Anaesthetic nurse training in KwaZulu-Natal government hospitals: exploring strengths and deficiencies

Abstract

Background: The anaesthetic nurse is a key assistant to the anaesthetist and integral to the provision of safe anaesthesia. Inadequate undergraduate training in South Africa necessitates anaesthetic nurses to acquire the requisite skills and knowledge in the workplace. Few studies explore the challenges faced by practising nurses to acquire such skills. This study sought to explore the experiences of working anaesthetic nurses to gain their perspectives on workplace-based learning, skills acquisition and how to improve anaesthetic nurse training.
Methods: We used qualitative methodology comprising an English-medium, self-administered, anonymous questionnaire. A purposive sampling method was used, and 73 anaesthetic nurses working in five government hospitals in eThekwini, KwaZulu-Natal were recruited. Questionnaires were thematically analysed, and simple statistical analysis was used for quantitative data.
Results: Most anaesthetic nurses received little or no undergraduate anaesthesia training and participants identified subsequent workplace-based training as inconsistent, and insufficient. Despite most participants’ arbitrary allocation to the position of anaesthetic nurse, the majority found their work stimulating and identified themselves as team-players, adaptable, and willing to learn. Further training and hands-on skills acquisition were keenly sought. Factors impacting positively on their learning and job satisfaction included a confident anaesthetist who was willing to teach and collaborate on learning, provide positive feedback, and include the anaesthetic nurse in case planning. Participants identified crucial areas for further development. In-theatre teaching and practical group tutorials led by anaesthetists were suggested as preferred training modalities. Responses to hypothetical case scenarios demonstrated qualities in the participants that are valued in the anaesthetists’ non-technical skills framework.
Conclusion: It is evident that there is insufficient formal training and inconsistent training methods of the current anaesthetic nurses in the five study hospitals. The workplace-based learning experiences of our study participants has given us a unique perspective from practising anaesthetic nurses and may be used to inform the formulation of appropriate training curricula and improve the learning partnership with anaesthetists. This should ultimately improve anaesthetic nurse job satisfaction and the theatre team experience.