Emergency Nurses Act As The Front Line Of Health Care

Because patients need round-the-clock care, working hours include days, nights, weekends and holidays. Nurses spend considerable time walking, bending, stretching and standing, so they must follow proper body mechanics to guard against injury. Because of the fast-paced and variable environment of emergency rooms, ER Nurses must possess good stress coping skills and be able to relate to people of all ages and backgrounds. They must be able to work accurately around frequent interruptions. Nurses may face hazards from exposure to chemicals and infectious diseases. In addition, they treat patients that may be confused, irrational, agitated, and/or uncooperative. Along with all this you need. At a minimum for most entry-level emergency room (ER) nursing careers, applicants must have a diploma from an accredited

For the most part, hospitals are places where one comes for healing and it is place where our clients should feel safe and away from harm. Nurses have an important role as a patient advocate and are to provide all clients with safe, compassionate, and quality care at all times. Nonetheless, the hospital can also be a dangerous place for inpatients. It is a foreign environment to clients and there may be alterations in their medical condition in regards to their physical and/or mental status. With this said, there is a need to improve upon how we care for our clients, especially those who are at most risk for various incidents.

There are many components to a hospital or medical facility. All of them are necessary to have a properly functioning environment. The emergency department of a hospital is a fast paced world. You have to be constantly on your toes and prepared for whatever may come through the doors. There are many people that work in an emergency room to make it run smoothly. Techs, nurses, CNA’s, LVN’s, and doctors all work side by side to help those who are critically injured. Without all these people it would be complete chaos.

Meanwhile, elsewhere in Habersham County, Tom was feeling slightly nervous as he exited the staff lounge and entered the hustle and bustle of County Hospital’s ER to begin his first shift as an RN. The first few hours of his shift passed slowly as Tom mostly checked vital signs and listened to patients complain about various aches, pains, coughs, and sniffles. He realized that the attending physician, Dr. Greene, who was rather “old school” in general about how he interacted with nursing staff, wanted to start him out slowly. Tom knew, though, that the paramedics could bring in a trauma patient at any time.

This study will include nurses that are currently working in emergency department with at least six months of experience with varying ages and levels of education. The emergency nurses would be required to complete a formal training on understanding the Emergency Severity Index (ESI) algorithm and the complexities in accurately assigning a triage level. The level of competence of the nurses will be increased if they participate in the online educational opportunities. In addition to the formal course, an online acuity level triage designation course will also be implemented. The ED leadership team will be instrumental in encouraging staff to participate so they are adequately prepared to function as a triage

Significance: Because nursing is the largest health care profession and nurses provide most of the patient care, and as an acute nurse, I can relate to how unsafe nurse staffing/low nurse-to-patient ratios can have negative impact on patient satisfaction and outcome, can lead to medical and/or medication errors and nurse burnout. It can also bring about anxiety and frustration, which can also clouds the nurses’ critical thinking. Most patients might not know the work load on a particular nurse and can assume that her nurse is just not efficient. Doctors also can become very impatient with their nurses because orders are not being followed through that can delay treatments to their patients. There is also delays in attending to call lights resulting in very unhappy patients who needed help.

An emergency room nurse may assist in moving patients, taking blood labs and must use care and compassion while treating or informing patients of their condition. They may help physicians during exams and treatments, and monitor and record patients conditions, evaluate patients response to treatment and notify the doctor when appropriate. The information collected will be used by the emergency room nurse to identify factors related to discharge and advise the patient and family on how to continue their proper health care after leaving the hospital. Upon discharge the ER nurse will provide referrals to other health care individuals for follow up treatment to ensure continued care.

Nurses are undoubtedly one of the most trusted professionals worldwide. Patients, family members, and doctors entrust nurses to provide the utmost quality care to sick individuals. Top priorities of all nurses are advocacy for their patients: including advocating for their physical health, holistic welfare, and utmost importantly, their safety. Patient safety will always be the top priority when providing patient care. The nurse’s responsibility during every patient encounter is to ensure that each patient under her care, receives no harm. As a direct result of the previous statement, it is crucial that every nurse knows their rights to refuse unsafe patient assignments, the process to refuse unsafe patient assignments, and the legal or ethical ramifications that could present themselves if proper judgement is not used. By understanding these rules, nurses not only achieve the responsibility of advocating for patient safety but also safeguard their careers and license.

