Emergency Nurse Role in the Nursing Profession - Essay Example

Emergency Nurse Role Running Head: Emergency Nurse Role Emergency Nurse Role in the Nursing Profession xxxxxx xxxxxx University of xxxxxx Emergency Nurse Role 2 Emergency is defined as "a serious, unexpected and often dangerous situation requiring immediate action" (Moore & Lakha, 2006, p.110). Emergency nurses specialize in rapid assessment and treatment when every second counts, particularly during the initial phase of acute illness and trauma. Emergency nurses must tackle diverse tasks with professionalism, efficiency, and above all-caring. Emergency nursing is a specialty area of the nursing profession like no other. To provide quality patient care for people of all ages, emergency nurses must possess both general and specific knowledge about health care to provide quality patient care for people of all ages. Emergency nurses must be ready to treat a wide variety of illnesses or injury situations, ranging from a sore throat to a heart attack (NHT, 2008). "The Emergency Nurse provides services to patients of all ages. This includes nursing assessment, intervention and management of perceived, actual/potential, sudden /urgent, and physical/psychological/social problems that present as episodic and /or acute" (NENA, 2003). The rationale behind the selection of this nursing role was due mainly to its challenging nature. Unlike medical ward settings, critical care skills are used more often in an emergency situation. The situations encountered test the nurse's differential diagnosis skills, exposes the nurse to various diseases, different patients every day and medical challenges in numerous competency areas. The nurse continues to learn and develops knowledge and skills that span many areas of nursing and medicine (NHT, 2008). Emergency Nurse Role 3 There are some educational qualifications and work experience requirements in emergency nursing. A Registered Nurse Designation is required. Ideally, the nurse would have a TNCC- Trauma Nursing Core Course certification and possess skills and experience in critical care. Some nurses have a Baccalaureate degree, others have diplomas and associate degrees as their base education. Some hold Masters degrees as well. PALS- Pediatric Advanced Life Support and ACLS- Advanced Care Life Support are other certifications that can be obtained in specialized areas (NHT, 2008) A minimum of one year work experience is preferred and critical care skills.The nurse must be an independent thinker, be comfortable with and capable of using nursing skills and procedures and be able to make a decision in a timely manner. Assertive and non- emotional nurses are preferred, with excellent communication and critical thinking skills. An excellent understanding of Anatomy, Physiology and Pathophysiology is also required (NENA, 2003) Emergency nursing requires expertise in several core competencies. The emergency nurse must be able to interpret data, perform objective assessments, interpret diagnostic results and select nursing interventions to manage the following areas of competencies. 1. Triage 2. Respiratory 3. Cardiovascular 4. Neurological 5. Maxillofacial/ eye/ear/nose/throat 6. Gastrointestinal 7. Genitourinary 8. Obstetrical client 9. Musculoskeletal/ Integumentary 10. Multi-system traumas Emergency Nurse Role 4 11. Environmental Emergencies 12. Immunological/Hematological/Endocrine systems 13. Knowledgeable in Domestic Violence/Sexual Assault 14. Toxicology 15. Mental Health 16. Infectious Disease 17. Psychosocial 18. Discharge Planning/ Client Education 19. Professional Practice Issues/ Legal & Ethical Issues Triage refers to the practice of grouping patients from the most critically ill/injured to the least. This is to ensure that where resources/personnel are limited, those requiring the most urgent medical attention are given it first and the others later, in order of a priority that is determined by the nurses/physicians in attendance. The first few hours may be critical for the patient and requires the nurse to assess the situation, organize the work environment and allocate resources, staff and medical care for the patients in a competent manner. Respiratory ailments due to illness, accident or injury can be alleviated by the nurse who can monitor vital signs, position the patient, use manual methods for ventilation, help in insertion of tubes into airways and chest drainage. The nurse can also use pharmacological methods such as bronchodilators, analgesics, sedatives, neuromuscular blocking agents and administer oxygen if needed. In cardiovascular ailments, the nurse can monitor