This emergency nursing lecture will cover a range of topics from roles and required skills through to complexlegal and ethical issues relevant to emergency nursing practice in the UK. As with all our online lectures, thislecture has been prepared by a qualified writer who is an expert in nursing and healthcare. Many of our writersare lecturing at UK universities or are trained NHS nurses and healthcare staff.Emergency nursing involves the episodic care of people with physical and / or psychological health problems.These health problems may result from injury and or illness, are usually acute, and require further, oftenimmediate, investigation and intervention.This lecture in emergency nursing covers the essential elements that are required to provide effective care andwill help you gain a better understanding of the standards required when working in this area of nursing andhealthcare.
Emergency nursing involves the episodic care of people with physical and / or psychological health problems.These health problems: (1) may result from injury and / or illness, (2) are usually acute, and (3) requirefurther, often immediate, investigation and / or intervention. Emergency nurses care for people of all ages,and work with conditions which may affect any - or, indeed, all - of the body's systems. Often (though notalways), patients requiring emergency care are physiologically (or psychologically) unstable, have complexhealth and other needs, and require intensive nursing care. As with all nursing care, emergency nursing careis provided in a way that is patient centred - that is, focused on the individual patient and theirunique needs, wants and preferences.
Emergency Nursing Lecture Notes Pdf
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Emergency nursing care may be delivered in a variety of settings - including in accident and emergency(A&E) departments, minor injury units, ambulance or other acute transport services, out-of-hours walk-incentres and in the armed forces. These settings usually allow for the unplanned or unscheduled presentationof a patient, often without prior warning, either via self-referral or referral from another service. Inemergency settings, care is often provided on an 'as-needed' basis - usually outside regular working hours,and often continually 24 hours per day, 7 days per week.
As noted earlier, emergency nurses must be able to effectively care for diverse populations. In the UK, thefour most likely groups to present to A&E Departments are people aged >90 years, people aged 80-89years, people aged 20-29 years, and people aged 0-9 years. In younger age-groups (35 years), menare slightly more likely than women to present. The ability to communicate with, assess and providetreatment to paediatric, adolescent, adult and elderly populations, and people of all genders, is clearly afundamental skill for emergency nurses!
Also highlighted earlier, emergency care services in the UK are often provided outside regular workinghours, and sometimes continually on a 24/7 basis. Statistics compiled by the National Health Service (NHS)suggest that the two busiest days in terms of A&E attendance are, interestingly, Mondays and Sundays.Most people attend A&E Departments during business hours, between 9am and 6pm; generally, the busiestattendance time is 11am, though ambulance arrivals at A&E Departments tend to peak at 3pm, and thequietest time is 5am. People tend to present to A&E Departments for different reasons at different timesacross the week; for example, presentations for injuries due to road traffic accidents are highest at 6pm onweekdays, and presentations for assault are highest during the early hours of Sundays. Regardless of theshift onto which an emergency nurse is rostered, they will encounter a diverse and challenging practiceenvironment.
Statistics compiled by the NHS suggests that around 13% of people who attend an A&E Department aredischarged without requiring any treatment, and another 35% receive advice and / or guidance only. However,this does not mean that these patients are attending A&E Departments unnecessarily, nor that they couldbe cared for in other settings. Indeed, there are a number of important reasons why people in the UK maypresent to A&E Departments for relatively minor complaints.
One key reason is the lack of general practitioner (GP) appointments available in the UK; indeed, the mostrecent UK GP Patient Survey suggests that 15% of patients requiring a GP appointment were unable to bookone, and around 4% of these patients presented to an A&E Department instead. Confusion about the UK'scomplex healthcare system, particularly in relation to the services providing out-of-hours care, may beanother reason that people present to A&E Departments for relatively minor complaints.
