Which Procedures Do Emergency Nurses Do Except for Their Duties and Authority and Why?

Yıl 2020, Cilt: 3 Sayı: 2, 72 - 82, 30.09.2020

Perihan Şimşek Gül Çakır Melek Ertürk Yavuz Ayşe Serpici Enes Bulut Ayla Gürsoy

https://doi.org/10.38108/ouhcd.763053

Cited By: 1

Öz

Amaç: Çalışma, acil servis hemşirelerinin görev tanımları dışındaki tıbbi uygulamaları yapma durumunun belirlenmesi amacıyla yürütüldü.
Yöntem: Çalışma 250 acil servis hemşiresi ile gerçekleştirildi. Çalışmada veriler, araştırmacılar tarafından Google Drive programı kullanılarak geliştirilen online veri toplama formunun Türk Hemşireler Derneği ve Türk Cerrahi Hemşireleri Derneğinin sosyal paylaşım sitelerinde paylaşılması ile toplandı.
Bulgular: Katılımcıların tamamına yakını (%99.2) görev tanımları dışındaki bazı tıbbi işlemleri yapmakta olduğunu belirtti. Acil servis hemşirelerinin %90.4'ünün dikiş attığı ve %84.4'ünün alçı-atel uyguladığı saptandı. Acil servis hemşirelerinin görev tanımları dışındaki tıbbi işlemleri yapmaları konusunda katılımcıların yaklaşık 1/3’ü herhangi bir neden belirtmezken, yaklaşık 1/3’ü hekim eksikliğini neden olarak gösterdi. Katılımcıların çoğu (%60.8) görev tanımlarının dışında kalan tıbbi uygulamaları yapma konusunda kısmen kendine güvendiğini belirtti. Çalışmaya katılan acil servis hemşireleri, görev tanımları içinde yer almayan bazı tıbbi işlemleri yapmayı reddetmeleri halinde hekimlerden (%78.0) ve hastane yönetiminden (%67.6) tepki aldıklarını ifade etti.
Sonuç: Acil servis hemşireleri görev tanımları dışında kalan bazı tıbbi işlemleri yapmakta ve bu durumu önemli bir sorun olarak değerlendirmektedir. Bu sorunun çözümü için konuyu tüm boyutlarıyla, geniş bir örneklem üzerinde araştıran ileri çalışmalara gereksinim duyulmaktadır.

Anahtar Kelimeler

Acil hemşireliği, acil servis, görev, hemşirelik uygulamaları, yetki

Destekleyen Kurum

Çalışma herhangi bir kurum tarafından desteklenmemiştir

Proje Numarası

-

Teşekkür

Çalışmaya katılan tüm acil servis hemşirelerine teşekkür ederiz

Which Procedures Do Emergency Nurses Do Except for Their Duties and Authority and Why?

Öz

Objective: The study was carried out in order to determine the situation of emergency department nurses performing medical practices that fall beyond their job description.
Method: The current study was completed with 250 emergency department nurses. In the study, the data were collected by sharing the online data collection form developed by the researchers using the Google Drive program on the social networking sites of the Turkish Nurses Association and the Turkish Surgical Nurses Association.
Results: Almost all of the participants (99.2%) stated that they have been doing some medical procedures that fall beyond their job description. It was determined that 90.4% of emergency nurses applied suturization and 84.4% applied plaster-splint. Approximately 1/3 of the participants did not state any reason for emergency department nurses performing medical procedures outside of their job description, while approximately 1/3 indicated the lack of physician as the reason. Majority of the emergency department nurses (60.8%) stated that they were partially confident in performing medical practices that fall beyond their job description. The emergency department nurses participating in the study stated that if they refused to perform some medical procedures that are not included in their job descriptions, they received backlash from the physicians (78.0%), and the hospital management (67.6%).
Conclusion: Emergency department nurses perform some medical procedures that fall beyond their job description and consider this to be an important problem. For the solution of this problem, further studies investigating the subject with all its dimensions on a large sample are needed.

