title: Anaesthesia care of older patients as experienced by nurse anaesthetists.
abstract: 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.
authors.affiliation: Karolinska Institutet, Neurotec Department, S-14183 Huddinge, Sweden. Annika.Mauleon@neurotec.ki.se
authors.forename: Annika Larsson
authors.initials: AL
authors.lastname: Mauleon
authors.forename: Liisa
authors.initials: L
authors.lastname: Palo-Bengtsson
authors.forename: Sirkka-Liisa
authors.initials: SL
authors.lastname: Ekman
mesh_terms: D000328:Adult; D000368:Aged; D002055:Burnout, Professional / Q000523:psychology; D004993:Ethics, Nursing; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D028681:Moral Obligations; D033262:Narration; D009719:Nurse Anesthetists / Q000941:ethics* / Q000592:standards; D024802:Nurse's Role; D015404:Nursing Methodology Research; D009871:Operating Room Nursing / Q000941:ethics* / Q000592:standards; D019555:Physician-Nurse Relations; D013514:Surgical Procedures, Operative / Q000451:nursing; D011795:Surveys and Questionnaires; D013548:Sweden