In the U.S, increased diagnoses of mental health issues and insufficient treatment places have resulted in many people turning to emergency departments for help. Unfortunately, this trend causes increased boarding times, ED overcrowding, and challenges for ED staff.
The increase in youth suffering from mental health issues is evident in a CDC survey. Emergency department visits for suspected suicide attempts by youth aged 12 to 17 increased by 39 percent from February through March 2021, compared with the same time in the same period in 2019.
On April 27, Sen. Shelley Moore Capito, R-W.V., introduced the Improving Mental Health Access from the Emergency Department Act (S. 1346). Supporting mental health treatment, decreasing boarding time, and addressing overcrowding are all priority issues for the Emergency Nurses Association. A similar bill is awaiting introduction in the House of Representatives.
“Many of the challenges facing emergency departments today can be directly linked to the need to improve care for behavioral health patients,” says ENA President Terry Foster, MSN, RN, CEN, CPEN, CCRN, TCRN, FAEN. “A lack of resources and treatment options often leaves individuals struggling with their mental health in the ED for extended periods, which leads to overcrowding and, frequently, acts of violence against health care workers.”
ENA President Terry Foster, MSN, RN, CEN, CPEN, CCRN, TCRN, FAEN
ENA research has shown the average ED stay for mental health patients is 18 hours compared to four hours for all other types of patients.
This proposed legislation would provide resources for EDs through a competitive grant program, allowing them to adopt more collaborative and connected care models to connect behavioral health patients with appropriate resources in their communities. It also aims to increase access to inpatient beds and alternative care settings, which will help alleviate boarding in emergency departments. Recognizing that all EDs are unique, this program would allow each ED to design solutions that will work best for them.
“The passage of this legislation could go a long way in reducing that wait time and providing a significant opportunity to establish a more collaborative approach to comprehensive mental health treatment options,” Foster says.
Nurses are lauded for their calm and focused manner when everything around them is erupting, but emergency nurses bring this laser focus to their jobs every day. Emergency Nurses Week (October 9-15) calls attention to this specialty as a career and to express gratitude for nurses working in emergency departments nationwide.
Emergency nursing is, by design, performed quickly and carefully to help patients who may be experiencing a life-threatening trauma or even those who visit the emergency department for a routine health issue. Nurses who work in this environment need rapid-fire assessment skills to help prioritize critical cases, particularly those where an obvious cause of the issue isn’t present. This particular work may not be something every nurse enjoys or thrives in, but for those who do, it’s particularly satisfying.
Emergency nurses work within a specialty, but that specialty encompasses nearly every possible area of nursing. Because anyone can come to the emergency department with virtually any symptom, and they depend on the medical team to treat even symptoms that are vague, emergency nurses have to know about many conditions, symptoms, medications, and injuries. They might, in a typical day, treat an infant or a 90-year-old, see multiple victims of a car crash or a worker who fell from a ladder, encounter someone with pregnancy complications or a person having an undetermined medication reaction. Emergency nurses frequently help patients who are in a psychiatric crisis as well. And many patients who come to the emergency department are stressed and agitated so emergency nurses must develop an approach toward patients that is both compassionate and in control.
If that sounds like an appealing challenge, then emergency nursing might be a terrific career path. After academic preparation, emergency nurses should gain myriad skills by working on different units. They should try to work with patients of all ages and with different health conditions to build a good foundation of skills from which to draw when needed in any given situation. Talk with emergency nurses to ask questions and look into the Emergency Nurses Association for resources about this field.
Gaining more experience will be a benefit–both because it helps nurses decide if this career path fits their interests and skills and because it will build the skills they need to help others. They will need to know how to treat catastrophic injuries or a heart attack one day and a person experiencing intense pain with no apparent cause the next, so an emergency nurse’s critical thinking skills must be sharp as they will need to triage patients constantly and in accordance with changing conditions.
After being in the field, gaining emergency nursing certification through the Board of Certification for Emergency Nursing will equip you with the additional knowledge needed to be a leader in emergency nursing. Although it is recommended that nurses who sit for the certification exam have two years of emergency nursing experience, it’s not a requirement; however, experience boosts your ability to pass and score well on the exam. And be sure to take the practice exams online as part of your study and preparation schedule as it will help you become familiar with the process and the types of questions.
And if you’re already an emergency nurse who is helping patients every day, thank you for all you do! Take some time this week to reflect on the people you help and the lives you have touched–and even how each of those people have touched your life as well.
As Emergency Nurses Week kicks off on October 11, emergency nurses around the world are reflecting on a year that has been like nothing many of them have ever seen. As the COVID-19 pandemic continues to surge in all corners of the world, emergency nurses continue to see influxes of patients that max out resources and energy. Despite the grinding stress and challenging work conditions, emergency nurses never waver in offering professional and compassionate care to their patients.
Sponsored by the Emergency Nurses Association, which marks its 50th anniversary in 2020, the week’s theme is Heart of Gold. The organization is dedicated to supporting emergency nurses and advancing this specialty. Particularly during this time, the ENA is focused on providing resources and COVID-19-specific information for nurses as well.
The emergency nurse’s specialty has been front and center in 2020, with stories and images from the frontlines of emergency treatment highlighting a powerful story of workers who continue to put their own lives at risk to save others. Nurses have supported each other throughout the months, traveling to high-impact areas as backup help is needed.
Round-the-clock shifts and the severity of illness nurses have seen this year have taken a physical and mental toll. And with a potential second surge looming over the winter months, nurses are stressed and trying to figure out how to manage boundaries between providing care and caring for themselves. This week is a good time to give them extra support and show them how much you appreciate their work and their commitment. If you’re an emergency nurse, being aware of your own response to the pandemic is important. When you’re in the middle of it, it all you can do to treat patients, but when you are able, paying attention to your sleep, nutrition, and mental health will be critical to being able to provide the best possible care.
