2022.07.003 [Google Scholar] [Crossref]

25. Hagrass, H. M., Ibrahim, S. A. E., Anany, R. I. E., & El-Gazar, H. E. (2023). Effect of an educational program about mentorship competencies on nurse mentors' performance: a quasi-experimental study. BMC nursing, 22(1), 429. https://doi.org/10.1186/s12912-023-01597-y [Google Scholar] [Crossref]

26. Harder, N., Watter, S., & Mould, A. (2021). Structured orientation and mentorship programs for novice nurses: Impact on competence and confidence. Nurse Education in Practice, 50, 102951. https://doi.org/10.1016/j.nepr.2021.102951 [Google Scholar] [Crossref]

27. Hedenstrom, M. L., Spiva, L., Thurman, S., Hale, R. L., Toney, S., Case-Wirth, J., Kairu, M., & Sneha, S. (2023). Developing and evaluating the effectiveness of a nursing leadership mentoring pilot program. Nursing Administration Quarterly, 47(2), 173–181. https://doi.org/10.1097/NAQ.0000000000000557 [Google Scholar] [Crossref]

28. Heggarty, M., & Foran, P. (2025). Perioperative preceptors’ education and training: An integrative review. Journal of Perioperative Nursing, 38(3), 38–42. https://doi.org/10.26550/2209-1092.1389 [Google Scholar] [Crossref]

29. Heizenroth, P. A. (1996). Key components of perioperative orientation. AORN Journal, 63(1), 185–190. https://doi.org/10.1016/S0001-2092(06)63453-4 [Google Scholar] [Crossref]

30. Hill, S. E. M., Ward, W. L., Seay, A., & Buzenski, J. (2022). The nature and evolution of the mentoring relationship in academic health centers. Journal of Clinical Psychology in Medical Settings, 29(3), 557–569. https://doi.org/10.1007/s10880-022-09893-6 [Google Scholar] [Crossref]

31. Hobenu, K. A., Adefuye, A. O., Naab, F., & Nyoni, C. N. (2025). Strategies to enhance clinical teaching and learning in undergraduate nursing education: A scoping review. PLOS ONE, 20(6), e0305789. https://doi.org/10.1371/journal.pone.0305789 [Google Scholar] [Crossref]

32. Horner, D. K. (2017). Mentoring: Positively influencing job satisfaction and retention of new-hire nurse practitioners. Plastic Surgical Nursing, 37(1), 7–22. https://doi.org/10.1097/PSN.0000000000000169 [Google Scholar] [Crossref]

33. International Council of Nurses. (2021). The ICN code of ethics for nurses (Revised 2021). International Council of Nurses. https://www.icn.ch/system/files/2021-10/ICN_Code-of-Ethics_EN_Web.pdf [Google Scholar] [Crossref]

34. Jangland, E., Gunningberg, L., & Nyholm, L. (2021). A mentoring programme to meet newly graduated nurses’ needs and give senior nurses a new career opportunity: A multiple-case study. Nurse Education in Practice, 57, 103233. https://doi.org/10.1016/j.nepr.2021.103233 [Google Scholar] [Crossref]

35. Joseph, H. B., Issac, A., George, A. G., Gautam, G., Jiji, M., & Mondal, S. (2022). Transitional Challenges and Role of Preceptor among New Nursing Graduates. Journal of caring sciences, 11(2), 56–63. https://doi.org/10.34172/jcs.2022.16 [Google Scholar] [Crossref]

36. Kakyo, T. A., Xiao, L. D., & Chamberlain, D. (2025). The role of motivation in the initiation and maintaining mentoring relationships among nurses and midwives. International Nursing Review, 72(1), e12977. https://doi.org/10.1111/inr.12977 [Google Scholar] [Crossref]

37. Kalbarczyk, A., Serafin, L., & Czarkowska-Pączek, B. (2022). Novice nurses’ leadership competence: A cross-sectional study. Nursing in the 21st Century, 21(2), 88–93. https://doi.org/10.2478/pielxxiw-2022-0015 [Google Scholar] [Crossref]

