Page 4
The experience of heavy workload was explained partlyby high production pressure. Staff shortages and limited opportunity for breaks and time off were perceived as strain. The most important negative factors were prob-lems of interdisciplinary relationships, the behavior of the anesthesiologist, work policies, and coworkers’ neglect of their duties. Gevers and colleagues21 also found that acute strain inhibits effective teamwork behavior between doctors and nurses in medical emergencies.In another study, Alves22 found a significant connec-tion between employment arrangements, educational levels, and scope of practice (SOP) of nurse anesthetists. The relationship between SOP and work-related stress was associated with role expectations and responsibil-ity. The group with high SOP scores experienced higher work-related stress than the group with lower SOP scores. These results indicate that improved competence goes together with more stress because of higher role expectations and more responsibility. On the other hand, responsibility was also accompanied by a feeling of confi-dence and self-esteem in the work situation. In any case, coping resources and social support were needed and used by everybody, regardless of SOP, in the handling of work-related stress.In another study of nurse anesthetists, by Jones and Fitzpatrick,23 role conflicts, unclear expectations, and limited SOP was shown to result in more work-related stress and less work satisfaction. A healthy collaboration between CRNAs and physicians, in which both partners strive for mutual adaptation, was recommended as the ultimate team constellation for quality of care as well as patient safety.In a study of healthy workplaces by Arwerson and col-leagues,24 several factors of importance were found. The most important factor was leadership. Other important factors were communication between the employees and the manager, the importance of feeling needed, working in an organization with a good reputation, opportunities for development and learning, and the ability to cope with new demands. These factors were not related to anesthesiology.