Background: Bullying is a form of violence and is described as unwelcome aggressive behavior(s) by unrelated individuals. The prevalence of bullying in the nursing profession has been reported to be as high as 31% in the United States, and has been studied extensively in undergraduate nursing, midwifery, medical school residencies, and Certified Registered Nurse Anesthesia (CRNA) professional roles. There is a significant gap in the literature and paucity of evidence about the extent of Student Registered Nurse Anesthesia (SRNA) bullying underscored that this topic required further investigation. Purpose: To investigate whether bullying behaviors occur among anesthesia preceptors, and if so, how SRNAs perceive bullying has affected their educational experience. Methods: The American Association of Nurse Anesthetists (AANA) disseminated an online survey based on an existing tool to SRNAs for this study. The study used a quantitative descriptive methodology consisting of a survey of nine demographic questions, eight 5-point Likert scale questions, and two multiple-choice questions. Setting and sample: A nationwide online survey sent to 1500 SRNAs yielded (N=133) participants, who were predominantly female (67.67%), in front-loaded programs (52.63%) with an average age of 24-29 years old. Results: Results revealed SRNAs entering clinical rotations in 2015 and 2016 were bullied more than those entering in 2017. The majority of the respondents (89.26%) reported that they couldn't think clearly when they were bullied. More than half of SRNAs agreed (74.62%) that bullying impedes learning. Overall, CRNA preceptors (85.48%) were reported as the most frequent bullies, with MD/DO anesthesiologists reported as the second most frequent (68.55%) followed by non-CRNA nursing staff (41.94%).

Hurricane Katrina devastated New Orleans in 2005. Certified Registered Nurse Anesthetists (CRNAs) and Student Registered Nurse Anesthetists (SRNAs) were impacted by the storm. CRNAs were required to be on duty during the storm and SRNAs’ education was disrupted by the storm. This dissertation is a compilation of three papers that represent the initial exploratory research into the impact of natural disasters on CRNAs and future CRNAs. The first article was a focused ethnography utilizing focus groups and described the shared experiences of CRNAs who were on duty in New Orleans during Hurricane Katrina and the psychosocial impact the storm had on them. Ten CRNAs participated in focus groups that were audio-recorded, transcribed and analyzed. Six major themes emerged from the study and represented how the CRNAs appraised and coped with the stressful events surrounding Hurricane Katrina. The psychosocial impact of Hurricane Katrina on the CRNAs resulted in short-term sleep disturbances and a temporary increase in alcohol consumption. The second article was also a focused ethnography that utilized focus groups to describe the shared experiences of SRNAs whose senior year was disrupted by Hurricane Katrina and the psychosocial impact the storm had on them. Ten former SRNAs participated in focus groups that were audio-recorded, transcribed, and analyzed. Three major themes emerged from the study and represented how the SRNAs appraised and coped with the stressful events surrounding Hurricane Katrina. The psychosocial impact of Hurricane Katrina on the SRNAs resulted in temporary increased alcohol consumption and anxiety. The third article discussed the results of an observational study regarding the impact of Hurricane Katrina on the outcome of the Self-Evaluation Exam (SEE) taken by senior-level students in the Louisiana State University Health Sciences Center Nurse Anesthesia Program. A convenience sample consisted of 174 former students. Regression analysis revealed the relationship between the overall percentile score of the SEE and the year the test was taken (prior to or after Hurricane Katrina) while adjusting for potential confounding variables. The findings suggest that Hurricane Katrina did not have an impact on the outcome of the SEE taken by these individuals.

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