Nurse Anesthetist Case Study

THE CERTIFIED REGISTERED NURSE ANESTHETIST: OCCUPATIONAL RESPONSIBILITIES, PERCEIVED STRESSORS, COPING STRATEGIES, AND WORK RELATIONSHIPS

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
In other words, the workload and dedication to the patients that anesthesia demanded of nurses presented less of an obstacle compared to the work politics and interactions. My mother is not alone. A 1990 national “Human Factors Inventory Survey” of 5,955 Certified Registered Nurse Anesthetists (CRNAs) conducted by the American Association of Nurse Anesthetists revealed that the quality of their relations with coworkers was one of the greatest risk areas affecting health and performance. Sixty percent of the respondents reported bad feelings between coworkers, and 50% felt that working with people in general was stressful. (Kendrick, 2000, p. 116). In a quantitative inquiry comparing and contrasting stress levels between practicing CRNAs and students in training, Kendrick (2000) reports that “CRNAs who practiced in groups with more than 20 CRNAs and doctors reported more stress and job dissatisfaction than those practicing in smaller groups . . . Additionally, CRNAs reporting the lowest stress levels were those who practiced alone” (p. 116). Cavagnaro (1983) parallels Kendrick’s findings after surveying 82 CRNAs using a questionnaire identifying the stress factors of the nurse anesthetist. Specifically, Cavagnaro’s (1983) respondents rated “job-related interpersonal conflicts as the number one stressor” (p. 290). Although the findings by
Selye estimated that the inability to adjust successfully to life situations and stress is at “the very root of the disease producing conflict (i.e., improper reactions to life situations)” (Wiley, 2000, on-line). Suffice to say, stage three is not a desirable level to reach when dealing with stressors. The general adaptation syndrome reflects Selye’s belief that an “ever increasing proportion of people die from the socalled wear and tear diseases, diseases of civilization, or degenerative diseases, which are primarily stress” (Wiley, 2000, on-line). While stress has positive implications (in manageable doses), such as increasing one’s level of alertness and cognition, its negative implications are the main focus of attention in the literature. Motowidlo, Packard, and Manning (1986) define stress as an “unpleasant emotional experience associated with elements of fear, dread, anxiety, irritation, annoyance, anger, sadness, grief, and depression” (p. 618). Ullrich and Fitzgerald (1990) write, “stress is a result from an imbalance between the demands of the workplace and the individual’s ability to cope” (p. 1013). Stress is usually associated with the environment or situation in which it is being experienced. For example, occupational stress is “the harmful physical and emotional responses that occur when the requirements of a job do not match the capabilities, resources, or needs of the workers” (National Institute