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In 2021, I took up a post as a trainee advanced nurse practitioner (ANP) in primary and urgent care with the Scottish Ambulance Service. My nursing background is in cardiac and intensive care and I have a master’s degree in advancing practice. I have always been interested in pre-hospital care, so when I saw the post advertised – a band 7 role under Scotland’s Agenda for Change – I applied and was successful. [ABSTRACT FROM AUTHOR]

Claire Poustie explains how emergency nurses in urgent treatment centres can provide evidence-based care to manage this common shoulder injury. [ABSTRACT FROM AUTHOR]

The Department of Health's four-hour operational standard for waiting times in emergency departments (EDs) was introduced in 2001 to speed up treatment and improve the patient experience. Studies and media reports have shown, however, that the standard has increased pressure on ED staff, particularly nurses. This article refers to an analysis of the literature in an attempt to determine whether the implementation of the standard has been beneficial or detrimental to nurses' work, and offers advice to help nurses meet it with minimum stress. [ABSTRACT FROM AUTHOR]

The emergency department (ED) education team at the Queen's Medical Centre, Nottingham, has developed a process to promote effective teamwork in major trauma management. To introduce this process to ED staff, the team developed a multiprofessional education and training programme. This article describes the development process, explains how and why it was undertaken, and provides details of the education and training programme. It also highlights the challenges met by the education team during implementation. [ABSTRACT FROM AUTHOR]

The article focuses on a study which explored the aspects of emergency care that are relevant to older people. The study included 20 patients aged 66 to 94 years who were interviewed and were grouped based on attentiveness, staff competence, communication, waiting times and overall care needs. Study findings emphasize the need for healthcare professionals to focus on providing fast and effective diagnoses and treatments for older patients.

The article discusses the results of an opinion survey of emergency department healthcare staff in Great Britain who treat patients who self-harm. In the survey by the Royal College of Psychiatrists (RCP), ED staff consistently reported that their training and education in the treatment of patients with mental health needs including those who self-harm was inadequate. In highlighting the complexity of working with people who self-harm, psychotherapist Jack Nathan suggested that they should be treated with the same care as any patient.

The article shows how the number of reported incidents of abuse towards emergency care staff increased since the introduction of a data recording tool in Great Britain. Violence against health care personnel, particularly in the emergency departments (ED), is an increasing concern to National Health Service (NHS) trusts. However, only few nurses are found to report incidents of violence in hospitals. According to the author, the installation of a data recording tool in ED revealed the prevalence of violence against emergency care staff.

In this article, the author examines the management of chemical eye injuries by emergency nurses. According to the author, initial management of potentially devastating chemical eye injuries by emergency nurses can affect patients' future prognosis as much as subsequent ophthalmic treatment. She notes that prognosis varies and depends on the extent and nature of exposure. She claims that in the most severe cases, chemical exposure can lead to complete loss of vision or of the eye itself.

In this article, the authors offer an insight into their experiences in providing emergency care in Antarctic. The authors recall their flight to Patriot Hills, a tented camp. They describe the limited source of heat at the camp, as well as the weather condition. The authors note that the conditions offer particular challenges for healthcare professionals providing care for staff and clients. They find that trauma and environmental problems are the issues that are encountered most often in Antarctica.

The article focuses on the challenges presented by major floods to emergency nurses in Hull, England. Among the crowd who went to the city hall for treatment include older people with long term conditions. Emergency care practitioners (ECPs) volunteered on their days off and enabled healthcare services to provide the nursing care that was needed. Carl Gardiner, an ECP, notes that nurses should have access to patient record through hand held computer technology to know which medications people were taking.

The article focuses on several case studies which discuss the issues that practitioners working in emergency care must consider when treating wounds in patients who self-harm. Suggested reasons why people self-harm include self-distraction and feeling of hopelessness or desperation. It cites the two main groups of wound, namely, acute, which is uncomplicated and chronic wounds described as those with delayed healing. Wound closure methods based on research include the use of sutures, glue and adhesive tapes.

