Job Satisfaction and Its Determinants among Nurse Anesthetists in Clinical Practice: The Botswana Experience

Job satisfaction (JS) correlates positively with patients’ satisfaction and outcomes and employees’ well-being. In Botswana, the level of job satisfaction and its determinants among nurse anesthetists were not investigated. A cross-sectional study was conducted from January 2020 to June 2020 encompassing all nurse anesthetists in clinical practice in Botswana. A self-administered questionnaire was used that incorporated demographic data, reasons to stay on or leave their job, and a validated 20-item short form of the Minnesota Satisfaction Questionnaire which was pretested on five of our nurse anesthetists. Percentage is used to describe the data. The independence of categorical variables was examined using chi-square or Fisher’s exact test. p value <0.05 was considered statistically significant. In Botswana, a total of 76 nurse anesthetists were in clinical practice during the study period. Sixty-six (86.9%) responded to the survey. Gender distribution was even, 50.0%. The overall JS was 36.4%. Males had significantly higher JS than females, p = 0.001 . Significantly higher job satisfaction was found in married nurse anesthetists ( p = 0.039 ), expatriate nurse anesthetists ( p = 0.001 ), nurse anesthetists in non-referral hospitals ( p = 0.023 ), and nurse anesthetists with ≥10 years’ experience ( p = 0.019 ). Nurse anesthetists were satisfied with security, social service, authority, ability utilization, and responsibility in ≥60.0% of the cases. They were not satisfied in compensation, working condition, and advancement in a similar percentage. The main reason to stay on their job was to serve the public in 68.2%. In Botswana, employers should make an effort to address the working conditions, compensation, and advancement of nurse anesthetists in clinical practice.

Anesthesia Care Provided by Nurses

One systematic review, 4 primary studies (observational studies: 3 retrospective and 1 prospective), and 1 economic evaluation were identified. A definitive conclusion is not possible regarding the clinical effectiveness of anesthesia provided by non-physician anesthetists compared with physician anesthetists, considering the evidence was from studies of low quality that were associated with considerable risk of bias, and there were inconsistencies in the findings. The incremental cost-effectiveness ratio (ICER) for physician anesthesiologists compared with nurse anesthetists was US$77,400 per quality-adjusted life-year (QALY) gained. The 1-way sensitivity analyses showed that with an increase in the cost of nurse anesthetist professional services or an increase in the number of unexpected hospital days, the ICER values would fall below US$50,000 per QALY gained.

Prática Clínica Do Enfermeiro Anestesista Nos Estados Unidos Da América

O objetivo deste trabalho foi descrever o perfil profissional do enfermeiro anestesista nos EUA (Estados Unidos da América) e descrever as atribuições do enfermeiro anestesiologista. A pesquisa é uma revisão bibliográfica de abordagem descritiva e qualitativa. Foi realizada nos bancos de dados da SciELO (Scientific Electronic Library Online), Google Acadêmico e BVS (biblioteca virtual em saúde) e com a seguinte pergunta de pesquisa: como é a prática clínica do enfermeiro anestesista nos Estados Unidos? Foram inclusos os artigos acadêmicos publicados entre 2011 à 2021, disponíveis de forma gratuita, em língua inglesa ou portuguesa. Foram excluídos os artigos inferiores a 2011, em outros idiomas, resumos, periódicos que não contemplavam nenhum dos objetivos, que não respondessem à pergunta de pesquisa e artigos repetidos encontrados nas bases de dados citadas acima, no qual resultou em uma amostra final de 18 artigos. Os Certified Registered Nurse Anesthetists (CRNAs) são profissionais aptos a desenvolverem práticas avançadas de enfermagem e em muitos estados norte-americanos praticam sem supervisão médica. São responsáveis por fornecer anestesia segura com alta qualidade e com melhor custo-benefício para o paciente, além de ter um perfil profissional que assume grande responsabilidade. A prática de enfermagem em anestesiologia não existe no Brasil, pois é uma área da medicina privativa ao profissional médico. A enfermagem nos EUA é bem avançada, não só para o enfermeiro anestesista, que possui autonomia para realizar a anestesia de um paciente, mas para as demais especializações da área. Os profissionais de práticas avançadas devem se especializar e estudar muito para desenvolver estas atividades, assim como se manterem atualizados.

Experiences of Burnout Among Nurse Anesthetists

Recent and mounting evidence indicates burnout among healthcare providers in the United States has been steadily rising over the last decade. Review of the literature has indicated that burnout affects provider clinical performance, professionalism, quality, incidence of medical errors, and intention to stay in the profession. Burnout has been shown to impact provider quality of life. However, education focused on coping skills can reduce burnout amongst providers. This article describes a quality improvement project conducted to determine the effect of a burnout awareness and coping skills program to decrease burnout among nurse anesthetists at a level one trauma center. The educational program provided information that helped staff to identify signs and symptoms of burnout and offered strategies to reduce burnout. We describe the project methods, and results, which suggested a significant decrease in participants’ levels of the emotional exhaustion component of burnout following participation in the program. We offer discussion about the clinical significance of our findings, note project limitations, and conclude with implications for research and practice.

Nurse anesthetists’ experiences using smart glasses to monitor patients’ vital signs during anesthesia care: A qualitative study

Purpose To describe nurse anesthetists’ experiences using smart glasses to monitor patients’ vital signs during anesthesia care. Methods Data was collected through individual semi-structured interviews with seven nurse anesthetists who had used smart glasses, with a customized application for monitoring vital signs, during clinical anesthesia care. Data was analyzed using thematic content analysis. Results An overarching theme became evident during analysis; Facing and embracing responsibility. Being a nurse anesthetist entails a great responsibility, and the participants demonstrated that they shouldered this responsibility with pride. The theme was divided in two sub-themes. The first of these, A new way of working, comprised the categories Adoption and Utility. This involved incorporating smart glasses into existing routines in order to provide safe anesthesia care. The second sub-theme, Encountering side effects, consisted of the categories Obstacles and Personal affect. This sub-theme concerned the possibility to use smart glasses as intended, as well as the affect on nurse anesthetists as users. Conclusion Smart glasses improved access to vital signs and enabled continuous monitoring regardless of location. Continued development and improvement, both in terms of the application software and the hardware, are necessary for smart glasses to meet nurse anesthetists’ needs in clinical practice.