Acil Servislerde Çalışan Hemşirelerin Sorunları: Nitel Bir Çalışma

Abstract

Amaç: Araştırma acil servislerde çalışan hemşirelerinin yaşadıkları sorunları incelemek amacıyla niteliksel (olgu bilim) tipte planlandı ve gerçekleştirildi. Yöntem: Araştırmada veri toplama aracı olarak acil servis hemşirelerinin özelliklerini içeren Demografik Veri Formu ve Yarı Yapılandırılmış Görüşme Formu kullanıldı. Araştırma verileri, ses kayıt cihazı kullanılarak toplandı ve Microsoft Word dosyasına transkript yöntemiyle aktarıldı. Araştırmada elde edilen veriler içerik analizi yöntemi kullanılarak değerlendirildi. Bulgular: Acil serviste yaşanan; şiddet olayları, aşırı hasta yoğunluğu, yetersiz güvenlik önlemleri, hemşirelik uygulamalarını ve bakımını gerçekleştirememe, iş kazaları, fazla mesai, triyajın etkin yapılamaması, aşırı personel sirkülâsyonu, hasta mahremiyetini sağlayamama, yönetici-çalışan-hasta yakını arasında iletişim eksikliği/bozukluğu gibi sorunların temelinde personel yetersizliği, fiziki ortam koşullarının uygun olmaması, güvenlik önlemlerinin yetersizliği, poliklinik sayısının yetersizliği ve iletişime bağlı sorunlardan kaynaklandığı belirlendi. Sonuç: Personel yetersizliği, hastaların müşahede altında uzun süre beklemesi, fiziki alanın yetersiz olması, tetkik sonuçlarının çok geç çıkması ve sistemsel sorunların olduğu, acil servis hemşirelerin bakım vermesini engelleyen faktörlerin; aşırı yoğunluk, prosedürler ve sistemsel işlerin çok olması, personel sayısının yetersizliği, hastaların müşahedede uzun süre beklemesi ve hasta yakınlarına bağlı sorunların olduğu saptandı.

Keywords

• Acil servis hemşireliği
• mesleki zorluklar
• hemşire deneyimleri

Problems of Nurses Working in Emergency Services: A Qualitative Study

Abstract

Aim: The research was planned and conducted as a qualitative (phenomenological) type to examine the problems experienced by nurses working in emergency services. Method: The Demographic Data Form and Semi-Structured Interview Form, which include the characteristics of emergency room nurses, were used as data collection tools in the study. Data were collected using a voice recorder and transcribed into a Microsoft Word file. The data obtained in the study were evaluated using the content analysis method. Results: It was determined that the problems experienced in the emergency department such as violence, excessive patient density, inadequate security measures, inability to perform nursing practices and care, work accidents, overtime, ineffective triage, excessive staff turnover, inability to ensure patient privacy, lack of/disruption in communication between managers-employees-patient relatives are mainly caused by insufficient staff, inappropriate physical environment conditions, inadequate security measures, inadequate number of outpatient clinics and communication-related problems. Conclusion: The factors preventing emergency room nurses from providing effective care were identified as excessive workload, redundant procedures and systemic inefficiencies, insufficient staffing, prolonged patient observation times, inadequate physical space, delayed examination results, and systemic issues.

Keywords

• Emergency service nursing
• professional challenges
• nurse experiences

References

1. 1. Ozturk H, Candas B, Babacan E. Determination of the problems experienced by nurses working in state hospitals, community and family health centers. Journal of Health and Nursing Management. 2015;1(2):25-36.
2. 2. Söyük S, Aslan Kurtuluş S. Evaluation of the problems experienced in emergency services from the perspective of the employees. Gümüşhane University Journal of Health Sciences. 2017;6(4):44-56.
3. 3. Atman Ü, Tay Z. Physicians' views on performance and quality improvement studies in health services. In: Kırılmaz H, ed. II. International Congress on Performance and Quality in Healthcare Ankara, Turkey. 2010:443-457.
4. 4. Korkmaz F, Görgülü S. Nurses' views on nursing in the context of professional criteria. Hacettepe University Faculty of Health Sciences Nursing Journal. 2010;1:1-17.
5. 5. Sarıyer G. Estimating demand in emergency services using time series models. International Journal of Engineering Research and Development. 2018;10(1):66-77.
6. 6. Edirne T, Edirne Y, Atmaca B, Keskin S. Characteristics of the emergency department patients of Yuzuncu Yil University Faculty of Medicine. Van Medical Journal. 2008;15(4):107-111.
7. 7. Özhanlı Y, Akyolcu N. Patient satisfaction with triage and nursing practices in emergency units. Florence Nightingale Journal of Nursing. 2020;28(1):49-60.
8. 8. Ersel M, Karcıoğlu Ö, Yanturalı S, et al. Evaluation of the usage characteristics of an emergency department and the urgency of the patients applied from the perspective of physicians and patients. Turkish Journal of Emergency Medicine. 2006;6(1):25-35.

