Abstract　Retention of experienced perioperative nurses in operative settings is essential for the provision of quality perioperative care. Hence, this study aimed to describe the decision-making processes of experienced perioperative nurses with regard to staying in and leaving the operating room (OR) nursing specialization.

　This study was a descriptive qualitative study using a constant comparative method, and data were collected through semi-structured interviews of 12 Japanese nurses with 3-8 years of OR experience between August and October 2013.

　The following six main themes emerged : (1) Specificity of the operative setting, (2) Gaining identity as a perioperative nurse, (3) Being unable to satisfy themselves as perioperative nurses, (4) Hesitating in deciding to leave the OR nursing specialization, (5) Deciding to leave the OR nursing specialization, and (6) Deciding to stay in the OR nursing specialization. Experienced perioperative nurses who decided to stay in OR nursing had obtained their nursing perspective through operative nursing work, and hoped to grow further and to fulfill their own responsibility in the OR. Many experienced perioperative nurses intended to leave OR nursing because they could not satisfy themselves, while a few experienced perioperative nurses intended to leave because they could not gain identity. Nurses who could not obtain a nursing perspective and could not feel growth through operative work tended to be unsatisfied. Nurses who could obtain perioperative expertise tended to gain identity. In addition, nurses with experience working only in the OR were more hesitant to leave, as they were apprehensive about leaving their workplace due to limited experience.

　The results indicate that to retain perioperative nurses, developing working environments that continually improve clinical skills and providing attractive role models who help junior nurses to achieve nursing perspective, as well as encouraging more growth in the operating room through their work, are potentially effective strategies.