Surgical team members’ perceptions of the operating room nurses: a metaphor study

Aims: Existing studies have not adequately explored the professional identity of operating room nurses and their perceived value within the surgical team, particularly through a metaphorical approach. This study examined surgical team members’ perceptions of the operating room nurse through metaphor analysis. Methods: This qualitative study examined surgical team members’ perceptions of operating room nurses in Turkiye with at least six months of experience through metaphors. Semi-structured interviews were conducted with 69 participants selected through purposive sampling. Participants were asked to generate a metaphor to describe operating room nurses and explain their rationale. Results: Participants generated 32 valid metaphors, grouped into four conceptual categories; ‘team leader,’ ‘supporter and assistant,’ ‘family member,’ and ‘patient advocate.’ The most frequent metaphors were found in the ‘team leader’ and ‘supporter/helper’ categories. The findings reflect the essential and multifaceted functions of the operating room nurse and demonstrate that surgical teams have a multidimensional perception of operating room nurses, spanning ‘invisible support,’ ‘silent leadership,’ and ‘patient advocacy.’ Conclusion: Operating room nurses are perceived within the surgical team for their technical skills and for their critical roles in leadership, coordination, and patient advocacy. Surgeons’ and nurses’ perceptions differed, rooted in professional and hierarchical dynamics. Increasing visibility of nurses’ leadership and advocacy roles and supporting shared leadership within the team are crucial to ensuring safer, more effective surgical care. Further studies are needed to develop interventions that increase team awareness and empower nurses in this area.