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On the other hand, many patients presenting in to the emergency department may not have that serious a clinical situation. However, an emergency nurse should be equipped with knowledge, expertise, learning, and clinical skills to handle these alone at her level.
There are several varieties of patients that may attend emergency department seeking care. Of these certain categories of patients may need immediate nursing or physician care since they may be potentially life-threatening. These include airway compromise, cardiac arrest, severe hemodynamic shock or compromise, injury or cases of multiple trauma, or altered level of consciousness. Certain other cases are also emergent, but may wait for some time. These are patients sustaining head injuries, severe trauma, lethargy or agitation, conscious overdose, severe allergic reaction, chest pain, chemical exposure to the eyes, severe back pain, gastrointestinal bleeding with unstable vital signs, cerebrovascular accidents with deficits, severe asthma, abdominal pain, vomiting and diarrhea with dehydration, acute psychotic episodes, fever in children, severe headache, severe acute pain of any origin, neonatal diseases, or sexual assault (Fry, 2008). Nurses may encounter cases of head injury presenting in an alert state but with vomiting, mild to moderate asthma, moderate trauma, cases of abuse or neglect, GI bleeding with stable vital signs, and patients with history of seizure who are alert on presentation. Many other conditions are trivial, which can be really very efficiently treated by the emergency nurses, and these include alert head injury without vomiting, minor trauma, vomiting or diarrhea without dehydration, earache, minor allergic reactions, foreign body in the cornea, and chronic back pain. There may also be cases of sore throat, cases with minor symptoms, or chronic abdominal pain (Schriver et al., 2003).
Anticipated Nursing Role
To be able to deliver competent care, being a registered nurse, the emergency nurse must be able to assess, plan, implement, and evaluate nursing care alone or in collaboration with the emergency physician in order to achieve the goals of care and health outcomes in such patients. This must be either independent or interdependent care delivery within the framework of accountability and responsibility (Hageness et al., 2002. ANMC, 2004). Where possible, according to competency standards, the emergency nurse would also deliver education in order to promote and maintain health with a preventative approach. The nurse would demonstrate critical thinking and analytic abilities for care decision making and would demonstrate satisfactory knowledge base. She would be able to appraise her own knowledge and learning in order to engage in professional development through a pathway of evidence-based care (ANMC, 2004).
From this angle, an emergency nurse has certain roles while delivering care to a patient presenting into the emergency department. The initial action is assessment, and a systematic and methodical assessment process through primary and secondary surveys enable the nurse to identify and prioritize the needs of such patients.
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