38. Kallerhult Hermansson, S., Kasén, A., Hilli, Y., Norström, F., Vaag, J. R., & Bölenius, K. (2024). Exploring registered nurses’ perspectives as mentors for newly qualified nurses: A qualitative interview study. BMJ Open, 14(5), e082940. https://doi.org/10.1136/bmjopen-2023-082940 [Google Scholar] [Crossref]

39. Kisanuki, N., Takase, M., & Yamamoto, M. (2024). Unveiling the challenges encountered by newly graduated nurses during night shifts: A descriptive qualitative study. International Journal of Nursing Sciences, 11(4), 447–456. https://doi.org/10.1016/j.ijnss.2024.08.009 [Google Scholar] [Crossref]

40. Lalithabai, D. S., Ammar, W. M., Alghamdi, K. S., & Aboshaiqah, A. E. (2021). Using action research to evaluate a nursing orientation program in a multicultural acute healthcare setting. International Journal of Nursing Sciences, 8(2), 181–189. https://doi.org/10.1016/j.ijnss.2021.01.002 [Google Scholar] [Crossref]

41. Leach, L. S., Myrtle, R. C., & Weaver, F. A. (2011). Surgical teams: Role perspectives and role dynamics in the operating room. Health Services Management Research, 24(2), 81–90. https://doi.org/10.1258/hsmr.2010.010018 [Google Scholar] [Crossref]

42. Li, J. S., & Conway, A. (2024). Implementation of a blended-learning perioperative nursing education program in Canada. AORN Journal, 119(4), 248–260. https://doi.org/10.1002/aorn.14112 [Google Scholar] [Crossref]

43. Liebenberg, M. (2018). Professional nurses’ perceptions of their role as mentors for novice nurses in the operating room (Master’s thesis). Stellenbosch University. http://hdl.handle.net/10019.1/103729 [Google Scholar] [Crossref]

44. Lima, M. S., & Alzyood, M. (2024). The impact of preceptorship on the newly qualified nurse and preceptors working in a critical care environment: An integrative literature review. Nursing in Critical Care, 29(5), 1178–1189. https://doi.org/10.1111/nicc.13061 [Google Scholar] [Crossref]

45. Lindfors, K., Flinkman, M., Kaunonen, M., Huhtala, H., & Paavilainen, E. (2022). New graduate registered nurses' professional competence and the impact of preceptors' education intervention: a quasi-experimental longitudinal intervention study. BMC nursing, 21(1), 360. https://doi.org/10.1186/s12912-022-01133-4 [Google Scholar] [Crossref]

46. Masitho, M., Hariyati, R. T. S., Handiyani, H., Yetti, K., Rahman, L. O. A., & Afriani, T. (2026). Development of a new nurse orientation program in the intensive care unit. Indonesian Journal of Global Health Research, 8(1), 195–200. https://doi.org/10.37287/ijghr.v8i1.593 [Google Scholar] [Crossref]

47. Mathenge, C. (2020). The importance of the perioperative nurse. Community Eye Health, 33(110), 44–45. https://pubmed.ncbi.nlm.nih.gov/34007106/ [Google Scholar] [Crossref]

48. Merillana, B. V. (2024). Patient safety practices among nurses in the operating room. Puissant, 5, 1952–1976 Retrieved from //puissant.stepacademic.net/puissant/article/view/366. [Google Scholar] [Crossref]

49. Moon, S. H., Jeong, H. W., & Jung, U. S. (2024). Exploring the impact of the mentoring new nurses for transition and empowerment program led by clinical nurse educators in South Korea: A mixed-methods study. Nurse Education Today, 140, 106251. https://doi.org/10.1016/j.nedt.2024.106251 [Google Scholar] [Crossref]

50. Nijkamp, N., Calleja, P., & Sahay, A. (2023). Transition support arrangements to support new graduate and novice nurses’ entry into perioperative nursing: A scoping review. Heliyon, 10(1), e23316. https://doi.org/10.1016/j.heliyon.2023.e23316 [Google Scholar] [Crossref]

