Emergency Nursing, Research Paper Example

Emergency Nursing is a specialty in the field of nursing in which nurses provide specialized care to patients in or critical phase of their illness, emergency or injury. The specialty involves receiving and treating patients in need of immediate medical care. Such patients my have complex needs, they may be unstable or patients requiring vigilant and intensive nursing care or even patients with minor problems. There are common illnesses in emergency department patients which include: traumatic injuries from car accidents and falls, orthopedic injuries which include strains, sprains and fractures., cardiovascular disorders like acute coronary syndromes ( myocardial infarctions and unstable angina) as well as heart failure. Respiratory disorders like pulmonary embolism, cute respiratory failure and asthma are also common.  Other illnesses include renal disorders like acute and chronic renal failure, urinary tract infections and kidney disorders, GI and hepatic disorders such as acute pancreatitis, acute liver failure, bowel obstruction and GI bleeding, shock occurring due to anaphylaxis ,sepsis, cardiac dysfunction acute spinal cord injury and hypovolemia. Others include pediatric ailments such as bronchiocitis, appendicitis and febrile seizures, obstetric and gynecologic problems, psychiatric emergencies, drug overdose, injuries resulting from violence like gun and knife injuries as well as minor injuries like abrasions and lacerations ( Williams L.  and Wilkins 2003).

An emergency nurse is defined as advanced practice nurse who assesses, diagnoses, and treats various injuries; disease processes common illnesses and common illnesses in emergency care settings. The Emergency nurse practitioner (ENP) also focuses on preventing future injury and illness through public health advocacy as well as patient and family education.

Training and Qualifications

As an ENP I should be trained in medical skills and advanced nursing. These medical skills include interpretation of x-ray, suturing, ophthalmic slit lamp examination, local and regional anesthesia, advanced airway techniques, abscess incision and drainage, reduction of fractures as well as casting and splinting I should also be a registered nurse with a Bachelor’s degree in Nursing on top of Registered Nursing licenses .In addition I should a have passed a licensing exam known as NCLEX-RN. In the case of a certified emergency nurse then I will be required to have additional and optional certificates specific to the Emergency Room. All Emergency Room Nurses are trained on tasks associated with gastrointestinal, gynecological, cardiovascular, maxillofacial, orthopedic neurological and psychological diseases. During the life of my Emergency Room Nurse career, I might also work in other fields of Nursing which  include geriatric care, home-care ,providing medical services in schools and businesses as well as the administration of other Nurses. Additional training and qualifications for an Emergency Nurse include: Advanced Trauma Nursing Course(ATNC), Advanced Trauma Life Support (ATLS) ,  Emergency Nursing Pediatric Course (ENPC) ,Advanced Cardiac Life Support( ACLS), Trauma Nursing Core Course (TNCC), Mobile Intensive Care Nurse( MICN), Pre-Hospital Emergency Care (PHEC)  and Pediatric Advanced Life Support (PALS) ( Pyrek K.  2006).

Necessary skills for an Emergency Room Nurse

Emergency Room Nurses offer first assessments and treatments to patients having medical crisis. As an emergency Room Nurse I am required to have quick and flexible responses to trauma patients and patients with serious illness supported by extensive medical knowledge. I should work alongside medical doctors, although I must also be able to work independently taking leadership roles when it is necessary. I should have   the ability to adapt to performing diversified tasks and techniques as well as be able to listen to directions. The  nature of the Emergency room is unpredictable and demanding and therefore as a forensic nurse it is necessary that I have  stamina and ability to make  decisions quickly and to be attentive to details .I  must also be capable of  tackling  all of these duties while still providing a caring and clear communication to both the patient and their families ; in addition to the ability to communicate clinical knowledge  empathy skills and client teaching abilities are very vital . I should also be able to perform rapid assessment, take history very fast and provide prompt formulation as well as intervention in emergency nursing. I must also be informed about legal issues related to emergency care like mandated reporting and Good Samaritan laws. Other important skills include ability to make sound clinical judgment, be an advocate and able to collaborate with multidisciplinary team in order to ensure patient outcomes are optimum. I should also be able to demonstrate understanding of cultural diversity that is demonstrate sensitivity and awareness towards a patients lifestyle, socioeconomic status, family make up age, gender, religion and values ( Pyrek K.  2006).

