Achieving recognition as a proficient nurse is not easy for nurses engaged in the emergency room of emergency care centers, and they only seem to become recognized as proficient nurses by overcoming various difficulties and adapting to their duties. We assume that these proficient nurses need a “motivating driving forces” that gives them the source of strength and energy to continue their work as nurses. This study aims to identify the motivating driving forces of proficient nurses in their nursing practice from narratives of their experiences in the emergency room of emergency care centers. A qualitative descriptive research design was employed, composed of semi-structured interviews conducted with six proficient nurses working in two participating emergency care centers. Transcribed interview data were categorized qualitatively and descriptively. The analysis yielded 214 codes, 25 subcategories, and the following five categories: ‘Pride in providing ideal emergency nursing’, ‘Confidence in one’s own practical skills cultivated through experience in a variety of field’, ‘Awareness of being a presence that promotes development in the field of emergency care’, ‘Support from others felt through interactions’, and ‘Self-acceptance of their development through effort in emergency nursing’. In order to maintain and strengthen the motivation of experienced nurses, it was suggested that it is necessary to clarify the knowledge, information, and learning methods they are looking for, hold study sessions and training that meet their needs, and provide support that allows them to build relationships in which they feel supported and trusted by others.

View full abstract

　The purpose of this study was to investigate the ethical issues related to the nursing practice of emergency nurses in the emergency department for elderly patients. Semi-structured interviews were conducted with 10 nurses working in the emergency department of an emergency center that provides primary to tertiary emergency medical care, and a qualitative descriptive analysis was conducted. The emergency nurses reported “nurses’ convenience” such as “giving priority to work and causing pain to the elderly”, “biased preconceptions about elderly patients” such as “evaluating the value of elderly patients life”, “unrepresentative elderly patients’ wishes”, such as “elderly family-first decision making”, “conflict with dignity of elderly patients to protect” such as “appropriately due to lack of manpower”. The participants experienced four categories of ethical problems in nursing practice with elderly patients. The reasons for the ethical issues were the included the uniqueness of the field of emergency medicine, nurses' biased preconceptions about elderly patients, and the nurses were not exercising their autonomy. Emergency nurses need to deepen their understanding of the elderly, be aware of the Code of Ethics for Emergency Nurses, have autonomy in their practice and provide opportunities to hold and discuss ethics conferences not only with emergency nurses but also with geriatric nurse specialists and certified dementia nurses.

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

Objective: To assess emergency nurses’ practices and perceptions of continuous support for patients with deliberate self-harm (DSH).

Methods: We surveyed nurses with at least three years of nursing experience in the emergency departments of secondary and tertiary emergency hospitals nationwide using a questionnaire to determine the frequency of providing “continuous support for patients with DSH”, awareness of continuous support, and recognition of the need for continuous support. The categories of continuous support for patients with DSH included [assessment], [physical and mental health care], [case management], and [family care]. Basic statistics were used for analysis, including multiple between-category comparisons. Group comparisons helped assess participation in DSH nursing education and the presence/absence of hospital-based arrangements. Correlation analysis explored the relationship between implementation frequency and recognition of the need for continuous support.

Results and Discussion: There were 245 valid responses (response rate=14.8％). Implementation frequency was the highest for [assessment] and lowest for [case management]. Awareness of continuous support and recognition of the need for continuous support were the highest for [case management]. Implementation frequency was significantly higher (p<0.01) in all categories for those who did (vs. did not) receive DSH nursing education, suggesting that education is important for continuous support. [Assessment] showed moderate correlation (r_s=0.36, p<0.01) between implementation frequency and recognition of the need for continuous support. This indicates that, while emergency nurses believe that patients with DSH need interventions that are sustainable over the long term, implementing such interventions is difficult.

View full abstract