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Introduction to Emergency Nursing Practice

Emergency nursing practice deals with patients who are suffering from trauma, damage, or severe medical issues that requiring immediate treatment are treated by ER nurses. These professionals must be able to swiftly identify the best strategy to stabilize patients and reduce pain because they work in emergency circumstances.

What is the difference between emergency and urgency?

The emergency is characterized by being everything that implies an imminent risk of death, which must be diagnosed and treated in the first moments after the finding. In this case, the person needs immediate medical assistance.

Already urgency can also be understood as a clinical or surgical situation, only without risk of imminent death.

However, if left untreated, it can progress to more serious complications, requiring, as well as the emergency, referral to the hospital shift.

Examples of emergencies are: deep cuts, electrical accidents, stings or bites from a venomous animal, burns, drowning, myocardial infarction, among others.

Urgent cases are: fractures, dislocations, sprains, fever greater than 38 degrees for at least 48 hours, which improves with antipyretics, but does not subside.

INFORMATION IN GENERAL

• Emergency nursing is responsible for human responses to any sort of trauma or unexpected disease that necessitates quick attention to avoid death or serious injury.
• Persons of all ages with real or perceived changes in emotional or physical health are cared for in any situation.
• Patients may not have had a clinical condition at first.
• When patients return frequently, it is episodic; it is primary when it is the first option for health or preventive care; and it is acute when patients require immediate and extra interventions.
• Emergency nursing is a unique speciality within the nursing profession.
• From a sore throat to a heart attack, emergency nurses must be prepared to manage a wide range of illnesses and injuries.

 EMERGENCY NURSING PRACTICE HISTORICAL DEVELOPMENT HISTORICAL DEVELOPMENT OF EMERGENCY NURSING

• During the Crimean War in 1854, Florence Nightingale was the first emergency nurse, caring for the wounded.
• In 1970, the Emergency Department Nurses Association (EDNA) was founded.
• Certification in Emergency Nursing is awarded by a competency-based test that was first administered in 1980 and is valid for four years.
• In 1983, EDNA established Standards of Emergency Nursing Practice as a guideline for excellence and outcome criteria against which performance is monitored and evaluated.
• The name of the organization was changed to Emergency Nurses Association (ENA) in 1985, to reflect the fact that emergency nursing is a role-specific rather than a site-specific profession.
• ENA began as a teaching and networking group, but it has now grown to become an expert, advocate, lobbyist, and voice for emergency nursing. It now has over 30,000 members and is still growing.

CONCEPT OF EMERGENCY NURSING

• The term “emergency” refers to patients who require immediate attention to avoid further deterioration or to stabilize their condition until resources are available near them.
• “A condition determined clinically or considered by the patient or his/her relatives as requiring urgent medical care, failure of which could result in loss of life or limb,” according to the definition.-WHO
• A medical emergency occurs when a patient requires immediate and high-quality medical care to avoid loss of life or limb, and/or to take action to return to a normal, healthy lifestyle.
• Emergency care is described as episodic and crisis-oriented care given to patients with injuries or diseases ranging from minor to critical or life-threatening. Emergency management has evolved to incorporate the premise that an emergency is whatever the patient or family deems it to be.
• Emergency nursing is a subset of professional nursing that focuses on the care of patients with medical crises, or those who require immediate medical attention in order to avert long-term injury or death.

PRINCIPLES OF EMERGENCY NURSING

Principles of Emergency Nursing includes –

 1. Guiding principles for emergency care 

• Make a quick assessment of the casualty and the circumstances in order to put life-saving measures in place.
• Place the patient in a dorsal position and cover his or her body with any available fabric to minimize heat loss.
• Handling should be limited to removing the person from further risk.
• Treat the wounded area using first aid.
• Observed the casualty’s initial state and kept a medical record of it until he arrived at the hospital.
• Assure the victim and his or her family that he or she is in good hands.
• Keep others away from the victim and enable fresh air to circulate around him or her.
• Do not give individuals with abdominal injuries water to drink because they may require rapid surgery.
• Arrange for safe transportation to the hospital following first aid.
• In a few emergency situations, such as unconsciousness or excessive bleeding, uncontrollable bleeding, respiratory issues, and other emergencies necessitate coordinated efforts for rapid transfer to medical institutions, as well as lifesaving necessary care.

