Emergency Room Nursing: A Unique Thesis

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There is a need for the nurse to be proficient and efficient in her work, because ED's are experiencing an increasing number of patient visits, and there are normally more patient's waiting to be seen than is appropriate for the size of the facility's ED (GAO, 2008).

If we compare the patient flow and the speed with which the ED nurse must work in order to accomplish her responsibilities and duties with those of a surgical nurse; we would rapidly find that the pressure on the ED is much greater on a patient flow capacity. The surgical nurses' patients are scheduled, not random, except in the case of a surgical emergency. The ED nurse must often deal not just with the patient, but with the patient's family too. The surgical nurse has little interaction with the patient, or the patient's family, and does not see the patient flow that is seen by the ED nurse on a single shift (except perhaps a war zone surgical nurse). The Government Accounting Office (GAO) released a study in 2008, citing 20 of 34 emergency departments were functioning at over capacity. The emergency department at the Washington Hospital Center (Washington, DC) was operating at 286% capacity at the time of the survey (p. 5).

In addition to the primary problem of over capacity, ED nurses:

Use cleaning disinfectants that can be hazardous to their health

Are exposed to anesthetic gases, drugs, and radiation

Risk injury by sharp needles and potential exposure to infectious diseases

Risk exposure to infectious bodily fluids

Suffer risks from lifting heavy patients, standing and walking for prolonged periods of time

Suffer burnout and other conditions from long hours and shift work

The surgical nurses' risk to these hazards are mitigated by planning, and working in environments where the risks to many of the hazards that are encountered by a ED nurse have been identified in advance of the surgery, and precautions can be taken because of that prior knowledge.

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Overcrowding in EDs also means that the ED nurse has a greater risk of encountering violence from patients than do surgical nurses. The ED nurse has a larger patient population to work with, and would encounter more patients or family experiencing stress and anger because of having to wait in overcrowded EDs. Also, the ED patient, unlike the surgical patient, could be under the influence of drugs or alcohol and become violent.

It takes a very special person to take on the stress and duties of a ED nurse. Many who are attracted to the higher paying shift work and nature of the work quickly learn that it is a fast paced and demanding environment that poses many risks to the nurse......

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