An observational study of emergency department waiting room nurses in action

Abstract

Background: Emergency department (ED) waiting room nurses (WRNs) have been introduced in some EDs to improve patient care by providing treatment in the waiting room before seeing a doctor. Despite their potential benefits, research on the WRN role is limited, particularly regarding the tasks, skills, and challenges associated with it. This study aimed to identify the activities and actions of WRNs in emergency care settings.
Methods: A nonparticipant observational approach was used within a mixed-methods framework, combining qualitative and quantitative data. The study took place in two EDs equipped with WRN roles. Registered nurses in the WRN role were observed over several months, with both structured and unstructured observations conducted. Data were analyzed using descriptive statistics and thematic analysis.
Results: The study included eight nurses with varying experience in the WRN role. Common tasks included administering medications, performing interventions like IV cannulation and ECG recording, and conducting patient assessments. Thematic analysis identified four key themes: the impact of nurse experience on patient care, unpredictable workloads and patient needs, delivery of patient-centered care, and challenges related to delays and resource limitations.
Conclusion: The WRN role is dynamic and essential to ensuring patient safety and timely care in the ED. Experienced nurses, particularly those trained in triage, were more effective in fulfilling WRN duties, enhancing patient care through ongoing assessments and proactive interventions. However, delays in accessing medical officers and resource limitations hindered care delivery. Further research is needed to address these challenges and optimize the WRN role.