It is also important for nurses to be aware of the ever-changing context in which they practice. In the UK,there have been a number of recent, and relatively major, policy shifts in relation to the delivery ofemergency services. In particular, there has been a rapid expansion of nurse-led emergency services, such asminor injury units, which require emergency nurses to practice in a largely autonomous capacity. Theemergency nurse's role has expanded, and nurse practitioners are now often responsible for leading thetriage of patients in tertiary emergency care settings. The development of protocols relevant to theemergency care context - most notably, for the management of traumatic injury - have been implemented in anattempt to improve the efficiency and cost-effectiveness of the delivery of emergency care. If you practiceas an emergency nurse, it is important that you remain abreast of the changes in the specialty, and that youare aware of how these changes affect you, your patients and your practice.
Consent is the agreement of a patient to submit to proposed investigation or treatment.Although it is a fundamental requirement in all nursing settings, consent is a particularly importantconsideration in the emergency nursing context where the care provided is often fast-paced, and may progresswith little direct patient involvement. Consent may be provided in written, verbal or non-verbal form. Oncegiven, consent applies indefinitely; however, it may also be refused or withdrawn at any time, if a patientconsiders this in their best interest - even if this places their wellbeing at risk. In the emergencynursing context, seeking consent can be thought of as a 'process'; nurses should continually seek theconsent of patients to provide investigation and / or treatment, rather than during a single event. Forconsent to be valid, or legally sound, "it must be given voluntarily by an appropriately informed person whohas the capacity to consent to the intervention in question" (Department of Health, 2009: p. 9).
As an emergency nurse, you may frequently deal with patients who are unconscious. It is important,therefore, to make a note about consent in unconscious patients. If a patient is unconscious, it is assumedthat - in most situations - as a mentally competent person they would wish for all appropriate measures tosustain life and promote wellbeing to be taken by the professionals involved in their care. However, in somecases (particularly in patients who are palliated), advance decisions may be made to refuse life-sustainingmeasures, such as resuscitation; in these situations, the decision to refuse consent will be formallydocumented.
Duty of care is owed by a nurse to any person - and particularly patients - who maybe affected by their actions, advice or admissions. A breach of duty of care occurs when a nurse fails to dowhat a 'reasonable' person would do in a similar situation, or does what a 'reasonable' person would not do.The standard of care expected is that of a nurse with an average level of skills, knowledge and experience.To maintain your duty of care, you must practice within your scope. Essentially, this means youmust provide care consistent with your own skills, knowledge and experience, and not beyond what you havelearned in your training and become qualified to administer. It is important to highlight that nursesworking in emergency care settings come from a variety of professional backgrounds and, therefore, havediverse skills, knowledge and experience. Furthermore, an emergency nurse's scope of practice may beimpacted by factors such as the type of emergency care setting in which they practice (including the degreeof autonomy they are afforded), and the region in which they are located. A nurse may be found legallynegligent if they work outside their scope of practice, breach their duty of care, and cause damage to thepatient (e.g. injury or loss). To avoid breaching your duty of care and practicing negligently, youmust be familiar with, and work within, your own scope of practice at all times.
Restraint - that is, restricting a patient's movement, with the intention of protectingtheir own and / or others' safety - can be used in managing patients who are violent or aggressive, andparticularly those who are mentally ill, intoxicated or otherwise incapacitated. There are two types ofrestraint: (1) physical restraint, or the restriction of movement by physical or mechanical means, and (2)chemical restraint, usually via the administration of sedative medication. Although there is a movement awayfrom restraint in healthcare settings in the UK, it is essential that you are familiar with yourorganisation's policies and procedures for the appropriate use of restraint.
Maintaining the right of patients to privacy and confidentiality is arequirement in all general practice settings, but is particularly important for nurses working in busy andfast-paced emergency settings. It is crucial that nurses working in emergency care settings understand withwhom, and under what circumstances, they are permitted to share a patient's confidential information. Nursesmust also ensure they are familiar with their organisation's systems for the collection, recording andstorage of a patient's confidential information in the busy, fast-paced emergency care settings. 7025e2c3df
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