EMERGENCY NURSING

Emergency Nursing

Emergency Nursing

Introduction

Designated emergency departments began in the early 1970s and functioned mainly as an after-hours patient entry point where a ward nurse came to monitor the patient's condition until the arrival of a doctor (McKay-Ingalls and Thayre-McCray, 1999). However, the increasing number of patients presenting to ED, demand for more emergency care, advances in technology and improvements in resuscitation procedures led to the need to expand services and create a specialty area for the delivery of emergency care. By 1985, these changes raised the expectation that both nursing and medical staff needed to become highly trained, specialised and permanently based in ED.

Emergency nursing as a specialty practice has evolved over the past 35 years. Emergency nurses deliver care to a diverse population experiencing episodic, abrupt, potentially life-threatening health or psychosocial conditions. Emergency care may require minimal intervention or advanced life support practices. Emergency nurses require in-depth knowledge and clinical expertise to provide care across the lifespan and to manage situations such as patient overcrowding and the use of complex technology.

Emergency practice requires nurses to blend theoretical knowledge systems, past experiences, collated patterns of knowing and ways of doing with a patient's physiological, interpersonal and communicative signs ([Fry, 2002] and [Sbaih, 2001]). Convergences of these knowledge systems with cognitive domains that include assessment, diagnosis, treatment and evaluation skills enable greater accuracy and speed in the decision making, troubleshooting, prioritisation and delivery of emergency care.

Discussion

The practice environment of emergency nursing is as diverse as the nursing profession itself. Table 1 identifies some of the practice environments of the United States emergency nurses. In keeping with the nursing profession as a whole, emergency nursing roles include patient care, referral, management, education, consultation, advocacy and research.

Table 1.

Emergency nursing practice environments

Emergency departments

Emergency treatment areas

Military services

Community health clinics

Remote and very remote health clinics

Industrial areas

Multipurpose centres

Maori health providers

Medical centers

Pre-hospital/retrieval services

Disaster response teams

An emergency nurse handles patients in trauma situations. This particular type of nurse is trained not only in patient care, but in how to deal with and assess a patient in an emergency setting. This is a specialization that registered nurses can elect and is usually part of their rotation when they go through training.

The primary organization in the United States for emergency nurses is the Emergency Nurses Association (ENA). In 1970, the Emergency Room Nurses Organization was launched in Buffalo, New York, by Anita Dorr, inventor of the crash cart. Meanwhile Judith Kelleher formed the Emergency Department Nurses Association in California. These two groups joined on December 1, 1970, to become the Emergency Department Nurses Association, renamed the ENA in 1985 . The ENA includes subspecialties for managers, trauma, government affairs, research, pediatrics, telephone triage, injury prevention, emergency medical services (EMS), and forensics. In 1972, the Royal College of Nursing in the United Kingdom established an accident and emergency nursing group, which became the Accident & Emergency Nursing Association in 1990 . The first international emergency nursing conference was held in 1985 in London ...