51. Ogdoc, M. A., & Superable, C. S. (2021). A case study on the clinical preceptorship among novice nurses: Their clinical competence and confidence. Journal of Multidisciplinary Studies, 10(1), 49–82. https://doi.org/10.7828/jmds.v10i1.1517 [Google Scholar] [Crossref]

52. Ojala, H., Kuivila, H.-M., Mikkonen, K., Jarva, E., & Juntunen, J. (2025). Factors associated with newly graduated nurses' work engagement: Systematic review of quantitative studies. Journal of Advanced Nursing. Advance online publication. https://doi.org/10.1111/jan.17069 [Google Scholar] [Crossref]

53. Olson, M. A., & Johnson, A. M. (2023). Orientation to the operating room: An acute care hospital and local technical college partner for success. Journal for Nurses in Professional Development, 39(4), E81–E85. https://doi.org/10.1097/NND.0000000000000856 [Google Scholar] [Crossref]

54. Operating Room Nurses Association of the Philippines. (n.d.). Vision & mission. ORNAP. https://www.ornap.org/about-us/vision-mission/ [Google Scholar] [Crossref]

55. Ortiz, J. (2016). New graduate nurses’ experiences about lack of professional confidence. Nurse Education in Practice, 19, 19–24. https://doi.org/10.1016/j.nepr.2016.04.001 [Google Scholar] [Crossref]

56. Oshodi, T. O., & Sookhoo, D. (2024). Nursing students’ perceptions of inadequate nurse staffing in the clinical learning environment: A systematic narrative review. Nurse Education in Practice, 82, Article 104221. https://doi.org/10.1016/j.nepr.2024.104221 [Google Scholar] [Crossref]

57. Owens, N. G. (2013). New graduate nurse preceptor program: A collaborative approach with academia. Journal of Nursing Education and Practice, 3(12), 1–9. https://doi.org/10.5430/jnep.v3n12p1 [Google Scholar] [Crossref]

58. Pelin, K., & Ayise, K. (2019). Assessment of mentorship applications in nursing clinical education. International Journal of Caring Sciences, 12(2), 869–876. Retrieved from https://www.internationaljournalofcaringsciences.org/docs/28_pelin_original_12_2.pdf [Google Scholar] [Crossref]

59. Persaud, D. (2008). Mentoring the new graduate perioperative nurse: A valuable retention strategy. AORN Journal, 87(6), 1173–1179. https://doi.org/10.1016/j.aorn.2007.10.014 [Google Scholar] [Crossref]

60. Qian, W., Qian, L., Xu, Q., & Lu, L. (2021). The effects of Roy’s Adaptation Model and the forgetting curve in the clinical instruction of operating room nursing interns. American Journal of Translational Research, 13(7), 8214–8220. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8340201/ [Google Scholar] [Crossref]

61. Quick, J. (2016). From novice to expert: A surgical care practitioner’s reflection on their role development. Journal of Perioperative Practice, 26(10). https://doi.org/10.1177/175045891602601003 [Google Scholar] [Crossref]

62. Richmond, J., & Issa, C. (2020, October). Implementation of mentorship-focused operating room circulating RN training program. Paper presented at the Mentoring Institute Conference, University of New Mexico Hospitals, Albuquerque, NM. Retrieved from https://www.nmnec.org/wp-content/uploads/2020/12/Implementation-of-Mentorship-Focused-Operating-Room-Circulating-RN-Training-Program-UNMH.Mentoring-Institute-Conference.2020.pdf [Google Scholar] [Crossref]

63. Riesenberg, L. A., Leischner, M., Yu, D., & Rajkomar, A. (2020). Standardized protocols and checklists in perioperative nursing: Enhancing safety and efficiency. Journal of PeriAnesthesia Nursing, 33(4), 212–220. https://doi.org/10.1016/j.jopan.2020.06.005 [Google Scholar] [Crossref]

