Anaesthetic team and the role of nurses—European perspective

The only evidence in favour of the provision of assistance for anaesthesiologists seems to be that single-handed anaesthesiologists generate higher anaesthetic mortality than does a team system. In mainland Europe, the independent scope of the practice of nurse anaesthetists has been constrained while possible new roles for nurses have been suggested in the United Kingdom. In the USA, Anesthesiology Assistants are developing as an alternative to nurse anesthetists. The current fluidity will probably settle in Europe into a cadre of Assistant Anaesthetists, predominantly drawn from graduate nurses but with some graduates in biological or medical sciences, receiving a further 2-year specialist training. To attract people of this calibre, their role will have to offer some degree of clinical autonomy over the management of general anaesthesia. Considerations of safety will constrain this autonomy but the introduction of a monitor of anaesthetic depth and sophisticated communication systems will relieve anxiety about this development