The Role of Registered Nurses in the Emergency Room - Essay Example

The Role of the RN in the ER (Emergency Room) Introduction Emergency Rooms (ER) are the most important places where the Registered Nurses (RN) is seen to take up more specialised and sophisticated roles and put forward their skills specific to their area of expertise. There are several roles an ER nurse needs to perform. It is a job that requires high amount of energy, enthusiasm, collaborations with the objective to save lives. In the ER each patient is exclusive and the information essential to measure each one of them can only improve with time and experience. Emergency nursing globally is undergoing rapid changes and is intensifying in relation to possibility and complexity of practice (Fry and Burr, 2001). Today the health care set ups are in a continuous phase of change that calls for better independence in decision-making and patient management (Beetson, 2004). The changes in RN roles especially in the ER are a result of increased public and political demands to set up higher benchmarks in the medical field (Gardner et al., 2007). Subsequently, emergency departments are focused to undertake initiatives to successfully meet government lay-down key performance standards and benchmarks that determine the performance of the healthcare units. Role of Registered Nurses In different parts of the world today the ER nurses have adapted their responsibility to incorporate tasks that were formerly undertaken by medical staff. For instance, suturing wounds, plastering fractures, and recording of electrocardiograms, X-raying of patients with potential fractures, and cannulation of patients are important tasks that ER nurses undertake (Neades, 1997). In recent years the educational qualification of an Emergency Nurse Practitioner in addition to sound nursing practice based on all aspects of nursing is an essential criterion. However, in general the requirement is formal post-basic education in holistic assessment, physical diagnosis, prescription of treatment and promotion of health. The Emergency Nurse Practitioner is a key member of the healthcare team directly available to members of the public (Neades, 1997). Hence in several health care set ups it is expected that the nurses must be an independent practitioner who is able to assess, diagnose, treat and discharge patients without reference to a doctor. Since this job comes with high responsibility, there are several guidelines provided by the government as well as the health care set up. Additionally, the nurses must be able to make independent referrals to other healthcare professionals (Neades, 1997). A variety of roles such as identification and management of minor injuries, preliminary scans, pain management, recommendation to other health professionals, and health promotion activities are the role of registered nurses. According to the Royal College of Nursing the role of registered nurses in ER include, several investigative tests (such as X-rays), preceding to the patient being seen by the specialist (Neades, 1997). It is a well known fact that the role of nurses is not restricted to the health care units but is also extended into the society. For instance, the health promotion aspects are also highlighted, signifying how their knowledge and skills can be further utilised to care for vulnerable groups in cases of emergencies. In order to reduce the over-crowding in the emergency rooms to some extend, the Nurse Practitioner may undertake advanced roles such as the assessment and treatment of injuries, as well as developing a health promotion and accident prevention role within the community (Neades, 1997). It is believed that the ER nurses may have a positive role in primary care delivery and reduce the work load of the doctors. Diverse needs and the function of NPs will vary between institutions and around the world. For example, registered nurses are qualified nurses with additional education at a graduate or masters level and successfully fulfilled a registration examination proving their ability in theoretical and practical knowledge. With the experience and educational background, these nurses possess highly developed knowledge and decision-making skills in health assessment, diagnosis and health care management and can be of great help in the emergency rooms. Nursing Practitioners have an extended scope of practice and present wide-ranging health services encompassing health support, prevention of diseases and injuries, restore to health, treatment and support services. They are also involved in activities such as communicating a diagnosis of disease or disorder to the patients and their relatives, ordering a diagnostic ultrasound, and prescribing a narrow range of drugs. Further, in some cases legislation also allows the registered nurses pronounce death. They also have the right to practice independently in the society without the use of medical directives (Drummond, 2003). These rules and regulations are undergoing several changes based on the public demand as well as the staff shortage. Doctors and registered Nursing Practitioners provide high quality care for patients with minor disease and injury and as a result there is a high level of patient contentment (Horrocks, et al. 2002). There are studies that point out that roughly about forty to fifty percent of cases that are brought to the emergency departments involve less critical cases that can be handled by the registered nurses and only if necessary referred to the doctors. As a result, it is possible to reduce the overcrowding as well as manage time in an appropriate manner. conclusion The highly developed evaluation skills of registered nurses may assist in the development the quality service in the emergency departments. For instance, these nurses may be useful for early triage and patient evaluation, in identifying elderly and serious patients, in performing sexual assault exams, in entrance screening, and also in the follow-up of examinations and treatment that the doctors have initiated in the emergency rooms. The registered nurses can utilize their experience in patient instruction, health promotion, injury prevention and patient advocacy that in turn may aid to reduce recidivism and help emergency departments to be more efficient (Drummond, 2003). The roles of registered nurses are not well defined and vary from institutions to institutions and from country to country. However, there are studies that point out that improved access to care, reduced waiting time, categorizing and redirecting the patients to other departments based on the seriousness help in trim down the number of patients who go without being seen by the doctors, avoid spontaneous revisit, increase patient satisfaction and also help in cost reduction. References Beetson R. (2004) Legalities associated with advanced emergency nursing practice. AENJ. 6(2): 28. Drummond, A.J. (2003) Nurse practitioners in the emergency department: a discussion paper. Editorials / Commentaries. CJEM 5(4):276-280. Fry, M. and Burr, G. (2001) Current triage practice and influences affecting clinical decision-making in emergency departments in NSW, Australia. Accid Emerg Nurs. 9: 227-234. Gardner, G., Chang, A and Duffield, C. (2007) Making nursing work: breaking through the role confusion of advanced practice nursing. J Adv Nurs. 57(4): 382-391. Horrocks, S., Anderson, E. and Salisbury, C. (2002) Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. BMJ 324:819-23. Neades, B.L. (1997) Expanding the role of the nurse in the Accident and Emergency department. Postgrad Med J 73: 17-22. Read More