The Practices in Nursing: Studies Annotated Bibliographies

‘The nurse-patient relationship in the post-anesthetic care unit’ by Joanne Reynolds

The purpose of this study was to obtain discursive insights into how nurses perceive what accounts for the scope of their professional duties, while dealing with patients in post-anesthetic care (PAC) units. The concerned study also aimed to expose the qualitative aspects of what PAC nurses consider the objective necessity for them to be assigned with taking care of post-anesthetic patients, in the first place. The study’s secondary objective was to confirm/disconfirm whether, while on the line of addressing their professional duties in the PAC clinical environment, nurses tend to establish an emotional relationship with patients.

Methodologically speaking, the study by Reynolds is best referred to in terms of a generic qualitative-research inquiry, which allows a researcher to subject the obtained data to an interpretative analysis. Partially, this explains a rather limited scope of the study’s participants – eight PAC nurses. Apparently, by limiting the number of the involved participants, Reynolds strived to ensure the spatial integrity of would-be-provided interpretations, relevant to the study’s subject matter. In order to be qualified to participate in the study, the sampled nurses were required to prove their registration with the Nursing and Midwifery Council and to have an experience of having worked with post-anesthetic care patients for the duration of no lesser than six months. The study’s empirical phase involved exposing the sampled nurses to the semi-structured interviews that lasted from 30 to 60 minutes. Consequently, the interview transcripts were analyzed, in order to identify the common themes/motifs, within the context of how the participants used to react to the proposed questions.

The study’s foremost finding suggests that, contrary to the assumption that the majority of PAC patients are being in no position to develop an emotional relationship with the nurses, due to the post-anesthetic ‘blurring’ of their cognitive and perceptual abilities, this in fact is far from being the actual case. As Reynolds noted, “The findings suggest that PAC nurses have the opportunity to develop relationships with patients… post-operatively” (2009, p. 45). The study’s another important finding, which appears fully consistent with the initially proposed thesis, is that in order to be considered thoroughly qualified to work in PAC units, nurses must be aware of the basics of a psychological counseling.

The study’s most obvious limitation is that the number of its participants can hardly be considered large enough, to represent any cross-sectional value. The study’s another drawback, potentially capable or undermining the obtained data’s integrity, is the fact that the author admitted of having known the selected participants personally. This, of course, creates objective preconditions to consider many of the participants’ responses (which were consequently analyzed), as such that feature the element of an intentional biasness.

Even though that Reynolds claims her study being ‘groundbreaking’ to an extent, there is a certain rationale in doubting the validity of the author’s claim, in this respect. After all, the very professional paradigm of nursing cannot be discussed outside of the nurses’ ability to provide patients with the emotionally-charged care, in the first place. As such, the concerned study can be most appropriately described, as the one that merely ‘deepens’ the subject matter in question.

Social support during anesthesia induction in an adult surgical population’ by Ian Mayne and Cora.Bagaoisan

This study was aimed to test the validity of the suggestion that, in order for the anesthesia-related anxieties, on the part of preoperative patients at Toronto Western Hospital (TWH), to be less severe, nurses must be assigned with the additional task of providing an emotional comfort to those individuals that are about to undergo the anesthetically supported surgery. Specially, the study’s subject matter was concerned with answering two main questions: 1) Do patients benefit emotionally from having a support person nearby, while induced with anesthesia? 2) Do nurses consider it a ‘must’ to be on site, while their close relatives are being sedated?

Being a latitudinal qualitative study, the project’s methodology was concerned with handing out questionnaires to the randomly selected patients (with the experience of having undergone the anesthesia-supported surgery), on the one hand, and to the representatives of the hospital’s staff, which were directly or indirectly involved with the procedure, on the other. Even though that initially, the sample of selected participants accounted for 100 individuals (50 patients and 50 ‘support persons’), only 34 patients and 35 ‘support persons’ provided a feedback. After having been quantified with the help of an online statistical calculator, the received responses were consequently mapped on the 5-point Likert scale – thus, providing the researchers with an additional opportunity to come up with the data’s discursively sound interpretation. Even though that the researchers strived to ensure the proportional integrity of participants (in regards to the latter’s gender-affiliation), it was specifically the female-participants, who provided the bulk of the obtained responses (patients – 60%, ‘support persons’ – 64.7%).

The study’s findings point out to the fact that, contrary to the tested suggestion, there is no good reason to think that, while addressing their anesthesia-related anxieties, the preoperative patients would be much better off having a ‘support person’ nearby. As the authors noted, “The patients and support persons did not show a significant inclination toward having a support person present during anesthesia induction” (Mayne & Bagaoisan, 2009, p. 315). Thus, the discussed study can be well considered, as such that contradicts the main premise of the currently deployed policy to staff the US clinical environment with more nurses, which is supposed to benefit patients.

There are quite a few limitations to the study in question. First, due to the comparatively small number of participants, the study’s empirical data cannot be considered cross-sectional, in the full sense of this word. Second, the study did not take into consideration the effects of participants’ ethno-cultural affiliation on how they handled the provided questions. Therefore, the study’s conclusion cannot be referred to as such that represents an objective truth-value. Third, while selecting participants, Mayne and Bagaoisan never considered the fact that those patients with the extensive history of surgical sedations would be less likely to experience the sensation of anxiety, prior to being ‘put asleep’ for the surgery’s duration. This, of course, implies that the discussed study is biased to an extent.

I personally find the study by Mayne and Bagaoisan thoroughly relevant to my future professional career, as a registered nurse, because it does contain a number of insights, as to what causes patients to experience the fear of being sedated, in the first place. Moreover, I also find this study fully consistent with my conviction that, being a particularly valuable ‘healthcare-resource’, nurses should not be required to perform non-essential/quasi-professional duties, as it will negatively affect the overall extent of their professional adequacy.

References

Mayne, I. & Bagaoisan, C. (2009). Social support during anesthesia induction in an adult surgical population. Association of Operating Room Nurses (AORN) Journal, 89 (2), 307-320.

Reynolds, J. (2009). The nurse-patient relationship in the post-anesthetic care unit. Nursing Standard, 24 (15), 40-46.