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The Effects of Mistreatment on Nurse Anesthesia Resident's Well-Being and Academic Success

Mark O'Brien, RN, DNP, CRNA

DNP Nurse Anesthesia 

The Effects of Mistreatment on Nurse Anesthesia Resident's Well-Being and Academic Success

Project Category: Evidence Generation

Project Team: Mark D. O'Brien, DNP, CRNA Wendy Biela, DNP, CRNA Jennifer Greenwood, CRNA, PhD, (Advisor)


Background: Several specialty healthcare trainees have reported various types of mistreatment during their training. The literature demonstrates that mistreatment can lead to lower overall well-being, depression, and a desire to discontinue training. Limited evidence exists on the incidence and impact of mistreatment among nurse anesthesia residents (NAR) specifically. The purpose of this study was to quantify the incidence of mistreatment during the didactic and clinical phases of training and determine the impact on one's emotional well-being and academic success. 

Methods: An anonymous electronic survey was emailed to 126 nurse anesthesia program directors nationwide in the United States to forward to all NAR cohorts. Data was captured using Qualtrics, and SPSS was used for analysis of demographic and continuous data related to well-being scores. Data was analyzed according to gender, race, sexuality, and religion to identify trends in responses. 

Results: A total of 432 NARs completed the survey. Public humiliation, verbal abuse, and being threatened with extra clinical hours were the most common forms of mistreatment reported and occurred more commonly during clinical training than during the didactic phase. African American/Black respondents were more likely to experience mistreatment based on their ethnicity when compared to Asian or Caucasian counterparts. Certified Registered Nurse Anesthetists (CRNAs) were the most common people responsible for the mistreatment experienced. During clinical practice 32% of respondents believed mistreatment affected their academic success. The WHO-5 Well-Being Scale identified 23% of respondents with an increased likelihood of depression, and over 70% of respondents experienced reduced well-being. The most common qualitative themes reported by NARs centered around reduced well-being, lack of time for self-care and spending time with foundational support persons, and various types of mistreatment.

Conclusion: This study shows that a culture of mistreatment can negatively impact NARs academic success and well-being. Nurse anesthesia programs and hospital systems should aim to create supportive environments for their anesthesia residents to help them be successful and improve their well-being during their anesthesia training.

Full Manuscript Slide Presentation Video