Evolution and future prospects of nurse anaesthetists in Catalonia: inception, upskilling and scope of practice

Abstract

Aim: To explore the current and future professional landscape of nurse anaesthetists within the healthcare system of Catalonia (Spain). Background: Nurse anaesthetists have played a key role in anaesthesia administration since the 19th century. In Catalonia, they are recognised as advanced practice nurses, with an evolving competency framework designed to meet contemporary healthcare demands. Methods: A descriptive qualitative approach was employed, with data collected through a focus group conducted in June 2021. The discussion followed a structured script addressing competency differences between nurse anaesthetists and generalist nurses, the evolution of anaesthesia nursing in the Catalan healthcare system, and its future trajectory. Discourse analysis and microanalysis of interlocutors were performed. Findings: Twenty-one codes were identified and grouped into four main categories: ‘Nurse anaesthetist profile’ (competencies, care provision, health education, experience, training, humanisation, perioperative process, patient safety), ‘Current professional situation’ (role differentiation, institutional organisation, work intrusion), ‘Factors extrinsic to the NA profession’ (increased demand for anaesthetic procedures, financial interests, shortage of anaesthetists) and ‘Future prospects’ (growth of the profession, nursing specialty, advocacy, institutional recognition). Discussion: This study highlights the expansion of the nurse anaesthetist role in Catalonia, driven by skill enhancement and the shortage of anaesthetists. While nurse anaesthetists advocate for greater autonomy and emphasise their contribution to patient safety, concerns persist regarding limited professional recognition and the risk of role displacement.