Nurse anesthetists live and work in a stressful environment. There is need for greater awareness and education concerning professional well-being among the CRNA-s. More specifically, wellness information should be integrated into publications, meetings, presentations, events, and educational materials.
Stress management education should begin ideally in anesthesia school. Many of students are older, with families and daunting debt. Anesthesia students are under substantial pressure to perform well in a complex and competitive environment. This may lead to starting a career with physical and emotional stress, which can be a factor in career dissatisfaction. Learning is all about change, which induces stress in the learner. How much stress is involved varies among individuals, but it is there for everyone. With too little stress, the student may not feel challenged and may become bored, but too much stress leads to information overload and may cause decreased retention. Therefore many CRNA-s put on hold successful careers because: financial strains,decreasing self-esteem that often comes with changing jobs, strains on personal relationships because of decreasing time for self and others, and stresses of starting school, often in an unfamiliar location requiring a move.
Managing and coping with these known stressors are not covered in anesthesia curriculum, but they all decrease the learner’s ability to concentrate on the myriad materials that they are expected to master. One wonders, how can these learners achieve success given the increasing complexity of their role? The greatest discontentment in both their career choice as well as where they were employed (in school). One has to ask the question: What will this do to long-term support by these future nurse anesthetists and overall to the profession? How can we enhance the satisfaction of the 20% of nurse anesthetist who wonder if they made the correct career choice?
Alternatively, is this a temporary condition that will reverse once they become more comfortable with their skills, graduate, pass board examinations, and become productive healthcare providers again? The CRNA population is growing older (average age is above 50 years ). The normal aging process, which influences both physical and cognitive abilities, may have implications for personal well-being and patient safety. With the addition of a stressful work environment, the practitioner may become overwhelmed.
Concerning the stressful anesthesia work environment and emphasizes the need for available resources to assist the practitioner in positive mechanisms to manage their stress. The personal cost of long-term stress is a factor that must be evaluated and emphasized. Resource management on a personal and corporate level is an asset that can be measured in real dollars. The avoidance of adverse patient outcomes coupled with lifelong physical, emotional, mental, and spiritual health of anesthesia providers is the win-win benefit of stress management.
How CRNAs manage stress?
When asked CRNAs indicated ways they managed stress. Many ways were positive but, unfortunately, some were negative, including substance abuse. Some of the more positive stress relievers included exercise, concentrating on making the situation better, getting support and help from others, finding “me” time, playing with a avorite pet, reading, and connecting with one’s “spiritual” self.
Some of the less positive, often destructive, ways indicated included alcohol, drugs, denial of the problem,
self-criticism, giving up, expressing negative feelings, and sleeping excessively.
When asked about how they handle stress, 31% of nurse anesthetist indicated they had sought professional help for their stress. The most frequent methods for handling stress involved interaction with or support from others (eg, movies/TV, going out with family). 18.9% CRNAs indicated they were taking prescription medications to help alleviate stress, and 19.3% indicated the same. Some of the commonly prescribed medications reported include paroxetine (Paxil), fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro), buspirone (BusPar), clonazepam (Klonopin), and bupropion (Wellbutrin).
Practitioner well-being is the foundation for optimal, safe patient care, and practitioners are increasingly accountable and visible to the public. Clearly, individual management of daily stressors is a critical component in the provision of quality anesthesia care.