Student Registered Nurse Anesthetists' Perceptions of Substance Use [Formula: see text]

Nurses enrolled in certified registered nurse anesthetist programs are taught to be experts in complex pharmaceutical agents, often under high stakes conditions. Such conditions may create maladaptive coping mechanisms, such as substance use. However, exploration of student registered nurse anesthetists' (SRNAs) perceptions of substance use and drug diversion have only been minimally described in the literature.

The study aims were to (a) investigate SRNAs' ratings of the American Association of Nurse Anesthesiology's (AANA) recommended strategies to reduce drug diversion and (b) analyze qualitative responses to open-ended items related to the use of substances.

Approximately 400 students responded to an online survey in March 2021. The survey was randomly sent to 3,000 SNRAs who were members of the AANA (return rate of 13%). Descriptive statistics and paired t-tests were calculated to determine differences between strategies viewed as effective and strategies that have been implemented. A descriptive content analysis was conducted to derive themes from four open-ended questions.

For all 11 AANA strategies, the means for effectiveness were significantly higher than means for strategies that were implemented, indicating that strategies were seen as effective, but were not being implemented. The highest scored perceived effectiveness strategy was "Creating a safe environment for prompt reporting." Themes captured a high-pressured, high-stakes educational environment, characterized by rigidity and incivility.

Policies to support a safe environment to encourage students to self-report substance use, an awareness of alternative-to-discipline programs, and reintegration into educational programs should be formulated and implemented by educational institutions.