The Psychometric Analysis of the Certified Registered Nurse Anesthetist Workload Perception Scale (CWPS): Final Phase

Background and PurposeIn two previous studies, the Certified Registered Nurse Anesthetist (CRNA) Workload Perception Scale (CWPS) was developed. The purpose of this paper is to report the final psychometric validation of the CWPS.MethodsAn 11-item CWPS was tested in a population of CRNAs. Classical psychometrics were performed on the 11-item instrument piloted in a sample of 393 CRNAs.ResultsParametric and nonparametric analysis indicated 7 of 11 items were a good fit to measure perception of workload. Conclusions: A revised 7-item final CWPS was developed.

The nurse anesthetist perioperative dialog

Background: In the perioperative dialogue, pre-, intra- and post-operatively, the patient shares their history. In the dialogue, nurse anesthetist (NA) gets to witness the patient's experiences, and can alleviate the patients’ suffering while waiting for, or undergoing surgery. The aim of this study was to describe the certified registered nurse anesthetist experiences of the perioperative dialogue. Methods: The study had a qualitative design. Interviews were conducted with 12 NA and analyzed with interpretive content analysis. The methods were conducted in accordance with the COREQ guidelines. Results: In the result, two categories emerge: A mutual meeting (the preoperative dialogue) where the patient and the NA through contact creates a relationship. The NA is present and listens to the patient, to give the patient confidence in the NA. In the category, On the basis of the patient's needs and wishes (the intraoperative dialogue), the body language of the NA, as well as the ability to read the body language of the patient, is described as important. Conclusion: The patient is met as a person with their own needs and wishes. It includes both a physical and a mental meeting. In a genuine relationship, the NA can confirm and unreservedly talk with the patient. When the patients leave their body and life in the hands of the NA, they can help the patients to find their inherent powers, which allows for participation in their care. Understanding the patient is possible when entering in a genuine relationship with the patient and confirm the patient. The perioperative dialogue forms a safety for the patients in the operating environment.

Who is in charge? Jurisdictional contests and organizational outcomes

We explored how professional jurisdiction contests influence organizational outcomes by examining how Certified Registered Nurse Anesthetist (CRNA) schools in the USA were impacted by a policy pursuing educational upskilling. While others have focused on boundary work at the field and work levels, we argue that contests between professions also influence important organizational outcomes. We detail how the profession’s accreditation decision requiring schools to provide Master’s degrees within a 17 year window took place in the context of physicians historically battling CRNAs. We provide an analytic narrative illustrating the history of this jurisdictional dispute, and empirically examine how CRNA schools with cultures differentially supportive of physicians’ field-level dominance responded to the requirement of educational upskilling. Our analysis indicates that the timing of a school adopting a graduate program was influenced by whether the organizational culture, represented by organizational ownership, supported physician dominance. We also highlight the importance of access to resources as another conduit for boundary work impacting organizational outcomes.