Expanding the emergency nurse role to meet demand: nurse and physician perspectives
evidence and practice    

Expanding the emergency nurse role to meet demand: nurse and physician perspectives

Michelle Cameron Professional Teaching Fellow, Faculty of Medical and Health Sciences, The University of Auckland, Peter Rothwell Academic Centre, Waikato Hospital, Hamilton, New Zealand
Victoria Shaw Professional Teaching Fellow, Faculty of Medical and Health Sciences, The University of Auckland, Hamilton, New Zealand; Matthew Parsons, professor, Waikato District Health Board, University of Waikato, Hamilton, New Zealand

Why you should read this article:
  • To understand how upskilling emergency department (ED) staff could assist in addressing workload challenges

  • To learn the views of nurses and physicians on transferring skills from doctors to nurses, and from nurses to healthcare assistants

  • To recognise the barriers to expanding the nurse’s role in the ED

Background Emergency departments (EDs) in New Zealand are experiencing growing demand because of rising attendances, and this is having a negative effect on patients, staff and organisations. The expansion of traditional nursing roles is one solution that has been explored internationally to ameliorate the adverse effects of increasing patient attendances.

Aim To explore the attitudes of registered nurses and physicians employed in emergency medicine towards an expanded role for registered nurses in the ED setting.

Method A mixed-methods approach was adopted, in which data were collected in two phases, using interviews and questionnaires. Semi-structured, face-to-face interviews were held with clinical and non-clinical staff employed in emergency medicine, and questionnaires were distributed to 140 physicians and nurses employed in one ED. The data were analysed to identify themes and to determine the differences between nurse and physician respondents.

Findings Ten ED staff were interviewed, including non-clinical managers (n=4), physicians (n=2) and nurses (n=4). Analysis of the interviews identified five themes: driving change; expanded nurse role; optimal environment; facilitating change; and optimising outcomes for patients. A total of 70 questionnaires were returned, with 63 from nurses and seven from physicians. Nurse respondents were more supportive than their physician colleagues of the need to expand the nursing role in the ED.

Conclusion The existing New Zealand nursing scope of practice has the capacity to develop roles, with nurses supporting this change more than physicians. If role expansion is undertaken, serious consideration needs to be given to developing clear professional boundaries to maintain patient safety and department flow.

Emergency Nurse. doi: 10.7748/en.2020.e2031

Peer review

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

Correspondence

michelle.cameron@auckland.ac.nz

Conflict of interest

None declared

Cameron M, Shaw V, Parsons M (2020) Expanding the emergency nurse role to meet demand: nurse and physician perspectives. Emergency Nurse. doi: 10.7748/en.2020.e2031

Published online: 01 September 2020

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