I would like to give you some insight as to the daily operation of a major Emergency Department in this city. Not unlike many other “ER’s” the nursing staff is tasked with the triage or assessment of patients in order to sort by priority. The nurse is then tasked with maintaining flow of the department and ensuring the timely care and physician evaluation of patients. This requires clinical nursing judgement and expertise which is tested constantly. To explain this plainly, nurses are faced with a meat grinder which cannot stop. There may be twenty patients in the lobby with ambulances lining up. The room nurses are trying to

“The emergency nurse acts with compassion, integrity and respect for human dignity while recognizing and safeguarding the autonomy of the individual”, (ENA, 2015). While this provision appears simply stated, most nurses find it difficult to remember their patient as a human being with intricate needs and basic human rights. As an emergency nurse, I have to keep these needs and rights at the forefront of my thoughts during the care of the patient during a very vulnerable time. Patients come in under stress, sometimes involuntary and at the most desperate times in their lives. I constantly have to make a concerted effort to communicate with the patient during a chaotic time, take time to listen to the patients fears and concerns and communicate those to the team.

Who is affected? Triage is the first patients to find. The responsibilities for these nurses are high. Nurses who care for patients in trauma or medical emergency, midwives who bring babies in the world, working with the mentally ill, or who enter a customer's house pose liability problems.

Unlike physicians who spend approximately 30 to 45 minutes per day with a patient, the presence of nurses at the bedside is essential throughout the day. Apart from attending the patients, they regularly interact with families of the sick and other healthcare practitioners, such as physicians and pharmacists. Given their constant presence at the bedside, nurses play a critical role in maintaining patient safety by continuously observing patients for deterioration or improvement of health. They also help in the detection of medical errors, identification of near misses, and discovery of weaknesses that might be inherent in some systems (“Nursing and Patient Safety,” 2017). Since the role of nurses is crucial to the maintenance of patient safety, it is logical that increasing their workload is bound to adversely affect their ability to deliver quality work and safe services.

A professional nurse is one who puts the needs and importance of patient care above all others. While striving for professionalism, nurses need compassion, patience, empathy, strong moral and ethics, accountability and the commitment to always act in the best interest of their patients. Nurses are held accountable for providing quality, safe, and effective nursing care (Hood, 2014). A professional nurse has the responsibility to continually improve and implement nursing standards while maintaining integrity by involving themselves in various tasks. Regular involvement in reading professional literature and sharing of evidence- based research with other healthcare personal helps increase knowledge and skills. This nursing ability can be used to encourage the actions of others in the healthcare team resulting in improved patient care. Nurses should encourage each other to become involved in hospital committees, provide an environment to encourage the discussions of ethical dilemmas, promote professional growth of nurses to voice their concerns and share viewpoints to address issues. “A professional nurse should expect to commit to a life of continuous learning growth and development”. (Hood, 2014, pp. 29). Nurses choose this profession to help others. As professional nurses we must maintain our ethics, values, characteristics, and commitment to drive our profession forward (CCN, 2015). Nurses must be autonomous, accountable, and be able to delegate to unlicensed assistive personnel. Being autonomous as a nurse means having control over their practice (Hood, 2014). It allows a nurse to take risks while being held accountable for ones’ actions (Hood, 2014).

Thus, emergency physicians cannot rely on earned trust or on prior knowledge of the patient's condition, values, or wishes regarding medical treatment. The patient's willingness to seek emergency care and to trust the physician is based on institutional and professional assurances rather than on an established personal relationship. Fourth, emergency physicians practice in an institutional setting, the hospital emergency department, and in close working relationships with other physicians, nurses, emergency medical technicians, and other health care professionals. Thus, emergency physicians must understand and respect institutional regulations and inter-professional norms of conduct. Fifth, in the United States, emergency physicians have been given a unique social role and responsibility to act as health care providers of last resort for many patients who have no other feasible access to care. Sixth, emergency physicians have a societal duty to render emergency aid outside their normal health care setting when such intervention may save life or limb. Finally, by virtue of their broad expertise and training, emergency physicians are expected to be a resource for the community in pre-hospital care, disaster management, toxicology, cardiopulmonary resuscitation, public health, injury control, and related areas. All of these special circumstances shape the

Urgency of acute care varies depending on the situation but can range to anything from emergency surgeries, to injuries, chronic illnesses, and also for the recovery of those procedures. Majority of the patients in acute care settings are critically ill. Nursing responsibilities in acute care settings are vital to patient’s recovery due to the front line position nurses play as well as the wide variety of tasks carried out. Assessments are made during every encounter the nurse has with the patient along with monitoring the patient’s progress. Nurses are responsible for recognizing symptoms the patient may be experiencing due to illness or injury and whether they fall in the spectrum of normal reactions. Vital signs are measured routinely and can be indicators of the patient’s current status. When vitals are questioned diagnostic tests can be arranged to further assess possible comorbidities the patient may have. Care plans are made to plan interventions the health care team can take to help patients through challenges they face, both physical and mental. Nurses administer medications as well as first aid as needed. They are responsible for maintaining special equipment patients may require including monitors and ventilators are well.