Analysis of Emergency Department Nurse Roles and Responsibilities

This report delves into the multifaceted roles and responsibilities of an Emergency Department (ED) nurse, particularly in the context of a domestic violence case. It emphasizes the nurse's primary duties, including patient assessment, ensuring patient safety, and administering immediate medical care. The report highlights the importance of maintaining legal rights and responsibilities, adhering to nursing guidelines, and prioritizing patient preferences. It discusses the nurse's role in providing emotional support, maintaining confidentiality, and facilitating communication with medical professionals. The report also outlines the steps involved in addressing patient safety concerns, including assessing the need for police involvement and offering resources for ongoing support. The nurse must build trust with the patient, respect their choices, and maintain both the patient's and their own safety. The report concludes by stressing the importance of health and safety guidelines in providing optimal care, especially in situations involving domestic abuse, where patient choice is paramount.

Running head: ROLES OF ED NURSE
ROLES OF EMERGENCY DEPARTMENT NURSE
Name of the Student
Name of the University
Author note

1ROLES OF ED NURSE
Recently I handled a patient who came to our department injured and was suspected
to be a case of domestic violence. As a nurse my first responsibility was to diagnose the
patient and to make sure that the patient is safe. I also asked few question as per my
assumption of the case. As a registered nurse I also need to keep and maintain my legal rights
and responsibility towards the safety of the patient as well for myself. As a nurse of the
emergency department assigned degree of urgency and treatment for the patient, noted the
vital signs and injuries, administered medicine immediately as there was several injuries and
helped doctor with medical actions.
I as a nurse, have a duty the approach and patient would approach the patient and ask
not to panic. I would make sure that the patient is stable before asking any question. It is my
legal duty to make the patient comfortable. As per nursing guidelines it is always suggested
to put patient choice as first preference (Jokiniemi et al., 2012). Before approaching or asking
anything to the patient it is necessary to ask if the patient if comfortable to have any
discussion at that moment. Depending on patient’s choice the discussion would be done. On
other hand, it is duty to maintain the privacy about patient’s choices. As it is the serious case
of domestic violence, few guidelines are set by our nursing policies (Johnston et al., 2016).
As a nurse I need to make the patient feel that those guidelines are beneficiary for the patient
and hence the patient might follow. I would also like to share about our policies regarding
domestic violence cases, so that the patient feels satisfied as well as contented in making
decision. However, as per NSW guidelines there would not be any pressurisation over the
patient. It is my duty as a nurse to abide my nursing as well as hospital rules (Elder, Johnston
& Crilly, 2015). Hence, it is also recommended that as a nurse I must follow all the
guidelines that had been set for us. Even from patient’s perspective, patient might not feel
comfortable or satisfied about the decision to be taken, in those case we can approach the
patient about our choices so would ask the patient for the preference. It is also recommended

2ROLES OF ED NURSE
to inform friends and family member as per patient’s choice to inform about the situation.
However prior doing this we need to ask the patient, if she wants any particular person to be
called for.
I would develop a better relation with the patient so that she can share the pain as it
will reduce her emotional pain that she underwent due to violence. I would keep the option
open so that she can share her emotion with me and I can support her and can provide her
with emotional support. As a nurse it is my duty help the patient in their fast recovery
(Shields, 2013). I would ask her if she wants any law proceeding against the violence she
faced. I would listen to her choices and support her in her choice and preferences.
As the responsibility of the nurse is to make the patient calm and maintain calmness
within myself. It is my responsibility be compassionate with the patient and maintain a quick
and good communication with the doctor (Wand et al., 2016). As a nurse I would discuss
about the difficulties the patient had faced and try to note down the details the patient is
mentioning about. As this is the case of domestic violence, as a nurse I need to make a good
relation with the patient. I need assure her that I can maintain confidentiality and she can
share the reason and cause of the domestic violence (Fanning, Jones & Manias, 2016). I
would also assure her that everything would be done and followed according to her choice.
Before doing all these, the patient need to trust me. Hence, a bridge need to be built between
myself and the patient (Nursing and Midwifery Board of Australia - Guidelines, 2020).
After the patient turned little well I would ask her few questions whether the patient is
feeling safe to go home, does the patient have any children and whether they are safe or not,
if she needs any safety place to live in immediately, and if she does not require immediate
safety what she is thinking about her future safety. I must make sure that the patient wants to
do any police complain or not and all the statements of the patient must be noted down and

3ROLES OF ED NURSE
the steps and precautionary measures would be taken depending on the consent of the patient
(Street et al., 2015).
If the patient chose not to do any official complain for her safety it would be my
responsibility to value her choice and suggest her to keep all the necessary, contact of people
whom she can contact for support in future. I would ask her choices and preferences and
maintain a confidentiality (Nursing and Midwifery Board of Australia - Guidelines, 2020).
As an emergency nurse once the risk and the cause of the risk is identified, it is my
responsibility to ask the patient about ways to eliminate it (Rippey et al., 2016). However, if
patient ignores to complain I would respect her choice. I have to maintain patient’s safety and
confidentiality.
It can be concluded by explaining that as per the health and safety measures it is the
duty for all the health professional to maintain a guideline for health and safety. The health
and safety guidelines provides equal benefit for both the patient as well as for the health care
people. As mentioned in the paper that both the patient as well as the nurse requires
emotional and physical safety. The heath guideline suggests that the patients’ choice would
always be given preferences. However, as it is the case of the domestic abuse, informing cope
would be the first priority for the hospital. It is the responsibility and duty of the nurse to
keep themselves and the patient healthy and safe.

4ROLES OF ED NURSE
References
Elder, E., Johnston, A. N., & Crilly, J. (2015). Systematic review of three key strategies
designed to improve patient flow through the emergency department. Emergency
Medicine Australasia, 27(5), 394-404.
Fanning, L., Jones, N., & Manias, E. (2016). Impact of automated dispensing cabinets on
medication selection and preparation error rates in an emergency department: a
prospective and direct observational before‐and‐after study. Journal of evaluation in
clinical practice, 22(2), 156-163.
Johnston, A., Abraham, L., Greenslade, J., Thom, O., Carlstrom, E., Wallis, M., & Crilly, J.
(2016). Staff perception of the emergency department working environment:
Integrative review of the literature. Emergency Medicine Australasia, 28(1), 7-26.
Jokiniemi, K., Pietilä, A., Kylmä, J., & Haatainen, K. (2012). Advanced nursing roles: A
systematic review. Nursing & Health Sciences, 14(3), 421-431.
Nursing and Midwifery Board of Australia - Guidelines. (2020). Retrieved 4 April 2020,
from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/
Codes-Guidelines.aspx
Rippey, J. C., Carr, P. J., Cooke, M., Higgins, N., & Rickard, C. M. (2016). Predicting and
preventing peripheral intravenous cannula insertion failure in the emergency
department: Clinician ‘gestalt’wins again. Emergency Medicine Australasia, 28(6),
658-665.
Shields, L. (2013). A personal essay on the role of the nurse Contemporary Nurse: A Journal
for the Australian Nursing Profession, 43(2), 213-218.
Street, M., Ottmann, G., Johnstone, M. J., Considine, J., & Livingston, P. M. (2015).
Advance care planning for older people in A ustralia presenting to the emergency

5ROLES OF ED NURSE
department from the community or residential aged care facilities. Health & social
care in the community, 23(5), 513-522.
Wand, T., D'Abrew, N., Acret, L., & White, K. (2016). Evaluating a new model of nurse-led
emergency department mental health care in Australia; perspectives of key
informants. International emergency nursing, 24, 16-21.