Term Paper: Exploring the Role of Emergency Room Nursing

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Emergency Room Nursing

Exploring the role of emergency room nursing

Introduction of emergency room nursing in Canada and the rationale for choice:

The emergency room nursing is governed under the aegis of Emergency Nursing Association -- ENA which is the national association for professional nurses committed to the development of emergency nursing practice. The ENA caters to its members through some of the objectives like (i) promoting excellence for emergency nursing, (ii) promoting quality emergency care (iii) acting as resource for emergency nursing practice, professionalism, education, research and consultation (iv) work closely with other health-associated organization in the direction of improvement of emergency care. The rationale for my choice of nurse as emergency nursing is because of the diversity of career choices it offers such as staff nurse, or manager in an emergency dept, an administrator, pre-hospital, flight, pediatric or trauma emergency nurse, an emergency clinical nurse specialist, nurse practitioner, student or educator. (Emergency Nurses Association, 2007)

2. Description of emergency room nursing, including roles and responsibilities, competencies and settings:

Emergency Nurses -EN has all along been at the vanguard of healthcare in delivering high quality care to the people in need. The present trend in EN is gravitating to an expanded advanced practice role in which extremely skilled nurses are assuming a leadership position in the emergency care environment providing quality care to all people. The role of the EN practitioner in the sphere of emergency care continues to grow and evolve. In the present competitive health care setting, nurse practitioners are taking upon more responsibility and a defining role in providing quality healthcare. For instance, a lot of expertise and methodologies which were once performed exclusively by doctors are presently being performed by nurse practitioners and since the year 1999, nurse practitioners in every state are able to prescribe drugs for patients which they treat. Being members of the healthcare team, nurse practitioners are delivering emergency care of settings from level 1 trauma facilities. With the EN establishing their presence, the advantages of their practice are being accorded recognition. (Cole; Ramirez; Luna-Gonzales, 1999)

Their benefits identified by Dowling and Dudley is as follows: (i) enhanced quality and patient care in a cost effective manner (ii) lowered malpractice costs and risks (iii) enhanced ED physician corporate profitability (iv) lowered actual contact time that the doctors must devote with non-urgent patients and (v) enhanced patient satisfaction. Nurse practitioners providing emergency care have carried out their functions under either an inherent scope of practice or the scope of practice for the field in which their education was received. For the regular progression of the nurse practitioner in emergency care, the normal evolution, fostered by professional and societal forces, is to elucidate the scope of practice for nurse practitioners in emergency care. The initial responsibility of the nurse practitioner in emergency care evolved from the requirement for healthcare providers to deliver care to a rising number of patients whose problems are not so urgent and who looked forward to healthcare in rural emergency setting. (Cole; Ramirez; Luna-Gonzales, 1999)

Since then, the essentiality has progressed to a situation for nurse practitioners who are able to deliver high quality and cost effective care to persons who look forward to healthcare for non-urgent, urgent, or emergent conditions in a variety of emergency care environment, inclusive of emergency departments. The settings under which the ENs function are providing healthcare to individuals, families, and communities in several environments that includes but not restricted to emergency departments or centers, urgent care clinics, and pre-hospital services. With the role of EN in emergency care continuing to evolve, novel practice settings will come forward. The practice environment for nurse practitioners in case of emergency care has the identical boundaries as those for emergency nursing in general. These boundaries comprise responsibilities, functions, roles, and skills which are associated to, and emanate from, the specific genre of emergency care knowledge. (Cole; Ramirez; Luna-Gonzales, 1999) lot of features which are uniquely applicable to emergency care typify the practice environment. These characteristics have been recognized in the Emergency Scope of Practice as: (i) evaluation, analysis, nursing diagnosis, planning, execution of interventions, result identification, and assessment of human responses of people across all age groups whose care is made intricate by the restricted access to previous medical history and the sporadic character of their healthcare (ii) triage and prioritization (iii) preparedness of emergency operations (iv) stabilization and resuscitation. (v) intervention of crisis for unique patient population like survivors of sexual battering. (vi) Delivering of care in uncontrolled and unpredictable settings (vii) consistency to the extent possible across the continuum of care. (Cole; Ramirez; Luna-Gonzales, 1999)

Within the emergency setting, the nurse practitioner delivers initial care for a broad variety of health problems. The delivery of this type of care is raged by the understanding that the patient might not possess the access to follow-up care; thus the treatment plans sometimes differ from that in other environments. As an advanced practice nurse, the nurse practitioner applies a judicious mix of both medical as well as nursing knowledge. Even though medical knowledge is applied to zero in on the diagnosis and recommend a medical intervention, like a medication, performing a procedure, like a minor operation of removing excess fluid from an abscess, the nurse practitioner includes these interventions into the agenda of nursing plan of care. (Cole; Ramirez; Luna-Gonzales, 1999)

3. Outline of educational requirements and experience for emergency room nursing in Canada:

Basic nursing education can be obtained in Canadian universities and diploma school of nursing offer a preparatory program that readies candidates to write the national examination and join the nursing practice. (Canadian Nurses Association, 2007) Besides, there are Graduate program which helps nurses to discharge their roles as leaders, researchers or educators. Some of them are involved in advanced and expanded or extended practice in nursing specialties. (Canadian Nurses Association, 1999)

4. Challenges within the role of emergency room nursing:

The challenges that emergency nurse practitioners face lies in adhering to the rules, regulations, and needs mandated by the state in which they are able to practice and as also those imposed by the credentialing body. While the standards of practice state the clinical practice of nurse practitioners in emergency care, they do not prescribe the management of patient conditions. Nurse practitioners must abide by the accepted practice guidelines for management of patient conditions. (Cole; Ramirez, 2001)

The other challenges include the nursing shortage. An aging population along a rapid growth and changes within the healthcare industry imply that the need of the hour is higher, more skilled nurses than compared to before. A latest U.S. Dept of Health and Human Services -- HHS study gives a projection that the demand for registered nurses will go up by 25% between 2000 and 2020. Nevertheless the number of people entering the profession has come down rapidly over the recent years. In the time span of 1990 and 2000, the population of the U.S. went up by 14% which the HHS reports that the number of nurses joining the workforce between 1992 and 1996 went up by 14% maintaining speed with the growth of the general population. Nevertheless the number of new nurses came down considerably in the years between 1996 and 2000 that outcome in workforce rise of just 4.1%. The aging of the present nursing workforce pose another challenge. According to a study reported in the Journal of the American Medical Association gives a prediction that by the year 2010, 40% of the nurses will approach the age of 50 or older. These nurses are supposed to start retiring in the space of the next 10 to 15 years similar to the baby boomer generation attains the age of 65, the time of life which produces the most often and most serous demands for healthcare. ("Challenges and Rewards," n. d.)

5. Examples and illustrations of role in current and future practice:

The practice arrangements differ in accordance with the rules of the state for advanced practice nursing. Every state controls the manner in which situations nurse practitioners might carry out their practice. Some needs that the nurse practitioners practice in a collaborated fashion with a physician whereas other states permit the nurse practitioners to run their independent practice. At the time when the involvement of a doctor is mandated for practice, the nurse practitioner normally adheres to agreed procedures or guidelines for the medical management of patient conditions. The practice arrangements might also differ if the nurse practitioner happens to be an employee of the hospital or a physician group. With either employer, the nurse practitioner in majority of the time has a contract that stipulates the arrangement for practice like such types of patients which might be cared, the area in which services will be provided like fast track, main emergency department, or both the types of patient conditions which the nurse practitioner is able to deal with as per the guidelines without the consultation of the physician; and the categories diagnostic or… [END OF PREVIEW]

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