Knowing how, arguing why: nurse anaesthetists' experiences of nursing when caring for the surgical patient

Patients undergoing surgery and anaesthesia are in a vulnerable situation, requiring advanced treatment and care. Nurse anaesthetists are specially trained to meet their needs when administering and monitoring anaesthesia, ensuring patient safety and comfort throughout the entire perioperative care. However, there is a growing concern that efficiency requirements might take precedence over humanistic care when having to prioritize. Most people have a limited understanding of the extended role of nurse anaesthetists in maintaining quality and safety in anaesthesia services. This study aimed to explore how nurse anaesthetists describe their practice as being nursing when caring for surgical patients.

We applied a qualitative inductive design. Twenty nurse anaesthetists working in small or large hospitals in different regions of Norway were recruited. Semi-structured individual interviews were carried out. Data were analysed using qualitative content analysis. This study was conducted and reported in accordance with the Consolidated Criteria for Reporting Qualitative Research Checklist.

We identified three categories and eight subcategories. The category Continuously attending to physical and psychological needs involved reading the patient and responding accordingly and the ethical and moral obligation to maintain patients' well-being and dignity. The category Providing a concerned presence involved the importance of the nursing process and nurse anaesthetists' self-confidence in their professional abilities and readiness to act when caring for the surgical patient. The category Aspiring towards excellence involved expectations towards nurse anaesthetists as professionals who display professional courage and undertake professional development through continuous learning.

Nurse anaesthetists experience themselves as being highly qualified to address the needs of surgical patients. Their nursing background and extensive training have prepared them to know how and argue why. Knowledge from this study could be expected to add to the field of describing and understanding nurse anaesthetists' practice in the perioperative context and support supervision in postgraduate education.