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Aims and Objectives: The aim of this study was to show what the experience of local anaesthesia and a surgical situation meant to patients., Background: Many patients who receive local anaesthesia will remain awake during surgery. The very fact of staying awake causes psychological and psychosocial needs. These needs must be met and it is therefore important to identify them., Design/method: Seven patients (aged 61-79) experiencing local anaesthesia and hip surgery (hip replacement surgery or repair of fractured hip) were interviewed. An interpretive phenomenological method developed by Benner was used to extract the experience of what it means to be in local anaesthesia and surgery. One paradigm case is used to illustrate the results., Results: Results show that the well-being and comfort of patients is compromised by challenges such as severe pain and long waits, which may be experienced as endless and which leave the patient thinking of nothing else. By contrast, the experience of trust helps the patient to feel control even in situations where the treatment is hard to grasp., Conclusions: The results highlight that local anaesthesia and surgery force patients to overcome and handle experiences of pain, trust and distrust as well as feelings of alienation and unreality., Relevance to Clinical Practice: The results illustrate the patient's needs, as seen from the patient's perspective. A shared experience makes it possible to understand, and thus to recognize, the required qualitative care to facilitate and to help the patient to remain in control and face the psychological challenges presented by anaesthesia care and surgical situations.

This article analyses problem situations in the context of anaesthesia care. It considers what it means for nurse anaesthetists to be in problematic situations in the anaesthesia care of older patients. Benner's interpretive phenomenological approach proved useful for this purpose. Paradigm cases are used to aid the analysis of individual nurses' experiences. Thirty narrated problematic anaesthesia care situations derived from seven interviews were studied. These show that experienced nurse anaesthetists perceive anaesthesia care as problematic and highly demanding when involving older patients. To be in problematic anaesthesia care situations means becoming morally distressed, which arises from the experience or from being prevented from acting according to one's legal and moral duty of care. An important issue that emerged from this study was the need for an ethical forum to discuss and articulate moral issues, so that moral stress of the kind experienced by these nurse anaesthetists can be dealt with and hopefully reduced.

This qualitative study identifies and describes different ways in which newly graduated nurse anesthetists (NAs) experience and perceive nurse anesthesia. It explains different approaches to nurse anesthesia care and, thus, to clinical nursing care (in an anesthesia and surgical context), provided by new NAs. One month after graduation, all NAs who had completed an anesthesia nursing program responded to 4 open-ended questions. A phenomenographic method was used to analyze their responses. The results were divided into 3 categories, which describe nurse anesthesia from the perspectives of (1) maintaining physical well-being; (2) being protectors and advocates; and (3) ability to perform good nurse anesthesia given all the demands placed on the NAs. The results indicate that, for the new NAs, the nurse anesthesia care situation was largely influenced by context and generated feelings of inadequacy because the NAs could not provide the emotional support that they believed their patients required.