A Phenomenographic Study of Swedish Nurse Anesthetists’ and OR Nurses’ Work Experiences

Abstract

In the complex OR environment, perioperative team members need to practice communication and teamwork to ensure safe, high-quality care. A lack of collaboration among professionals in the OR during surgery results in inefficiency, increased tension, and suboptimal patient care. The purpose of this study was to determine how nurse anesthetists and OR nurses experienced their work in the OR. We used a qualitative design with a phenomenographic approach and conducted 12 interviews in two surgical departments in the southern part of Sweden. We identified four categories of description: team member approach, professional awareness, lifelong learning approach, and safety and the patient's interest. We found that the nurses' work experiences in the OR were multifaceted and correlated with concepts of teamwork, safety, and communication.T he OR is a highly technological and multiprofessional environment where team members must manage medical technology, time pressure, and productivity. In Sweden, the responsibilities of nurse anesthetists and OR nurses are to maintain a safe and secure environment of care for the patient during surgery. 1,2 The nurse anesthetist independently induces and maintains general anesthesia and extubates the patient with support from the anesthesiologist. 1 The OR nurse is responsible for aseptic technique, maintaining a sterile field, preparing supplies and instruments, counts, documentation, supporting the surgical team, and advocating for the patient. 2 Collaboration and communication among surgical team members help to ensure safe care during surgery. [3][4][5] Communication in the OR requires both verbal and nonverbal skills, the ability to listen actively, and basic interpersonal skills, such as being polite and speaking clearly. These skills help to achieve optimal communication among team members and a safe and effective OR environment. 6 Surgical team members who work together often can communicate and collaborate more effectively because working relationships need time to develop. 7,8 The absence of basic communication and respectful acknowledgment among OR staff members affect the ability to develop shared understandings, which is important in enhancing team performance. 8 STATEMENT OF PURPOSEThe purpose of this study was to describe the work experiences of nurse anesthetists and OR nurses in the OR. LITERATURE REVIEWBringing different professionals together does not always lead to optimal collaboration. Members of a team must trust each other to develop a common process, achieve professional collaboration, and develop high-quality care. 9 Four interactional factors are important for effective collaboration among health care teams: willingness to participate in collaborative practice, trust, communication, and mutual respect and understanding. 10 In the study by Lingard et al, 11 team members in the OR lacked insight into the professional roles and obligations of other team members, and when tension in the OR occurred, this often CONCLUSION Nurse anesthetists' and OR nurses' work expe...

Mapping registered nurse anaesthetists’ intraoperative work: tasks, multitasking, interruptions and their causes, and interactions: a prospective observational study

“…When combining these different aspects of practice, a picture of a complex and dynamic work process is revealed. Previous research regarding RNAs’ work has focused on areas such as non-technical skills,44 45 experiences from different clinical aspects of work,46–49 patient advocacy50 51 and work experiences 52. This study builds on this knowledge by illuminating how RNAs’ work is actually done, uniquely mapping the different dimensions of work in relation to the intraoperative work process and thus providing further insights into the context and challenges for safe practice.…”

“…The professional roles of RNAs’ vary between countries,43 making direct comparison of studies on intraoperative anaesthesia care challenging. RNAs’ work has been studied as regards to non-technical skills,44 45 experiences from clinical work processes,46 47 skills assessment using simulation,48 experiences of the WHO’s surgical safety checklist,49 patient advocacy50 51 and work experiences 52. Among the professionals working in the surgical team, RNAs had the highest task frequency, with the largest amount of multitasking and interruptions 27.…”

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