9. 9. Sony M, Mekoth N. The relationship between emotional intelligence, frontline employee adaptability, job satisfaction and job performance. Journal of Retailing and Consumer Services. 2016;30:20-32.
10. 10. Derlet RW, Richards JR. Overcrowding in the nation’s emergency departments: complex causes and disturbing effects. Ann Emerg Med. 2000;35:63-67.
11. 11. Kavlu İ, Pınar R. The effects of burnout and job satisfaction on the quality of life of nurses working in emergency services. Turkey Clinics J Med Sci. 2009;29(6):1543-1555.
12. 12. Källberg AS, Ehrenberg A, Florin J, et al. Physicians’ and nurses’ perceptions of patient safety risks in the emergency department. International Emergency Nursing. 2017;33:14-19.
13. 13. Ramos RR, Calidgid CC. Patient safety culture among nurses at a Tertiary Government Hospital in the Philippines. Applied Nursing Research. 2018;44:67-75.
14. 14. Başkale H. Determination of validity, reliability and sample size in qualitative research. Dokuz Eylül University Faculty of Nursing Electronic Journal. 2016;9(1):23-28.
15. 15. Erdoğan S. Qualitative research. In: Erdoğan S, Nahcivan N, Esin N, eds. Research in Nursing. 3rd ed. İstanbul: Nobel Medical Bookstores; 2018:131-165.
16. 16. Baltacı AA. A conceptual review on sampling methods and sample size issues in qualitative research. Bitlis Eren University Journal of Social Sciences Institute. 2018;7(1):231-274.
17. 17. Özbek-Yazici S, Kalayci I. Evaluation of activities of daily living in elderly patients. Suleyman Demirel University Journal of Engineering Sciences and Design. 2015;3(3):379-383.
18. 18. Sert ET, Mutlu H, Kokulu K, et al. 5-Year analysis of patients applying to our emergency department. Muğla Sıtkı Koçman University Medical Journal. 2021;8(1):1-4.
19. 19. Aydin T, Aydin S, Koksal O. Evaluation of the characteristics of patients who applied to the Uludag University Medical Faculty Hospital emergency department and emergency department activities. Academic Emergency Medicine Journal. 2010;9:163-168.
20. 20. Pines JM, Hilton JA, Weber EJ, et al. International perspectives on emergency department crowding. Acad Emerg Med. 2011;18(12):58-70.
21. 21. Gindi RM, Cohen RA, Kirzinger WK. Emergency room use among adults aged 18-64: early release of estimates from the National Health Interview Survey, January-June 2011. National Center for Health Statistics. 2012.
22. 22. Çevik C, Tekir Ö. Evaluation of emergency department applications in terms of diagnosis codes, triage and socio-demographic data. Balıkesir Journal of Health Sciences. 2014;3(2):102-107.
23. 23. Atilla ÖD, Oray D, Akın Ş, et al. View from the emergency department: patients brought by ambulance and referral consents. Turkish Emergency Medicine Journal. 2010;10(4):175-180.
24. 24. Gülen M, Silibolatlaz A, Avci A, Satar S. Analysis of adult patients brought to the tertiary emergency service by 112 ambulance. Boğaziçi Medical Journal. 2018;2:51-57.
25. 25. Yüksel B. Retrospective evaluation of applications made to the emergency department of Ege University Faculty of Medicine via 112 ambulance [specialization thesis]. Ege University Faculty of Medicine, Department of Emergency Medicine; 2013.
26. 26. Önerbay S, Sayan İ. Nurses' assessment of their work duties outside. 12th National Nursing Congress (International Participation); Sivas, Turkey. 2009:105.
27. 27. İnce S, Bingöl S. Perceptions of nursing care among nurses working in emergency services. Hacettepe University Faculty of Nursing Journal. 2020;7(1):23-30.
28. 28. Bucco T. The relationships between patients' perceptions of nurse caring behaviors, nurses' perceptions of nurse caring behaviors and patient satisfaction in the emergency department [doctoral dissertation]. South Orange, ABD: Seton Hall University; 2015.