64. Roy, C. (2009). Assessment and the Roy Adaptation Model. The Japanese Nursing Journal, 29(11), 5–7. [Google Scholar] [Crossref]

65. Schuler, E., Mott, S., Forbes, P. W., Schmid, A., Atkinson, C., & DeGrazia, M. (2021). Evaluation of an evidence-based practice mentorship programme in a paediatric quaternary care setting. Journal of Research in Nursing, 26(1–2), 149–165. https://doi.org/10.1177/1744987121991417 [Google Scholar] [Crossref]

66. Sizer, M. E. (2018). Staff education for registered nurses using the teach-back method (Doctoral dissertation, Walden University). Walden Dissertations and Doctoral Studies Collection. https://scholarworks.waldenu.edu/dissertations [Google Scholar] [Crossref]

67. Song, Z., Shen, Y., Yao, X., Wen, S., Wang, J., Chen, Y., Zhang, P., & Huang, X. (2024). “Discovering shine through feedback seeking”—Feedback seeking among new graduate nurses: A qualitative study. BMC Nursing, 23(1), 10. https://doi.org/10.1186/s12912-023-01657-3 [Google Scholar] [Crossref]

68. Sterner, A., Ramstrand, N., Palmér, L., & Hagiwara, M. A. (2021). A study of factors that predict novice nurses’ perceived ability to provide care in acute situations. Nursing Open, 8(4), 1958–1979. https://doi.org/10.1002/nop2.871 [Google Scholar] [Crossref]

69. Turner, S. (2023). Psychological safety in simulation: Perspectives of nursing students and facilitators. Journal of Psychiatric and Mental Health Nursing. Advance online publication. https://doi.org/10.1016/j.pnmhn.2023.000060 [Google Scholar] [Crossref]

70. Uçak, A., & Cebeci, F. (2025). Competency perceptions of operating room nurses and opinions of the surgical team on factors facilitating competency acquisition: A mixed-methods study. Journal of Evaluation in Clinical Practice, 31(5), e70233. https://doi.org/10.1111/jep.70233 [Google Scholar] [Crossref]

71. Udan, J. (2020). Theoretical foundation of nursing (2nd ed.). Educational Publishing House. [Google Scholar] [Crossref]

72. Varghese, B., Al-Balawi, R. M. O. A. M., Joseph, C. M., Al-Akkam, A. A. A., Alomari, A. M. A., & Swallmeh, E. (2023). The lived experiences of nurse preceptors in training new nurses in Qatar: Qualitative study. BMC Nursing, 22, 456. https://doi.org/10.1186/s12912-023-01619-9 [Google Scholar] [Crossref]

73. Wakefield, E. (2018). Is your graduate nurse suffering from transition shock? Journal of Perioperative Nursing, 31(1), 47–50. https://doi.org/10.26550/311/47-50 [Google Scholar] [Crossref]

74. Wangensteen, S., Johansson, I. S., Björkström, M. E., & Nordström, G. (2012). Newly graduated nurses’ perception of competence and possible predictors: A cross-sectional survey. Journal of Professional Nursing, 28(3), 170–181. https://doi.org/10.1016/j.profnurs.2011.11.014 [Google Scholar] [Crossref]

75. Wu, X. V., Chan, Y. S., Tan, K. H. S., & Wang, W. (2018). A systematic review of online learning programs for nurse preceptors. Nurse Education Today, 60, 11–22. https://doi.org/10.1016/j.nedt.2017.09.010 [Google Scholar] [Crossref]

76. Yen, P. H., & Leasure, A. R. (2019). Use and Effectiveness of the Teach-Back Method in Patient Education and Health Outcomes. Federal practitioner: for the health care professionals of the VA, DoD, and PHS, 36(6), 284–289. [Google Scholar] [Crossref]

77. Yin, R. K. (2009). How to do better case studies. In The SAGE handbook of applied social research methods (2nd ed., pp. 254–282). Sage Publications. https://doi.org/10.4135/9781483348858.n8 [Google Scholar] [Crossref]

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