Variabilities and contentions in anesthesiologists' perspectives on Japanese perianesthesia nurses: A qualitative study

In Japan, the escalating demand for anesthesia services has resulted in a shortage of anesthesiologists, presenting a societal challenge. Urgent measures involve the imperative task shifting to nurses. The perspectives of anesthesiologists on perianesthesia nurses (PANs) and the PAN system significantly influence the collaboration between anesthesiologists and PANs. Twenty-four anesthesiologists initially approached in writing among a pool of 304, ultimately agreed to participate in interviews. Verbatim transcripts from these interviews were analyzed using the framework method. In this procedure, data analysis was facilitated by MAXQDA software (version 22.7.0) to construct a case-code matrix, enhancing the reliability of our findings. Five themes and fifteen categories related to PAN and its system emerged. Participants provided insights into the diverse social conditions accompanying the implementation of the PAN system. They highly regarded PANs as colleagues, expecting a spectrum of capabilities. Nevertheless, the analysis revealed considerable variation in role expectations across institutions and individuals, with some perspectives being mutually critical. Conflicting opinions emerged on two crucial aspects: assigning anesthesia management conducted by PANs and substituting PANs for anesthesiologists. Multiple suggestions were put forth for enhancing and evolving the PAN system. This qualitative study is the first to reveal that Japanese anesthesiologists hold diverse perspectives on PANs and the system. The approach was well-suited for exploring diverse perspectives, showing significant differences among institutions and individuals. Our data provided crucial insights, including findings suggesting potential barriers to task shifting of anesthesia duties to PANs.