29. 29. Gül Ş, Dinç L. Investigation of patients' and nurses' perceptions of nursing care. Hacettepe University Faculty of Nursing Journal. 2018;5(3):192-208.
30. 30. Raffii F, Hajineshad MO, Haghani MO. Nurse caring in Iran and its relationship with patient satisfaction. Aust J Adv Nurs. 2009;26(2):75-84.
31. 31. Burtson P, Stichler J. Nursing work environment and nurse caring: relationship among motivational factors. J Adv Nurs. 2010;66(8):1819-1831.
32. 32. Tam HL, Chung SF, Lou CK. A review of triage accuracy and future direction. BMC Emerg Med. 2018;18(1):1-7.
33. 33. Durmaz H, Cebeci SP. Triage attitudes of health professionals working in emergency departments. Anatol J Emerg Med. 2021;4(2):72-78.
34. 34. Tarhan MA, Akın S. The roles of nurses in triage practices. Celal Bayar Univ Health Sci Inst J. 2016;3(2):170-174.
35. 35. Abdulwahid MA, Turner J, Mason SM. Senior doctor triage (SDT), a qualitative study of clinicians’ views on senior doctors’ involvement in triage and early assessment of emergency patients. Emerg Med J. 2018;35(7):440-446.
36. 36. Oruç OA, Üzel H. Satisfaction levels of patients applying to the emergency department. Kocatepe Med J. 2014;15(2):131-136.
37. 37. Mersinlioğlu G, Öztürk H. Satisfaction level of patients applying to emergency department with nursing services. J Health Nurs Manag. 2015;2(2):70-82.
38. 38. Bilir Ö, Şişmanlar D, Ersunan G, Ayaz T. The perspective of emergency service workers on patient rights. Konuralp Med J. 2015;7(1):28-33.
39. 39. Topal FE, Şenel E, Topal F, Mansuroğlu C. Patient satisfaction survey: Satisfaction levels of patients applying to the emergency clinic of a state hospital. Cumh Med J. 2013;35(2):199-205.
40. 40. Kocaman G, Yürümezoğlu HA, Uncu S, et al. Development of healthy work environment standards for nurses in Turkey. J Educ Res Nurs. 2018;15(1):30-38.
41. 41. Aydemir İ, Yaşar GY. The effect of ergonomic design on health care worker and patient safety. J Health Nurs Manag. 2016;3(3):174-184.
42. 42. Rôlo B, Santos B, Duarte I, Pires L, Castro C. Humanization of nursing care in the emergency service: a systematic review. Ann Med. 2019;51(1):204-204.
43. 43. Doğan H, Sözen H. Evaluation of sharp object injuries in healthcare workers. Ege Univ Fac Nurs J. 2016;32(2):35-43.
44. 44. Olgun S, Khorshid L, Eşer İ. Investigation of the frequency of sharp object injuries and affecting factors among nurses. J Ege Univ Fac Nurs. 2014;30(2):34-48.
45. 45. Akgün S. Work accidents in the health sector. J Health Acad. 2015;2(2):67-75.
46. 46. Dikmen AU, Medeni V, Uslu İ, Altun B, Aycan S. Evaluation of occupational accidents reported by healthcare personnel working in a university hospital in Ankara. TTB Occup Health Saf J. 2014;14(53):22-29.
47. 47. Korkmaz M. Sharp object injuries in healthcare workers. Fırat Health Serv J. 2008;3(9):17-37.
48. 48. Hamdan M, Hamra A. Workplace violence towards workers in the emergency departments of Palestinian hospitals: a cross-sectional study. Hum Resour Health. 2015;13(1):1-9.
49. 49. Erdem İ. Managerial problems of nurses: a research on working nurses. Ahi Evran Univ Soc Sci Inst J. 2021;7(1):151-162.
50. 50. Ozturk H, Sule K, Serin GM, et al. Problems of newly employed nurses in hospitals. Acıbadem Univ J Health Sci. 2016;(4):189-201.
51. 51. Uygur E, Kaya N, Kaya H, Karaman N. Health team service perceptions of nurses working in a state hospital and the problems experienced. IU Florence Nightingale Sch Nurs J. 2008;16(62):102-113.
52. 52. Manisali A. Causes of Conflict Between Physicians and Nurses [master's thesis]. Istanbul, Türkiye: Haliç University, Health Sci Inst; Istanbul; 2013.