Perspectives of Emergency Nurses With Overcrowding State in Taiwan

Friday, 28 July 2017

Chun-Chih Lin, PhD, RN
Department of Nursing, Chang Gung University of Science and Technology, Pu-tz city, ChiaYi county, Taiwan
Li-Chin Chen, MSN
Department of Nursing, Chang Gung Memorial Hospital, Taoyuan County, Taiwan
Chin-Yen Han, PhD
Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
Chiung-Jung (Jo) Wu, DrHlthSc, MN (ICU), BN
School of Nursing, Midwifery and Paramedicine | Faculty of Health Sciences, School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia

Purpose:  The purpose of this presentation is to provide an overview of emergency registered nurses’ perceptions and express their work identity within an overcrowded emergency department.

Methods:  A qualitative approach with symbolic interactionism was used to allow participants to express their own individual experience. Data collection was undertaken by semi-structured interviews was used to collect data between May and November, 2014 in a tertiary hospital in Taiwan. Purposeful sampling was performed and forty nurses were recruited as saturation of data reached. The interview data were analyzed by adopting grounded theory approach, including open, axial and selective coding. The credibility, transferability, dependability, and confirmability were carried out to ensure the trustworthiness throughout the data collection and analysis process.

Results:  Main themes of seeking and keeping within boundaries were identified supporting by perceptions of being an emergency nurse as working and continually enduring within a state of overcrowded environment. . The identified themes have been supported by three categories, including identifying herself, searching for possible solutions, and going on the situation. The first category was further supported by defining the role of emergency department, characterizing overcrowding and interacting work within an overcrowded environment. The second category was reinforced by searching for possible within multi-factorial emergency in overcrowding, nurses’ experience about their professional social behaviors. The last category was, going on the situation, illustrated by the consequences of nurses’ work and clients’ satisfactions, as well as leading to a psychosocial distress.

Conclusion: The findings fill a gap in knowledge about how emergency nurses working and searching for their work role within the overcrowded emergency state. The results informed that emergency nurses’ perceptions of working in an overcrowding situation. Consequently, three strategies are recommended to support emergency nurses facing the overcrowded state, including using a bed –transferring manager position, considering to modify current government health insurance policy; and decreasing the nurses-clients ratio .