How safe staffing can improve emergency nursing: time to cut the Gordian knot
evidence and practice    

How safe staffing can improve emergency nursing: time to cut the Gordian knot

Lisa Wolf Director, Institute for Emergency Nursing Research, Hadley, Massachusetts, United States

Why you should read this article
  • To understand how nursing presence can enhance emergency nurses’ job satisfaction, staff retention and patient outcomes

  • To recognise the combined effects of fatigue, workplace bullying, moral distress and inadequate staffing levels on nursing presence and staff retention

  • To understand the various factors to consider when making safe staffing decisions in the emergency department

The phrase ‘cut the Gordian knot’ describes a bold and direct solution to a complicated problem. Nursing presence has been defined as nurses’ ability to pay attention to patients and make them feel that their needs have been considered. In the emergency department (ED), nursing presence can be adversely affected by factors such as fatigue, workplace bullying, moral distress and inadequate staffing levels, which could lead to suboptimal patient outcomes and compromise the goals of nursing. Nursing presence is also important for nurses’ job satisfaction and therefore for staff retention.

This article explores the combined effects of fatigue, workplace bullying, moral distress and inadequate staffing levels on emergency nurses. To cut the Gordian knot it also provides recommendations for mitigating these issues in EDs through safe staffing decisions that consider patient acuity and skill mix.

Emergency Nurse. doi: 10.7748/en.2019.e1928

Peer review

This article has been subject to external double-blind peer review and has been checked for plagiarism using automated software

Correspondence

lisa.wolf@ena.org

Conflict of interest

None declared

Wolf L (2019) How safe staffing can improve emergency nursing: time to cut the Gordian knot. Emergency Nurse. doi: 10.7748/en.2019.e1928

Published online: 26 November 2019