Type of Clients

As an emergency nurse I handle patients in critical phases of diseases, emergency patients or patients with traumatic injuries .There are also patients with non–emergency needs as well as their family members. Because of the rising numbers of non- emergency patients in the Emergency department I should be capable of doing  triage which is method in which patient care is prioritized according to the type of   injury or illness and the urgency of the patients condition. Triage is performed to make sure that each patient get appropriate care according to his or her need and also in good time.

The role of emergency Nurse Practitioner

A specialist nurse in emergency centre is involved in independent assessment, diagnosis, investigation, and treatment of a wide range of common injuries and accidents working autonomously without making reference to medical staff. The role involves primarily the treatment of a wide range of skin problems, musculoskeletal problems and minor illness therefore many emergency nurses are considered experts in management of wounds. These nurses are trained in advanced nursing like taking a full medical history and examination, suturing and plastering, x-ray interpretation and prescribing. Although the training is medical in nature it also encompasses a holistic assessment of the needs of the patients taking into account continuing care within the family, the need for health teaching and education and ongoing health support in the community.

As an emergency nurse I can assume several roles in the emergency setting like nurse practitioner, staff nurse, nurse manager, trauma care specialist, sexual assault nurse examiner, clinical nurse specialist, flight nurse, nurse educator or nurse researcher. As an emergency nurse educator I should facilitate patient family as well as staff education. Staff education involves teaching the staff on how to prescribe new medication how to use new equipment, and on how to interpret results of diagnosis. on the other hand   education offered to patients involve teaching them an d their families about diagnostic and laboratory testing,  the patients illnesses, planed surgical procedures ,instructing on specific patient care, like wound care ,the importance of comorbid disorders management, illness and prevention of injuries ,prescribed medicines as well as follow up appointments and instructions on homecare. I can do my duties in emergency centers, minor care departments, rural clinics, prehospital care environments and flight programs (Williams L. and Wilkins 2003).

Responsibilities of an emergency nurse

My responsibilities as an emergency nurse are to ensure that all patients as well as their family members get the best care and close attention possible.  This involves doing a complete nursing process that is: assessments which require that I do constant assessment of the patient for minor changes in condition and also monitoring all the equipments in use. This is because caring for emergency patients might involve the use of highly sophisticated equipments like the homodynamic monitoring devices, cardiac monitors, and ICP monitoring devices all which require high concentration when performing procedure. Assessment of the patient should also involve psychologic as well as physiologic statuses of the patient. The second part of the process is planning which is done according to patients physiologic and physiologic needs to ensure make sure the patient passes safely through the emergency environment. In the emergency setting, changes in patients re always anticipated and therefore the plan my change if such changes occur. for example in patients admitted with MI diagnosis arrhythmia changes  my occur such s complete heart block if such occurs the treatment plan should be changed s well s the set goals. Planning is followed by implementation of specific interventions to handle existing as well as potential problems of the patient for example managing pain and monitoring therapy responses. The last stage of the nursing process is evaluating the patient’s response to interventions. These evaluations are very important as they help change the care plan when necessary to ensure that the patient outcome goal is optimally achieved (Williams L. and Wilkins 2003).

