The emergency nurse differs from the med-surg nurse in that he or she has had specialized education, training, experience, and expertise in assessing and identifying patents’ health care problems in crisis situations. In addition, 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 within a time limited , high pressured care environment.
Nursing interventions are accomplished independently, in consultation with or under the direction of the physician or nurse practitioner. Emergency nursing is demanding because of the diversity of conditions and situations that present unique challenges. These challenges include legal issues, occupational health and safety risks for ED staff, and the challenge of providing holistic care in the context of a fast paced, technology driven environment in which serious illness and death are encountered on a daily basis.
In the daily routine of the emergency department, triage is ued to sort patients into groups based on the severity of their health problems and the immediacy with which these problems must be treated. Emergent patients have the highest priority-their conditions are life threatening and they must be seen immediately. Urgent patients have serious health problems but not immediately life threatening ones; they must be seen within 1 hour. Nonurgent patients have episodic illnesses that can be addressed within 24 hours without increased morbidity.
The triage nurse must have advanced skill and experience. They must spend hours learning how to classify different illnesses and injuries to ensure that patients most in need of care do not needlessly wait. Collaborative protocols are developed and used by the triage nurse based on their level of experience. Nurses in the triage area collect crucial baseline data: full vital signs, pain assessment, history of the current and past medical history, neurologic assessment, weight, allergies, current medications, necessary diagnostic data, and ask specific questions that influence the care received in the ER.