The article describes the case of a 63-year-old male patient who complains of severe abdominal pain, nausea, vomiting and dizziness. On examination, he was tachycardic with a pulse of 120, a respiratory rate of 36 and a blood pressure of 90/30. The symptoms indicated abdominal aortic aneurysm. The patient asked for his wife to accompany emergency nurses in the ambulance. He died a few days after his surgery, but his wife expressed appreciation for what the team had done.

The article discusses the management and treatment of pretibial lacerations in the emergency department. Pretibial lacerations are most commonly caused by trauma to the anterior aspect of the tibia as a result of falls or blunt injury. Successful management and healing of any pretibial injury relies on accurate wound assessment. In treating pretibial lacerations, nurses must first rule out any threat to the patient's life or limb as a result of injury. Then, wounds should be cleaned and temporarily closed.

The article discusses the impact of human factors on the provision of emergency care and the application of team resource management to staff in emergency care departments. An increase in the number of attendance in emergency departments creates a challenging working environment and affects staff retention and morale. Negative human interactions affect the performance of teams in the departments. Team resource management is important to emergency medical personnel.

Discusses the assessment and management of Weber A ankle fractures in accident & emergency departments. Role of emergency nursing staff in assessing and managing patients with ankle fractures; Importance of understanding the anatomy and mechanics of the ankle in managing fractures; Determination of the position of the foot at the time of the injury to locate the damage.

Discusses ways of improving assessment of pain in older people. Barriers to effective pain assessment and management; Role of emergency department nurses in addressing problems with pain assessment; Attitudes of nurses toward older people; Importance of communication and listening skills in nursing care.

Presents information on a study that investigated the ways in which ambulance personnel act and feel at a disaster site. Stages involved in the evacuation of teenagers in the disaster site; Methodology of the study; Results and discussion on the study.

Emergency nurses are ideally placed to advise people who self harm on how to minimise risks, says service user Louise Pembroke. [ABSTRACT FROM AUTHOR]

The article examines a specialist training package for accident and emergency (A&E) clinicians launched by the Great Britain government and run by The Haven. This can be used to help train staff in using early evidence kits (EEKs), which are vital to protect forensic evidence, and to teach best care for people who have been sexually assaulted. The aims of the training package are given.

Bob McMaster and Roisin Gent propose the early use of assessment teams to manage patients' journeys through A&E. [ABSTRACT FROM AUTHOR]

This month, Nick Castle received the Nursing Standard Robert Tiffany international award for his work on shared learning and research. Here he describes his work. [ABSTRACT FROM AUTHOR]

Describes how the effectiveness of minor injury management was evaluated by emergency nurse practitioners (ENP) at South Glasglow University Hospitals NHS Trust in Scotland. Definition of ENP, according to the Nursing and Midwifery Council; Popular way of evaluating nursing practice; Questionnaires used in the evaluation; Key findings from the study.

Describes the role of the Admissions & Emergency (A&E) extended scope physiotherapy practitioners program launched by the British National Health Institute. Reason for the emergence of the practitioners; Significance of physiotherapy practitioners working in extended roles to the A&E experience of patients; Findings of a study by Jibuike et al in 2003 on the efficiency of physiotherapy practitioners; Details of the pilot scheme undertaken in Epsom General Hospital in 2003 to assess the impact of providing a senior physiotherapist in the A&E Department with the remit to treat patients with musculo-skeletal injuries.

Describes a shared learning program for emergency nurses and paramedics which meets the challenge of emergency care through interprofessional education. Efforts to address the challenges in emergency healthcare services; Difference between the roles of emergency nurses and paramedics; Elements underlying the program; Approach taken by the program on the assessment of clinical skills.

The article discusses the repercussions from a Healthcare Commission report on emergency care at Mid Staffordshire National Health Services Foundation Trust. After the report was release, hospital personnel experienced a combination of abuse and support from patients and their families. The improvements the hospital has made to correct the problems including adding health care staff, a triage system, and refurbishing the department.

