Care for the elderly: a challenge in the anaesthesia context

Anaesthesia care involves bioscience and technical knowledge. Provision of anaesthesia care for elderly surgical patients can be a significant challenge when promoting patient comfort, safety, and satisfaction in a high-tech context with time constraints. Many patients in anaesthesia care are old and frail and have multiple illnesses and other problems, such as delicate skin, malnutrition, and pain. All this must be accounted for when caring for the elderly. Extra time in anaesthesia care is required to prepare elderly surgical patients for anaesthesia and surgery. And surgical patients have limited opportunities to influence their situations while in anaesthesia and surgery. So the overall aim of the research was to obtain insight into what anaesthesia care means in the lifeworld of anaesthesia - through accounts of experiences of nurse anaesthetists (NAs) and elderly patients. Research objectives were to: qualitatively identify and describe ways in which new NAs experience and perceive anaesthesia (I), describe the essence of the problematic anaesthesia-care situation phenomenon (as it relates to NAs) that involves elderly patients (II), illuminate what it means for a nurse anaesthetist to be in a problematic anaesthesia care situation (III), and illuminate what it means for elderly patients to be in intra-anaesthesia care and surgical situations (IV). The research takes a phenomenological approach to facilitate understanding of human beings (nurse anaesthetists and elderly patients) in a specific context (anaesthesia care). Three analysis methods were used in an effort to find congruence between research. questions and methods: phenomenography (I), descriptive phenomenology (II), and interpretive phenomenology (III and IV). In study I, nine newly graduated nurse anaesthetists had one month of clinical experience when they responded to four open-ended questions. The questions dealt with their views on anaesthesia care, and they provided clinical examples that further clarified their written answers. In studies II and III, seven experienced nurse anaesthetists were interviewed. Their narrations focused on concrete experiences in problematic anaesthesia care situations. In study IV, seven elderly patients (ages 61-79) were interviewed within six months after they had had hip replacement surgery or femur fracture surgery with regional anaesthesia. All participants were told that participations were voluntary and that they could withdraw from the studies at