International emergency nursing
-
Violence is a major public health problem worldwide. Emergency nurses are often in a unique position to identify, assess, evaluate, and treat these patients, but there is limited forensic knowledge and skills to enable emergency nurses to feel confident to guide their practice in New Zealand. The purpose of this study was to establish the level of forensic knowledge and skills currently known and used by nurses in clinical practice working in New Zealand District Health Boards (DHB)'s emergency departments. The study aimed to develop a tertiary education course based on the needs and the knowledge required, to enable nurses to practice confidently and safely with Forensic patients in the emergency department setting. ⋯ As forensic patients generally require emergency medical attention, it is important that nurses as part of the front-line first responders have forensic knowledge around preservation and collection of evidence during the provision of medical care. It was found that, emergency nurses do not have enough knowledge around forensic issues indicating that forensic education is warranted, needed and desired among ED nurses within the clinical setting. The study also provides support for the implementation of tertiary forensic science nursing postgraduate study in New Zealand.
-
The Swedish ambulance service has undergone major changes in recent decades due to advancements being made in medical and technical resources, professional competence, and patient care. Registered and specialist nurses share the same role, accountabilities, and responsibilities in the ambulance service, and their professional competence has not yet been evaluated. ⋯ The findings indicated that there are differences in the professional competence of registered nurses and specialist nurses. Length of work experience in the ambulance service is an important factor associated with higher professional competence.
-
To explore emergency department clinicians (nurses and medical doctors) perceptions of stressors and coping strategies in their work environment. ⋯ Exposure to occupational stressors remains problematic for emergency department clinicians. Continued exposure can, in some instances, result in demoralisation of the workforce. Immediate attention to causes and effects of occupational stress and demoralisation is warranted. Implementing tailored strategies has the potential to ameliorate effects of occupational stressors.
-
The emergency department (ED) is an important entry point for patients with cancer requiring acute care due to oncological emergencies. Febrile neutropenia (FN) is one of the most common oncological emergencies and carries a significant risk of morbidity and mortality. There is evidence from previous studies that FN patients wait far longer in the ED than recommended by international guidelines. ⋯ The allocation of patients with FN to a lower, inaccurate priority was partly responsible for the inability of those patients to meet the standard benchmarks for the initial physician assessment and the administration of antibiotics identified by the triage and febrile neutropenia guidelines. Ongoing strategies are needed to both enhance the application of the triage guidelines and institute organizational and system changes that promote timeliness and effectiveness throughout the entire ED episode of care.
-
Many ambulance personnel can withhold or terminate resuscitation on-scene, but these decisions are emotionally, ethically and cognitively challenging. Although there is a wealth of research examining training and performance of life-saving resuscitation efforts, there is little published research examining how ambulance personnel are prepared and supported for situations where resuscitation is unsuccessful, unwanted or unwarranted. ⋯ Clinical and life experience is highly-valued by ambulance personnel who provide training and support. However, novice ambulance personnel may benefit from greater awareness and rehearsal of skills associated with terminating resuscitation and managing the scene of a patient death. Organisations need to acknowledge idiosyncratic staff needs and offer a variety of support mechanisms both during and after the event.