The author explains how interpretation by telephone is essential for emergency care staff in cities such as London, England where many languages are spoken. He provides information on the partnership between London Ambulance Service (LAS) and Language Line Services (LLS). He notes that a telephone interpretation is the most economical and time efficient for emergency care organizations such as LAS. The ideal way to conduct three-way telephone interpreting in accidents and emergencies (A&E) is through dual handset telephones.

The author emphasizes the need for emergency nurses to stand their ground when it comes to ensuring that they act in their patients' best interests. The author cited her and other nurses' experience on the lack of central lines in ward areas. She argued that nurses should insist on central line insertion and avoid administering inotropes peripherally. She added that nurses must stand their ground in maintaining standards of care and they must refuse to administer drugs via incorrect routes.

The article offers information on a series of recommendations to emergency medical personnel published by British Health Minister Andy Burnham. According to him, emergency care staff should have more clearly defined powers to refer on patients at triage from accident & emergency. His report is entitled "Days Out in the NHS: Listening to Staff."

Discusses the Agenda for Change initiative and its significance to emergency nurses in Great Britain. Difference of job evaluation from clinical grading; Status of emergency nurses in the system; Consequences of an unmatched job.

Presents an article on a role change from being a senior staff nurse in the emergency department of the University Hospitals Coventry and Warwiskshire NHS Trust to nurse adviser at the Coventry NHS Walk-in Centre. Fears of walk-in center staffs about their profession; Purpose of the role shift; Opportunities and medical skills provided by the role change.

Edward Owen reports on how Spanish emergency services coped with the Madrid bombings last month. [ABSTRACT FROM AUTHOR]

Presents information on the importance of disaster simulated exercises for emergency medical staff in Great Britain. Involvement of the University of Ulster and healthcare trusts in Northern Ireland in developing a disaster management plan; Aims of the disaster simulated exercises; Benefits of the exercises for emergency care personnel.

Alison Young lays out some of the problems faced by emergency departments in developing the role of emergency department assistants. [ABSTRACT FROM AUTHOR]

Focuses on the modernization plans for delivering emergency care and its effect on the quality of care given to patients in Great Britain. Response of the public and health service staff to the consultation on the introduction of modernization plans; Improvement in the waiting time targets; Benefits of the waiting time targets on emergency care to patients and emergency nurses.

The author examines the issue of dealing with the trauma of death and its implication to ambulance and emergency department staff. She suggests that participants in the Royal College of Nursing congress in 2010 should discuss the finding of the British government that most people would prefer to die at home. From a nursing student perspective, she contends that the topic of dying should be included in school curricula.

A letter to the editor is presented in response to an editorial about the role of ambulance crews in referring suspected stroke patients to general practitioners (GPs) that was published in a previous issue.

The article covers issues of interest to emergency nurses in Great Britain as of November 2009. A toolkit that would help healthcare commissioners and providers improve urgent and emergency services by better understanding why demand for these services is increasing was published by the Department of Health (DH). The Water Accident Injury Database developed by members of the National Water Safety Forum including the Royal Society for the Prevention of Accidents (RoSPA) will be launched at the National Water Safety Congress of RoSPA on November 9.

The article reports on the swine influenza vaccine given to front line medical personnel as part of a mass immunisation programme in Great Britain in October 2009. The first front line staff to receive the vaccine include emergency department matron Amanda Webb. The vaccine will first be given to front line staff and to patients belonging to high-risk categories. A revised swine influenza clinical package, which consists of tools to be used in extreme and exceptional circumstances in the event of pandemics has been released by the Department of Health.

The article reports on the disciplinary action faced by emergency care staff who allegedly played the so-called lying down game at Great Western Hospital in Wiltshire, England. It is reported that seven of the 18 staff who took part remain suspended while the hospital management is investigating the allegations. Information on how to play the game is also provided.

