When an experienced OR leader announces a retirement, resignation or unexpected departure, the first question is often, “Who can step in?” Unfortunately, by the time that question is being asked, succession planning is already late.
Perioperative leadership requires clinical credibility, operational expertise, financial stewardship, talent management and regulatory accountability. Replacing that expertise is rarely as simple as promoting the strongest clinician on the team. Leadership succession is not only a human resources exercise. It is an operational continuity strategy. It is also a risk-management strategy that protects organizational stability, preserves institutional knowledge and supports uninterrupted patient care.
Mentorship Is Important, but It Is Not the Plan
Mentorship is a valuable component of leadership development, but a mentorship relationship alone does not constitute a succession plan. A mentor helps an individual grow. A succession plan asks broader questions: Which roles are critical? What competencies are required? Who could step into those roles? What experience do they still need? How will knowledge transfer before a transition occurs?
AORN nurse leaders Kayla Simiele and Amber Wirkus describe effective succession planning as “preparation, not promotion,” emphasizing the importance of developing leadership capacity before vacancies occur.
The distinction matters. A healthy leadership pipeline includes more than one person and more than one career stage. Some nurses may be ready for a charge role now. Others may be developing toward manager or director responsibilities over several years.
Start With the Role, Not the Person
Succession planning can unintentionally introduce bias when leaders begin by asking, “Who is my replacement?” A stronger starting point is, “What will this role require?”
A role-based approach may also help organizations create more equitable leadership pathways by focusing on competencies, experiences and demonstrated potential rather than familiarity or informal sponsorship alone.
The American Organization for Nursing Leadership (AONL) recommends succession planning, career mapping, transition-to-practice programs, career ladders and competency-based leadership development to create clearer advancement paths and bridge the gap from clinical practice to management (American Organization for Nursing Leadership, 2025).
In surgical services, a role map may include staffing and productivity, budgeting, quality improvement, accreditation readiness, surgeon relationships, conflict management, service-line planning and leading change. Defining the work first gives the organization a more objective way to identify and prepare potential leaders.
Give Emerging Leaders the Work Before the Title
Future leaders need opportunities to practice leadership before they carry the full responsibility of a role. That might include leading a quality project, participating in budget planning, workforce planning, productivity analysis, managing a scheduling challenge, chairing a committee, supporting accreditation preparation or representing the department in a cross-functional initiative.
These assignments build skills while giving the organization and the nurse a clearer picture of readiness. They also answer an important question early: Is this individual interested in pursuing leadership responsibilities? Not every excellent clinician does, and a succession program should make room for that answer without treating it as a lack of ambition.
Where CSSL Fits in the Pipeline
For perioperative organizations, the Certified Surgical Services Leader (CSSL) credential from the Competency & Credentialing Institute (CCI) can provide a profession-specific reference point within the development pathway. CSSL is designed for perioperative leaders, managers, directors and nurses who oversee personnel, a budget, business unit or service line. The exam covers communication and relationship management, leadership, strategic management, operational management, financial management, human resource management and professionalism (Competency & Credentialing Institute, 2026).
Those domains can help facilities identify the knowledge future leaders need and build development plans around gaps. CSSL should not, however, be treated as the starting line. Current eligibility requirements are available on the CCI website and include a current, unrestricted RN license, a bachelor’s degree or higher, and two to four years of perioperative management experience. The exact experience and professional development requirements depend on CNOR status (Competency & Credentialing Institute, 2026).
Organizations can use the CSSL framework earlier in the pipeline, then support certification once an emerging leader has the experience to qualify. In that way, certification becomes a milestone within a broader leadership development plan rather than the plan itself.
Build a Bench, Not a Chosen Successor
A succession plan built around one presumed replacement can create risk. People relocate, change career goals or decide the role is not right for them.
Instead, leaders can organize the bench into three practical categories: ready now, ready within one to two years and developing. Critical knowledge can be transferred through cross-training, project ownership, shadowing, structured handoffs and documented processes. Important annual cycles, key relationships, unresolved operational issues and regulatory responsibilities should not live only in one leader’s inbox or memory.
Keep Developing Leaders After Promotion
The pipeline does not end when someone accepts the job. A 2024 report from AONL and Laudio found that nurse manager turnover was highest during the first four years of leadership. It also found that average RN team turnover increased 2 to 4 percentage points in the 12 months after a nurse manager transition (American Organization for Nursing Leadership and Laudio, 2024). New leaders need structured onboarding, mentoring, peer support, coaching, feedback and continued development well beyond the promotion announcement.
Succession planning works best when it is reviewed regularly, not when a resignation forces the discussion. As part of ongoing workforce planning, leaders can periodically ask: Do our critical roles have potential successors? What experience do those individuals still need? Who has progressed? Where is the bench thin? What knowledge would be difficult to replace if someone left tomorrow?
A strong leadership pipeline does not predetermine who gets the next job. It gives the organization options, gives emerging leaders a visible path and reduces disruption when leadership changes. The goal is not to turn every perioperative nurse into a manager. Rather, it is to ensure that nurses with leadership aspirations can see a clear path forward, gain meaningful leadership experience and be prepared to step into critical roles when opportunities arise. The strongest organizations do not wait for vacancies to begin developing leaders. They build leadership capacity continuously.
Sources
- American Organization for Nursing Leadership. “Strengthening Nurse Leadership.” Nursing Leadership Workforce Compendium 2.0, 2025. https://www.aonl.org/resources/Nurse-Leadership-Workforce-Compendium/Strengthening-Nurse-Leadership
- American Organization for Nursing Leadership and Laudio Insights. “Trends and Innovations in Nurse Manager Retention.” Fall 2024. https://www.aonl.org/Trends-and-Innovations-in-Nurse-Manager-Retention
- Competency & Credentialing Institute. “Certified Surgical Services Leader (CSSL).” 2026. https://www.cc-institute.org/certify/cssl/
- Simiele, Kayla C., and Amber Wirkus. “How Proactive Leadership Development Can Work.” AORN, April 8, 2026. https://www.aorn.org/article/how-proactive-leadership-development-can-work
