New practices bring new challenges: the psychological experiences and needs of anesthesiologists transitioning to work in the AICU

Background The global population aging continues to accelerate, also posing significant challenges to Chinese society. The growing geriatric population has substantially increased demand for critical care beds, compelling governmental initiatives to expand specialized Intensive Care Unit (ICU) capacity in addressing this deficit. The establishment of an Anesthesia Intensive Care Unit (AICU) in a comprehensive hospital has effectively alleviated the pressure on the general ICU. However, anesthesiologists have historically lacked sustained experience in prolonged critical care management, as their work was mostly limited to intraoperative and postoperative care management. The change in scope, target, content, and mode of work may have an impact on their physical and mental well-being. This qualitative study employs phenomenological interviewing with AICU anesthesiologists to systematically explore their lived clinical experiences and needs. The findings will provide references for managers to develop appropriate intervention measures. Methods This phenomenological qualitative study was conducted at Jiaxing University Affiliated Hospital, a tertiary academic medical center in Zhejiang Province, China. We conducted semi-structured interviews with 15 anesthesiologists working in the AICU from January 27, 2025, to March 30, 2025. Participants were recruited through purposive sampling. Interviews lasted 45–60 minutes, with data saturation determined when no new information emerged. Interview data were analyzed using Colaizzi's seven-step phenomenological method. Results Four core themes with twelve subthemes emerged from the analysis: (1) Negative psychological experiences, including sub-themes of "Challenges from cognitive and skill delays", "clinical anxiety during patient deterioration management", "stress from changing duties", and "impacts of research, administrative, and family roles";(2) Positive psychological experiences, including sub-themes of " sense of duty for AICU development ", "increased sense of professional accomplishment", "enhanced professional capabilities", and "strengthened non-technical skills"༛(3) Diversified support facilitates role adaptation, including sub-themes of "self-support", " team support reinforcement" ,and " family support engagement"(4) Needs and aspirations, including sub-themes of "improved training", "higher remuneration", and "streamlined management". Conclusion The transition of anesthesiologists to roles in the AICU is a complex and demanding process. This highlights the importance of hospital and departmental management in addressing the psychological challenges and needs faced by healthcare professionals during this shift. Efforts should be made to strengthen training, refine management systems, ensure equitable compensation, and foster a sense of professional identity and belonging. Such measures are essential for improving staff well-being and, ultimately, enhancing the quality of care.