The article reports on the move by the South Wales Police to conduct a reinvestigation on 10 cases of violence against emergency medical personnel and other nurses at the Cardiff and Vale National Health Service (NHS) Trust. Such decision for a reinvestigation came after staff complained that they were not given justice. The police has assured the Royal College of Nursing (RCN) Wales during a meeting that the cases will be examined again. It adds that during the meeting, emergency nurses contend that no follow up work was done on their cases.

The article focuses on the set of minimum requirements for the treatment of patients with less serious diseases or injuries released by the College of Emergency Medicine (CEM), Faculty of Emergency Nursing and the Emergency Nurse Consultation Association in Great Britain. It notes that the requirements have been designed to ensure that safe, quality, appropriate and cost-efficient patient care is provided by unscheduled care facilities (UCFs). The required staffing arrangement involves two health practitioners (HPs) per shift.

The article focuses on a report published by the National Chemotherapy Advisory Group (NCAG) which stresses the need to grant emergency department staff in England access to the skills and expertise of acute oncology service staff. The report notes that emergency personnel will be able to ensure that patients in emergency care who have not been diagnosed with cancer or are having side effects from chemotherapy will receive the appropriate treatment once they have been granted such access.

The author reflects on the career offered to nurses in the field of emergency medicine in Great Britain. She recalls some of her experiences as a registered clinical nurse. She argues that the pressure associated with clinical practice can put patients and nurses in an endangered position. The author reveals that as a university lecturer she tries to encourage her students about an exciting career in emergency care despite its many challenges.

The article warns that the Great Britain National Health Service (NHS) may lose many of its emergency staff if ministers force them to report incidents of knife crime, according to delegates at the 2008 Royal College of Nursing (RCN) Emergency Care Association conference. It discusses the statements of Eleri Wyn Williams of the Powys Local Health Board and Mike Hayward, head of patient safety at Mayday Healthcare NHS Trust.

This article reports that emergency care workers at Warrington Hospital in Cheshire, England took part in a response training exercise called Golden Knight in September 2008. The mock exercise involves more than 100 fire, police, ambulance, primary care and hospital staff and up to 80 volunteers. It was designed to test how local emergency services would work together to respond to a major incident.

The article reports that the British government has categorised emergency nurses and ambulance staff as professionals who need extra training to treat and support patients with life-limiting illnesses. The categorisations appear in the government's End of Life Care Strategy, which details how services for patients with life-limiting illnesses must be improved. Brian Dolan, a nurse and independent consultant in emergency care, has welcomed the strategy's emphasis on alternatives to emergency department (ED) admissions.

The article highlights the findings of an opinion poll, commissioned by the BBC, concerning the confidence of the public in emergency care staff in Great Britain. The poll included over 1,000 adults across the country. 94 percent of the respondents said that they are confident that the National Health Service (NHS) would provide good care in an emergency. Results showed that the public has confidence in emergency care staff.

This article reports that attacks on emergency care staff in England occur at rate of more than one an hour, according to health minister and former nurse Ann Keen. She told the House of Commons that, from April 2004 to March 2007, a total of 31,543 physical attacks were recorded, an average of just under 29 incidents every day.

This article reports on a reception hosted by the Royal College of Nursing (RCN) in London, England, for emergency nurses in the British armed forces in 2008. Defence minister Derek Twigg and Department of Health deputy chief nursing officer Viv Bennett were also at the reception. Peter Carter, general secretary of the RCN, read a message from Prince Charles of Wales in support of the nurses.

This article discusses the effort of the British Healthcare Commission calling on emergency and other healthcare staff to ensure they do not expose patients to unnecessary radiation through X-rays, computed tomography scans and other procedures. A report from the commission stresses that most reported incidents involved low doses of radiation and carried little risk to patients. It also highlights variations in the number of incidents reported by National Health Service trusts and other healthcare providers.