An emergency care development for consideration worldwide

The aim of this 2018 research study was to determine why nurse-based Injury Units were developed in Ireland and how they function in the Irish healthcare system, including what they contribute in relation to addressing the healthcare needs of Irish citizens. A document review was completed and interviews of nurse practitioners and physicians working in Irish Emergency Rooms (ERs) and Injury Units, as well as nurse managers with responsibility for Injury Units and health service executives who helped design Injury Units. A new model of emergency care was needed 20 years ago when two issues were apparent. The first was concern over unsafe care in small ERs as a result of low patient volumes and staff not having ER expertise. The second issue was long waits for ER care. Considerable opportunity for change was present, including financial imperatives and nurse, physician, and political leaders who were together ready to design and move a new-to-Ireland ER services model and nurse practitioner education forward. The Injury Unit model is based on nurse practitioners providing a defined set of services to nonurgent patients in daytime hours. This model was pilot tested and is being implemented across Ireland after it was determined that quality services were being rapidly and safely provided. Nurse practitioner education was also initiated and is now in expansion mode to gain 700 more nurse practitioners by the year 2021 over the current 240.

Protecting emergency room nurses from burnout: The role of dispositional mindfulness, emotion regulation and empathy

Aim: To verify the role of dispositional mindfulness, difficulties in emotion regulation and empathy in explaining burnout levels of emergency room (ER) nurses.

Background: Many studies have examined the variables that can affect burnout amongst ER nurses, but little is known about factors that can protect ER nurses against work-related stress.

Method: A multi-centre cross-sectional design was used. Burnout level intensity, dispositional mindfulness facets, difficulties in emotion regulation and empathy dimensions were assessed using valid and reliable self-report questionnaires in a sample of ER nurses (N = 97) from three different hospitals.

Results: Higher dispositional mindfulness and cognitive empathy levels and lower difficulties in emotion regulation, were negatively associated with emotional exhaustion levels.

Conclusion: ER nurses with more mindful, emotion regulation and empathy skills are more able to manage work-related distress.

Implications for nursing management: Experiential interventions to promote mindfulness skills, emotion regulation variability and flexibility in a clinical context and the cognitive side of empathy are recommended for ER nurses to reduce professional distress, and to enhance personal and work satisfaction. Future research should assess the effectiveness of new multi-factorial interventions which combine the development of mindfulness, emotion regulation and empathy skills in ER nurses.

 

Sources:

Wilson DM, Devkota R. A study of nurse-based Injury Units in Ireland: An emergency care development for consideration worldwide. Int J Health Plann Manage. 2019 Jan;34(1):e72-e84. doi: 10.1002/hpm.2700. Epub 2018 Nov 8. PMID: 30408239.

Salvarani V, Rampoldi G, Ardenghi S, Bani M, Blasi P, Ausili D, Di Mauro S, Strepparava MG. Protecting emergency room nurses from burnout: The role of dispositional mindfulness, emotion regulation and empathy. J Nurs Manag. 2019 May;27(4):765-774. doi: 10.1111/jonm.12771. Epub 2019 Apr 9. PMID: 30887587.