Methods used to analyze the role of emergency nurses

My role as an emergency nurse can be analyzed by conducting studies that assess the satisfaction of patients. Questionnaires are commonly used to collect data from the patients or relatives and then logistics regression and descriptive statistics are employed to analyze the data. Research has proved that nurse practitioners provide high quality care to adult, non-urgent emergency patient’s as well as pediatric patients. Although there has been  studies that assess satisfaction of  patient  with nurse practitioner care, only  few have   reported on the  factors that  initially influence the public to use these services especially in the case of children there re  no studies which  have examined the factors that influence the parents  decision-making to get  nurse practitioner care in emergency settings for their children.  In 2002 a group of 100 parents who visited a tertiary pediatric emergency department which provided for their children’s non-urgent emergency care were involved in a study to determine what influenced parents to rely on emergency nurse care .they filled in a questionnaire. Data collected included parents’ understanding of the characteristics of the role of nurse practitioner, role, responsibility and tasks that parents would wish to have a nurse practitioner provide well demographic variables. Logistic regression and descriptive statistics were used to analyze the demographic data, and logistic regression was used to analyze parents’ perceptions of the characteristics of the nurse practitioner role and percentiles compiled for the role responsibility tasks. The results from Logistic regression showed that there was statistically significant compatibility between nurse practitioner services and parents’ beliefs about the role while demographic variables did not have a statistically significant influence (Martin-misener R. 2005).

Organization

Emergency nursing is a nursing department which operates in all clinical disciplines covering outpatients (clinics), the inpatients (wards), accident and emergency, health education/staff training, special units and counseling. It has 1945 established nurses, both registered and enrolled. The departments aim is to maintain high standards of nursing care in the hospital by implementing Primary Nursing Care model.

The department offers various nursing services including, , Curative, Preventive, Promotive and  rehabilitative services .

Preventive Measures-Their main objective is to empower, the clients, patients, relatives, care givers and health workers with knowledge on diseases that can prevented and the preventive measures.  these measures Provide education,  information and communication, create awareness,  advocate for family planning and  maternal child health , help to network with multi-disciplinary organizations which  provide health care such as  Ministry of Health and Non-governmental organization (NGO) and also help Liaise with other disciplines within the institution;

Promotive Measures-The main objective of these services  is to encourage the clients, patients  relatives, care givers and health workers  on physical,  spiritual ,psychological,  and the well being of an  family, community ,individual and the whole  nation  by  Providing education, information  and communication , Creating awareness, developing   materials on issues related to  health ; encouraging  the community on family planning and maternal  child health and emphasizing  preventive measures  as a means to promote good health.

Curative measures-The main objective of these measures is to encourage the care givers, patient and clients on taking both preventive and curative measures. This is achieved through creating awareness on relevant disease/condition, the importance of seeking health services for early diagnosis and treatment; compliance of drugs and follow up as well Provision of education, information and communication materials on relevant diseases.

Rehabilitative Measures-The main goal of these services is to encourage patients, clients, their relatives as well as care givers to accept their condition and live positively.  it therefore  provides education information and communication (IEC) s well s introducing  beneficiaries to respective social groups from which they can get  relevant support for psycho-social, counseling support materials ( IEC materials) and create enabling environment.

Training/Research-The department also offers training activities. The unit involved with training conducts and co-ordinates various seminars, workshops and courses which range from hours to one year for specialized diplomas.  Emergency nursing also belong to international organizations like the Emergency Nursing Association  which is one the biggest organizations of nursing specialty world wide .It has more than 28,000 members .Its main goal is to promote emergency nursing excellence through education, leadership, research and advocacy. ENA can also give certification to an emergency flight nurse or an emergency nurse ( Pyrek K.  2006).

Conclusion

This nursing service ensures restoration of the patient/client state of physical, psychological, spiritual and social health to the best level possible.  nurses use various strategies  in offering the nursing care  in the hospital ,the strategies include advocating  on health issues  vi  community based health care programmes , providing  health related campaigns and providing  daily health talks in wards and clinics for example  immunization campaigns,  nutritional awareness, malaria ,tuberculosis and HIV/AIDS campaigns. The department also collaborates with other multidiscipline in the health sector on new issues on the alert for example disease outbreaks, in getting information updates and also when participating in health camps or when in outreach.

References

Martin-miener R. (2005)   Journal of advanced nursing.  vol. 52,  pp. 231-238 .London :Blackwell publishers.

Pyrek K  (2006). Emergency Nursing . Arizona: CRC Press

Williams L. and Wilkins (2003).Emergency nursing made incredibly easy. London: spring house publishers.