The purpose of this study was to explore the culture of a perioperative department to identify elements of the culture that impacted on nurses' resilience. The field setting was a tertiary referral hospital in southeast Queensland which provided 24 hour surgical coverage. Fieldwork was conducted over a 6 week period. Nurses, doctors and support staff who worked across perioperative specialties of anaesthetics, recovery and scrub/scout roles were observed and interviewed. The observation notes and interviews were transcribed and thematic analysis occurred. These textual data were analysed in three phases. Three themes emerged from the analysis, the first, primacy of specialist knowledge and demonstration of competence, is the focus of this paper. Cultural significance was ascribed to clinical competence, which was described in terms of the knowledge and experience nurses possessed. These findings have implications in the ways which perioperative education is currently approached, and may suggest the need for educational reform.