If you’re a student nurse or even a veteran nurse who has been motivated to pursue this career path, there’s no question that your days will be varied and busy. Because they see patients of all ages, from all racial and ethnic backgrounds, from every socioeconomic standing, and with complex conditions, emergency nurses use all their skills and are learning new skills all the time.
If you are wondering if you’d make a good emergency nurse, there are a few things to consider. This career is especially suited for people who are able to focus in the middle of chaotic situations, who think quickly on their feet, and who rely on their evidence-based practices and instincts to work quickly and accurately.
Emergency nurses need certification and will want to continue with their education throughout their career. Because evidence-based practices change frequently and emergency nurses treat so many different cases, staying current on treatment of the conditions especially prevalent in your population is a good idea.
Help celebrate emergency nurses this week with #ENWeek and #HeartofGold in your social posts, writing to your legislators to support emergency workers, and offering a thank you for what they do.
As an emergency nurse, being empowered in your role and in your career can look different for each nurse. During Emergency Nurses Week (October 7-13) condsider some ways you feel “EmpowerED.”
1. Education
Some nurses want to learn more about particular conditions or situations they see routinely. A busy urban ED will see fairly different visits from an ED in a farming community. Learning how to best treat patients with the more common injuries and conditions can help your performance and care. Sometimes, it’s just being continually prepared for the things you never expect to see. If something is going to happen, it will happen in the ED and you won’t have notice. Learning how to stay agile and use your critical thinking skills in high-pressure situations is essential.
2. Teamwork
Other nurses might find working on teamwork skills is an important way to feel empowered in their careers and their daily roles. In an emergency department, teamwork truly is life-or-death. Teams that work seamlessly will have more potential for better results. They will also have more resources to lean on when they lose a patient or when injuries are overwhelming. Like any skill, teamwork takes practice, study, and repetition. If you feel your collaborative skills could use a boost, learning more will only make you a better nurse.
3. Leadership
For other emergency nurses, becoming empowered might mean taking on more leadership responsibilities and roles. As you become more familiar with the workings of your own department, you might find you have ideas to make the department work better and be more effective. Maybe you have already implemented some actions that have turned out with positive results. Becoming empowered for you might encompass making a difference in your department and which can have an immediate and long-lasting impact on patient care.
4. Advocacy
Emergency nurses aren’t always in the unit. They can become powerful and persistent advocates for nurses and patients. They can speak out on issues like nurse bullying, violence in the workplace, safety concerns, and push to make changes for the better. Emergency nurses can take action and connect with government officials. They can use their voices to let them know of issues that could improve patient outcomes like improved hygiene processes, more detailed paperwork processing, increased medication checks, or training new nurses on staff.
If you’re an emergency nurse, what makes you feel empowered?
Emergency Nurses Week kicks off today and offers a reflection of the lifesaving efforts and skill of emergency nurses who are called on to deal with catastrophic conditions, both natural and human-created, with little or no notice.
Karen Wiley MSN, RN, CEN, and president of the Emergency Nurses Association, says recent events highlight the unpredictability of the job and the exceptional need for emergency nurses.
“I am most proud of the way our nurses have come together in the past several weeks,” she says. “With the devastation from multiple hurricanes and the unconscionable event in Las Vegas, we have seen countless acts of sacrifice, selflessness, and dedication in emergency care from our nurses. I am proud of my colleagues every day, but the effort I have seen through these tragedies is truly remarkable.”
Wiley says emergency nursing is a complex role that involves treating the physical reasons for the visit, but also careful and expert communication with the team and the patient, families, and loved ones. “Most people do not realize the diversity of work emergency nurses must perform besides treating physical injuries,” she says. “Patients enter emergency departments struggling with addiction, mental health issues, as victims of sex trafficking, and, all too often, are violent themselves.”
If nurses are considering moving into emergency nursing or are wondering if the path would be right for them, Wiley says it helps to consider the range of what nurses encounter on a given day. “Thinking quickly on your feet is an essential skill for emergency nurses,” she says. “Situations change in a moment in the emergency department and nurses must react effectively.”
In the midst of an environment where many things are happening simultaneously, emergency nurses are still in charge of the patient’s comprehensive needs. “Emergency nurses must keep patient advocacy foremost at all times,” says Wiley. “The care, safety, support, and education of patients is our primary focus and dominant concern during a shift in an emergency department.”
Because they will take care of patients with many different conditions and situations, emergency nurses have to stay current on the latest medical information, so they have to be willing and able to constantly reeducate themselves about new developments, treatments, and methodologies. Emergency nurses continuously hone their craft, says Wiley, and that means being able to multitask effectively, efficiently, and accurately in a high-stress situation.
Emergency nursing is physically taxing, but it can also be an emotional challenge as well. Because of the very nature of an emergency room, patients don’t always survive despite the heroic efforts to save them. “Emergency nurses need to be prepared for the death of patients while not letting emotions affect their care,” says Wiley. Many hospitals have supports for their emergency room teams, especially after a trauma event, but the day-to-day exposure to death is something emergency nurses must cope with for their own job performance and their own mental health.
In addition to the challenges of treating so many physical and mental health issues, emergency nurses have to be able to quickly decipher and assess patients’ needs and conditions. “Choosing which patients need the most immediate care is challenging because the number of factors that need to be taken into consideration,” says Wiley.
For some nurses, the emergency room is where they perform best. And the ability to make such deep connections during that time is powerful. “Caring for patients who are in the most vulnerable state of their lives is an absolute privilege and an honor,” says Wiley. “The ability to comfort the patients and their loved ones when they need it most is humbling.”
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