 2. Principles of emergency management 

• Maintain a patent airway and give enough breathing, using resuscitation techniques as needed.
• Control hemorrhage and its consequences
• Evaluate and restore cardiac output
• Prevent and treat shock, preserve or restore effective circulation using resuscitation methods where necessary
• Perform a rapid initial and continuing physical examination of the patient to determine whether or not the patient is awake, whether or not the patient can obey directions, and the size and reactivity of the patient’s pupils.
• If necessary, start ECG monitoring
• Splint suspected fracture sites, including cervical spines, in patients with head trauma
• Begin a flow sheet of the patient’s vital signs and neurological state to aid in decision-making.

SCOPE AND PRACTICE OF EMERGENCY NURSING PRACTICE

• In a time-limited, high-pressured care environment, the emergency nurse establishes priorities, monitors and continuously assesses acutely ill and injured patients, supports and attends to families, supervises allied health personnel, and teaches patients and families. Interdependent nursing interventions are carried out in consultation with or under the supervision of a competent physician.
• Based on the assessment results, appropriate nursing and medical actions are expected.
• Members of the emergency health care team work together to conduct the highly technical, hands-on skills needed to care for patients in an emergency.

 EMERGENCY NURSES

• Non­emergent populations with non­life threatening concerns are also dealt with by emergency nurses. The ages of patients that appear to the Emergency Department range from newborns to the elderly.
• Emergency Nurse Qualities • Nurses who work in emergency or trauma units must possess particular abilities in dealing with emergencies. Some of these abilities include:
• Ability to observe and assess
• Ability to make quick decision
• Ability to care for patients in an emergency.
• Emotional balance
• Self-assurance, as well as the capacity to lead and control patients and attendants.
• Ability to record and report information.

Roles of the Emergency Nursing Practice

• Care provider: gives the patient and family with complete direct care.
• Educator: Educates the patient and family based on their learning needs and the severity of the condition, allowing the patient to take on more responsibility for meeting health care demands.
• Manager: plans and directs the work of others in the multidisciplinary team in order to achieve the specific aim of providing emergency treatment.
• Advocate: guarantees that the patient’s rights are protected.

 Functions of the Emergency Nurse

• Determines priorities using triage based on examination and anticipation of the patient’s needs.
• Provides direct resuscitation measures if necessary • Provides preliminary treatment before the patient is transferred to the primary care area • Educates the patient and family on health issues
• Provides support and safety for the patient and family by supervising patient care and ancillary employees.

Qualifications of An Emergency Nurse

• An emergency nurse is a registered nurse who has received additional training and experience in the care of emergency patients.
• Emergency nurses keep up with the latest trends, concerns, and practices in medicine by continuing their education.
• Many people take a specific test to demonstrate their degree of expertise. They are certified in emergency nursing after passing this exam.
•  Some emergency nurses also have a bachelor’s degree in nursing.

What are the steps to becoming an emergency nurse?

The first stage is straightforward: you must get an Associate’s Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN) to become a registered nurse (RN) (BSN). Both paths lead to a job as an RN, but you must decide if an ADN or a BSN is ideal for your goals. After earning your nursing degree, you must pass the National Council Licensure Examination (NCLEX-RN) to work as a registered nurse. You can start working toward a specialty in emergency nursing after becoming a fully certified RN. It will be crucial to gain experience in emergency medical circumstances. Work as a floating nurse at your hospital’s emergency room or as a paramedic’s assistant. You can also apply for a certification from the Board of Certification for Emergency Nursing after gaining a minimum of two years of related emergency experience (BCEN). This certification isn’t essential to work as an emergency nurse, but it may give you an advantage over other applicants.