Nurse Anesthetist

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Tristan Roberts Perry

Dissertation submitted to the Faculty of the Virginia Polytechnic Institute and State University in partial fulfillment of the requirements for the degree of Doctor of Philosophy In Curriculum and Instruction

Kerry Redican, Chair Jane Abraham Charles Baffi Bonnie Billingsley John Burton

November 6, 2002 Blacksburg, Virginia Keywords: Nurse Anesthetists, Stress, Work, Coping

THE CERTIFIED REGISTERED NURSE ANESTHETIST: OCCUPATIONAL RESPONSIBILITIES, PERCEIVED STRESSORS, COPING STRATEGIES, AND WORK RELATIONSHIPS By Tristan Roberts Perry (ABSTRACT) A qualitative inquiry was launched to explore occupational stress among Certified Registered Nurse Anesthetists (CRNAs). Four research questions were posed: 1) What are the roles and responsibilities of the CRNAs as they see them? 2) What are the CRNAs perceived stressors encountered on the job? 3) What are their coping strategies related to the perceived stressors? 4) What is the relationship between CRNA job stress and interpersonal work connections? Twenty CRNAs, with varying anesthetic backgrounds, and 15 of their co-workers from North Carolina and Tennessee participated in the study. Semi-structured interviews, clinical observations, and artifact data (i.e., photographs) were employed to answer the research questions. The perceived occupational-related stressors that were recognized by the CRNAs pertain specifically to patient care, anesthesia work in general, interpersonal job relationships, inadequate surgical preparation, the operating room environment, and physical stressors. Staying focused upon the task at hand (i.e., patient care), the use of humor, verbalization and internalization of concerns, along with adopting personal hobbies were identified by the anesthetists as coping mechanisms to combat work-related stress. The participants take their professional duties to their patients and devotion to their fellow colleagues seriously—so much so that they rarely take vacation time or sick leave. After data analysis, six major themes surfaced: the role of being an attentive, reliable coworker alleviates the antagonism found within OR relationships; maintaining open lines of communication is an effective way to address concerns and prevent staff conflict; among the CRNAs, occupational-related stressors create concern for patient safety; interpersonal work relations cause more stress than any of the other perceived job stressors; engaging in personal

hobbies assists the CRNA in coping with work-related stress; and the nurse anesthetists’ work lives are not as stressful as their personal lives. The answers to the research questions and the themes underscore the necessity that the shortage of Registered Nurses and anesthetists needs to be addressed in order to more effectively tackle the participants perceived stressors. In addition, employers can adopt concrete measures in assisting CRNAs with handling occupational stress, such as offering mandatory in-servicing and adequate time to attend in-servicing.

This dissertation is wholeheartedly dedicated to: my mother, Nancy H. Roberts, CRNA It was truly a privilege for me to seek your guidance while researching this topic. Your devotion to Nurse Anesthesia and to your patients is inspiring. I admire you more than any other nurse-past, present, or future.


ACKNOWLEDGEMENTS First of all, I wish to acknowledge my Savior, Jesus Christ. You have guided me through the best and worst of times during this educational pursuit. Thank you for never leaving my side! To my husband, William: your unending support and encouragement to attain my dream will never be forgotten. You always seemed to know when I needed a smile, a laugh, or a massage. Your sense-of-humor was a lifesaver! I could not have asked for a better husband, and I love you even more. I also...
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