vital signs, set up IV access and monitor fluid intake/outflow, assist with/perform defibrillation, introduce pharmacological agents into the cardiovascular system and administer oxygen etc. In multi-system traumas, the emergency nurse can monitor changes in airways and breathing, enhance circulation by proper balance of fluids and monitor vital signs and Emergency Nurse Role 5 changes in neurological states e.g. coma, unconsciousness. In cases of psychosocial traumas, domestic abuse or mental health problems, the nurse can provide support to family members e.g. at a cardiac arrest situation, arrange for appropriate medical care for the patient, ensure maximum privacy and comfort, maintain a quiet environment, provide referrals to police, pastors and procedural advice e.g. cases of child abuse require mandatory reporting to the authorities (CNA, 2008). The emergency nurse has many roles and responsibilities. The nurse works along with Medical Officers and others in a collaborative team and assists with the following: Triage and Prioritization Stabilization and Resuscitation Assessment, Diagnosis and Treatment of patient situations where limited data is available Provisions of care in uncontrolled and /or unpredictable situations Crisis interventions to meet the needs of unique patient situations Disaster Planning/Implementation Education of the patient and community to facilitate attainment of an optimal level of wellness (NENA, 2003). The role of the Emergency Nurse includes: Patient Care-Emergency nurses care for patients and families in hospital emergency departments, ambulances, helicopters, urgent care centers, cruise ships, sports arenas, industry, government, prisons, military, poison control centers Education-Emergency nurses provide education to the public through programs to promote wellness and prevent injuries Leadership and Research-Emergency nurses also may work as administrators, managers, and researchers who work to improve emergency health care (NHT, 2008). "Emergency Nursing is practiced in a unique environment which includes unplanned situations requiring intervention, the allocation of limited resources, and the need for Emergency Nurse Role 6 emergent care as perceived by many patients arriving in an unscheduled manner, potentially creating a stressful, chaotic environment" (NENA, 2003). There are several challenges and responsibilities within the role. When a critically ill patient presents to the Emergency Dept, the Emergency Nurse must triage that person accurately to ensure prompt treatment of life-threatening illnesses.The Emergency Nurse must be able to provide life-sustaining measures when required.The Emergency Nurse must care for a variety of patients even if short staffed which is a challenge in this situation. The Emergency Nurse has to be flexible in her routine to allow for unforeseen health status changes in patients, another challenging aspect of this situation (NENA, 2003). The emergency nurse sets up equipment, completely undresses the patient, obtains peripheral intravenous access, acquires laboratory specimens, administers fluids and medications, places uncomplicated nasogastric tubes and urinary catheters, monitors vital signs frequently, records the resuscitation, assists the physician team and monitors seriously injured patients taken to other departments (i.e. radiology) (Scaletta & Schaider, 2001, p.20). There is scope for this role both now and in the future. Nurses in the Emergency Department are more autonomous. Critical thinking is used in all nursing decisions. Nurses are part of the collaborative team and are providing suggestions and recommendations. The nurses work side-by-side with the Physicians, not under them in a subordinate role (NENA, 2003). The role of the emergency nurse is rewarding and offers many opportunities for learning, gaining experience, accepting responsibilities and handling challenges. Emergency Nurse Role 7 References CNA.Canadian Nurses Association (2008). Emergency Nursing Certification. Retrieved May 13, 2008 from [http://www.cna-aiic.ca/cna/documents/pdf/publications/CERT_ER_e.pdf] Moore T. & Lakha R. (2006). Tolley's Handbook of Disaster and Emergency Management. Elsevier Ltd., UK NENA. (2003). History of National Emergency Nursing Affiliation, NENA(INC.) Retrieved May 13, 2008 from [http://www.nena.ca/index.phpmodule=subjects&func=printpage&pageid=1&scope=all] NHT. Nurses for a Healthier Tomorrow (2008). Career Info - Emergency Nurse. Retrieved May 13, 2008 from http://www.nursesource.org/emergency.html Scaletta T. & Schaider J. (2001). Emergent management of Trauma. McGraw-Hill, USA Read More