June 1, 2026
Performance improvement isn’t just about turnaround times, first case on-time starts, or block utilization. A less quantitative performance measure often doesn’t receive the attention it should: the workplace culture in the perioperative suite, the ramifications of which can positively or negatively impact success in those more familiar performance metrics and beyond.
Perioperative culture is often shaped not only by what is taught, but by what is tolerated. Over time, inefficiencies, workarounds, and behaviors become normalized, producing potentially negative impacts on workforce engagement and psychological safety and, ultimately, patient outcomes. Those patterns are rarely examined holistically.
In their session at Periop Leader Week, “Better than we found it: Reimagining perioperative culture, leadership and our profession,” two perioperative professionals will view this existential topic through dual lenses. Jennifer Jump, DNP, MSN, MBA, BSN, RN, NE-BC, CRNFA-E, CNOR, is a seasoned perioperative services leader with over two decades of OR and executive experience in numerous roles. Jennifer Rovegno, RN, BSN, ACC, is a second-career perioperative nurse and executive leadership coach who is experiencing the profession through the eyes of an adult learner.
Together, they will illuminate the gap between what has been accepted and what should be challenged in the perioperative suite. They’ll explore common cultural challenges in surgical environments such as normalized dysfunction, unspoken hierarchies, and reliance on workarounds to sustain operations, and examine the impact of these patterns on workforce stability, team dynamics, patient care and, ultimately, performance improvement.
Their interactive presentation will also focus on empowering both OR teams and those who lead them with practical approaches to influence cultural change. By integrating system-level design with individual leadership behaviors, session participants will gain strategies to challenge accepted norms, foster psychological safety, and drive sustainable improvements.
We spoke with Dr. Jump and Ms. Rovegno about their upcoming session.
What was the genesis of this session?
Dr. Jump: We feel we really have a lot to share on this topic from a dual lens perspective. When we met, Jennie talked about culture and some of the challenges she has experienced as a second-career perioperative nurse, and we really connected at that level.
Ms. Rovegno: I had a career in sales and training, and went into perioperative nursing. I actually was a patient in the OR having surgery right before my first day of nursing school, and Jen and I discussed the challenges I saw in there. We agreed: Doesn’t it just feel like we should leave the profession better than we found it? What are the challenges of someone coming into the OR as a new hire, and what are the challenges that leadership faces? We have a real culture issue in the OR. How do we keep our most valuable resources, our well-trained perioperative staff, whole and happy?
We’re really focused on evidence-based research in this area. One thing we found is that turnover in perioperative nursing increased from 25% to 59% from 2016 to 2022. Culture was the number-one reported reason why nurses decided to leave or intended to leave, and many reported it was about the leadership, about not feeling validated and heard, and even about system drivers that were implemented to improve things that did not necessarily feel authentic and didn’t translate to the real world. Another statistic in a study that we both agree is really kind of depressing is that of 140 certified perioperative nurses, 49.3% intended to leave the position, and the primary factor was leadership.
These statistics mean that culture is not just a retention variable, it is an imperative. People don’t leave jobs. They leave cultures.
How are leaders failing perioperative nurses?
Ms. Rovegno: I’ll cite another statistic we discovered: your average nursing leader gets three hours of training on how to lead their team. Everybody in the OR essentially is a leader – the surgeon, the anesthesiologist, the nurses. The whole team needs to feel valued, and know they have that autonomy and that voice to be heard and to act for the safety of the patient in concert with the team. This really isn’t so much an indictment of leadership as it is an opportunity. Behavioral and communication skills can be learned. We are getting data that says these skills matter, and that they can be taught, and we can measure them to improve individually and as teams.
Dr. Jump: I don’t view this as a failure of leadership. I view this as an opportunity, and part of recognizing that is awareness and actually talking about it. A lot of things in the culture behind the red line become normalized. I had no awareness about some of the statistics we’ve talked about, and as a leader, not only is it frightening to me, but it makes me really sad. I’ve spent the better part of the last 15 years every single day trying to leave it better than I found it. When Jennie and I connected on that title for our session, it just hit so close to home for me because this is something a lot of leaders will attest to. They want to know this information. They just don’t have a line of sight to it. It really changes things when you start to talk about it.
Is it a general truth that when people are put into perioperative leadership positions, they’re taught how to run something, but not how to lead properly?
Dr. Jump: Although I don’t have the statistics to back it up, I have witnessed that, and I absolutely believe that’s a true statement. I think it’s the support for those leaders too. Not only are they not adequately trained, but where is their support system and their mentorship that helps them along the way?
You mention inefficiencies, workarounds, behaviors becoming normalized over time.
Ms. Rovegno: There are many pillars that contribute. We start with the culture and the attrition, but there’s also burnout and emotional exhaustion in terms of how events and conflicts and safety concerns are handled in the OR when they need to be addressed. That all contributes to burnout. It is very hard for an anxious mind to understand information in a crisis. I think behind the red line in the OR, we’re a little bit late to this conversation.
We’ll discuss a three-part strategy, which is you have to identify a problem, understand what’s going on, and then start to take action. Leaders set the tone, but we’re all leaders on these teams. Everybody is accountable in an OR. It’s really empowering leaders first and then their teams with these leadership skills. There’s a way to have a difficult conversation that’s very constructive and useful that doesn’t leave someone going home feeling really dissatisfied. How do you make everybody feel like they own a part of this, that we all showed up to try and do the best we could today and leave it the best we could? Most people don’t go into healthcare to get rich. This starts as a mission for so many of us, and it takes a mission-driven, coordinated effort.
As a perioperative leader, how do you steward that culture? How do you enable the kind of environment you’re talking about?
Dr. Jump: It’s always a work in progress, and it’s not easy to accomplish. It’s a continuous, ever-evolving project, and it’s a top-down approach that starts with support. The leaders who report to me need to know they’re supported and feel empowered to maintain the culture we agree is appropriate. That then trickles down to our staff level, to the leaders who report to the leaders who report to me. Everyone needs to feel psychological safety, knowing they’re going to be supported. I’ve tried to incorporate and instill all of this into my own leadership, and reinforce it with the leaders who report to me.
For the perioperative leaders who attend your session, what knowledge and tools will they take home with them to affect positive change?
Dr. Jump: Some of what we’ll talk about is recognizing and acknowledging some of these behaviors. Sometimes people fail to recognize that change really starts with you. From a leadership perspective, we all have a part to play in this. Sometimes we need to focus within ourselves and what we contribute and our ability to impact changes. Sometimes it’s easier to look at what other people are doing and what they’re contributing or what they’re not contributing versus the role that we actively can play towards change and towards making things better. I want to empower leaders. We want to provide the opportunity to talk as a group about what they can do to make sure that they are leaving it better than they found it, and how to take that back to their teams and engage them about it as well. We want to help people understand that just because we’ve always done it this way doesn’t mean it’s the right way. The things we did yesterday that retained our staff will not be enough for tomorrow. That’s the honest truth, and that’s a reality we all have to accept and figure out how to make it better.
