Emergency nursing how it is different from ward nursing care

Nira Neupane M.Sc (Psychiatric Nursing ) (Rajiv Gandhi University)Bangalore,Ex Dy Matron UCMS Medical Colleges & Hospital Bhairawaha Nepal & Lecturer of Sanjeevani College of Medical Sciences Butwal Nepal.

Emergency Nursing is a nursing specialty concerned with the care of patients who are experiencing emergencies or who are critically ill or injured.

It deals with human responses to any trauma or sudden illness that requires immediate intervention to prevent imminent severe damage or death.

Care is provided in any setting to persons of all ages and sexes with actual or perceived alterations in physical or emotional health.

Emergency nurses must be ready to treat a wide variety of illnesses or injury situations, ranging from a sore throat to a heart attack. Uses triage to determine priorities based on assessment and anticipation of the patient’s needs.

In contrast to ward nursing care, in which a patient arrives with a diagnosis applied by a physician, Routine care (eg, hair wash, back care, body bath, timely medication, collection of investigation report etc.) must be provided to the patient as per the individualized need; where patient are admitted from Outpatient department and Emergency room. In ward long term care (since admission to discharge) needs based care is provided where as in emergency short term (symptomatic) care is required. In ward; teaching are provided regarding home based and continuity care and also patient are encouraged to follow up visit as per doctor advice and if any complications arises must visit the doctor as soon as possible as well as emphasize is given on side effects of the drugs and relapsing sign and symptoms and further complications. During the time of discharge referral service can also be provided in the rehabilitative centre as the need of the patients. In ward the aim of nursing is to provide a high standard of medical and nursing care in a comfortable and friendly environment, in which patients and their family members are encouraged to contribute to planning their care. The patient should retain his or her individuality and should be cared for physically, socially, psychologically, spiritually and culturally, whilst maintaining dignity, privacy and confidentiality. Care will be planned and undertaken jointly by doctors, nurses, the multidisciplinary team, and family when appropriate.

But in emergency; Emergency nurses work with patients when a diagnosis has not yet been made and the cause of the problem is not known. Emergency nurses frequently contact patients in the emergency department before the patients see physicians. In this situation, the nurses perform skilled rapidly, tactfully and accurately does physical examination, early recognition of life-threatening illness or injury, the use of advanced equipment and monitoring system and in some cases, the ordering of testing and medication according to "advance treatment guidelines" or "standing orders" set out by the hospital's emergency physician staff. Emergency nurses most frequently are employed in hospital emergency departments, though they may also work in free-standing emergency centers or urgent care clinics.

Emergency Nursing is a specialty in which nurses care for patients in the emergency or critical phase of their illness or injury and are adapt at discerning life-threatening problems, prioritizing the urgency of care, rapidly and effectively carrying out resuscitative measures and other treatment, acting with a high degree of autonomy and ability to initiate needed measures without outside direction, educating the patient and his family with the information and emotional support needed to preserve themselves as they cope with a new reality. These activities may be carried out in a variety of settings and not necessarily in an "Emergency Room."

An Emergency Nurse is characterized by high degrees of knowledge and skills, with diagnostic and decision-making power to effectuate urgently needed activities in autonomous fashion or in the closely-collaborative team approach with other health professionals. Typically, an Emergency Nurse is capable of providing a broad spectrum of skills that in other settings would be delegated to other health care workers. Without disregarding the critical activities, Emergency Nurses commonly triage and treat more urgent problems, providing care and treatment of those injuries or illnesses, and providing the educational and psychosocial evaluations and support to return the patient successfully to his milieu.

The Emergency Nurse typically works with patients who are not yet diagnosed, may have new problems not previously perceived, is not yet accustomed to the institutional environment, is still struggling to deal with a new reality of illness or injury, who may have an element of uncertainty to their problem, and who may have intoxicants or other behavioral barriers to effective diagnosis or treatment. The Emergency Nurse is at "the front line" of the hospital's contact with the community. The environment and patient situations are dynamic. There is some risk of personal harm from situations that are not yet completely controlled. The Emergency Nurse may need to assess and provide guidance for patients who call for "advice" or who have not yet arrived in the Emergency Department. The Emergency Nurse must also be sensitive and skilled in discerning the patient's educational needs to understand and care for the problem and be a successful and supportive teacher under less-than-ideal conditions. Likewise, the Emergency Nurse must be similarly talented with psychosocial problems and be knowledgeable of available community resources and able to implement them.

In conclusion, ward nurse focus on holistic care whereas emergency nurse focus on firstly primary care later on provide holistic care as well.