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Anaesthesia Care of Older Patients as Experienced by Nurse Anaesthetists

Annika Larsson Mauleon

Karolinska Institutet, Stockholm, Sweden; Blekinge Institute of Technology, Karlskrona, Sweden, Annika.Mauleon{at}neurotec.ki.se

Liisa Palo-Bengtsson

Karolinska Institutet, Stockholm, Sweden; Blekinge Institute of Technology, Karlskrona, Sweden

Sirkka-Liisa Ekman

Karolinska Institutet, Stockholm, Sweden; Blekinge Institute of Technology, Karlskrona, Sweden

This article analyses problem situations in the context of anaesthesia care. It considers what it means for nurse anaesthetists to be in problematic situations in the anaesthesia care of older patients. Benner’s interpretive phenomenological approach proved useful for this purpose. Paradigm cases are used to aid the analysis of individual nurses’ experiences.

Thirty narrated problematic anaesthesia care situations derived from seven interviews were studied. These show that experienced nurse anaesthetists perceive anaesthesia care as problematic and highly demanding when involving older patients. To be in problematic anaesthesia care situations means becoming morally distressed, which arises from the experience or from being prevented from acting according to one’s legal and moral duty of care. An important issue that emerged from this study was the need for an ethical forum to discuss and articulate moral issues, so that moral stress of the kind experienced by these nurse anaesthetists can be dealt with and hopefully reduced.

Key Words: anaesthesia care • ethics • moral distress • older patients • paradigm case • problematic care • responsibility

Nursing Ethics, Vol. 12, No. 3, 263-272 (2005)
DOI: 10.1191/0969733005ne788oa
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