The impact of overcrowding on registered nurses in the paediatric emergency department at a tertiary hospital

摘要

The purpose of this qualitative study was to explore and describe the extent towhich registered nurses’ practice was affected by emergency departmentovercrowding. Participants were recruited from a tertiary hospital by using thepurpose sampling method. Data collection was done using a semi-structuredinterview guide. Individual interviews were conducted with eight registered nursesworking in the paediatric emergency department. Data analysis was conductedusing thematic content analysis and Yin’s (2003:178) five-phase cycle. The studyfindings revealed that the lack of professional nurse leadership and the difficultexisting relationship with the physicians were obstacles that had to be obviated ifthe paediatric ED were to function optimally and best practice were to beachieved. It was revealed that a problematic issue in the setting was that themost critical decisions on allocating where patients should be treated were madeby physicians who have more authority than nurses. It was recommended thatthe ED need to be clearly defined in the policies as an outpatient, emergencycare or as an episodic patient care area as “Admission” can mean admission tothe ED or admission as an inpatient/boarded patient.