Anahtar Kelimeler

Emergency nursing, emergency department, duty, nursing practice, authority

Proje Numarası

-

Kaynakça

• Ahwal S, Arora S. (2015). Workplace stress for nurses in emergency department. International Journal of Emergency & Trauma Nursing, 1(2), 17-21.
• Akpabio II, John ME, Akpan MI, Akpabio F, Uyanah DA. (2015). Work-related conflict and nurses’ role performance in a tertiary hospital in South-south Nigeria. Journal of Nursing Education and Practice, 6(2), 106.
• Azuri P, Haron Y, Riba S. (2014). Israeli emergency department nurses' atitudes to an extension of their role and powers. Journal of Clinical Nursing, 23(1-2), 261-267.
• Ballard E, Godfrey S, Stoker D. (1995). A Model for Mentorship in Nurse Teacher Preparation. The Vocational Aspect of Education, 47(4), 387-404.
• Ballard KA. (2003). Patient safety: A shared responsibility. Online Journal of Issues in Nursing, 8(3), 4.
• Bari A, Khan RA, Rathore AW. (2016). Medical errors; causes, consequences, emotional response and resulting behavioral change. Pakistan Journal of Medical Sciences, 32(3), 523-528.
• Benner P. (1982). From novice to expert. The American Journal of Nursing, 82(3), 402-407 Berg E, Weightman AT, Druga DA. (2020). Emergency Department Operations II. Emergency Medicine Clinics of North America, 38(2),323–337.
• Bowling NA, Beehr TA. (2006). Workplace harassment from the victim's perspective: A theoretical model and meta-analysis. Journal of Applied Psychology, 91(5), 998-1012.
• Brook S, Crouch R. (2004). Physicians and nurses in emergency care: where are the boundaries now? Trauma, 6(3), 211-216.
• Canatan HE, Yılmaz S. (2015). A research on sorts and reasons of medical errors made in hospitals: suggestions for solutions and a questionnaire study in a private hospital in Istanbul. Journal of Health Academicians, 2(2), 83.
• Daft RL, Samson D. (2014). Fundamentals of Management: Asia Pacific Edition PDF. Cengage Learning Australia, pp. 317.
• Dale J. (1998). Primary care in accident and emergency departments: the cost effectiveness and applicability of a new model of care [PhD thesis]. London: School of Hygiene & Tropical Medicine;DOI: DOI:https://doi.org/10.17037/PUBS.00682264. Retrieved from: http://researchonline.lshtm.ac.uk/682264/
• Dall’Ora C, Pope C, Crouch R, Sujan M, Griffiths P. (2017). Skill mix and new roles in emergency and urgent care: what is the evidence? Health Work: Evidence Briefs, 4, University of Southampton.
• Doetzel CM, Rankin JA, Then KL. (2016). Nurse Practitioners in the Emergency Department. Advanced Emergency Nursing Journal, 38(1), 43-55.
• Eşer İ, Khorshid L, Demir Y. (2007). A survey of the factors effecting the critical thinking dispositions of intensive care nurses. CU Journal of Nursing High School, 11(3), 13-22.
• Fukada M. (2018). Nursing competency: definition, structure and development. Yonago Acta Medica, 61, 001–007.
• Istomina N, Suominen T, Razbadauska A, Martinkėnas A, Meretoja R, Leino-Kilpi H. (2011). Competence of nurses and factors associated with it. Medicina, 47(4), 230-237.
• Jarvis PRE. (2016). Improving emergency department patient flow. Clinical And Experimental Emergency Medicine, 3(2), 63-68.
• Kerzman H, Van Dijk D, Eizenberg L, Khaikin R, Phridman S, Siman-Tov M, et al (2015). Attitudes toward expanding nurses’ authority. Israel Journal of Health Policy Research, 4(1), 19:1-8.
• Kızıl EG, İncazlı SB, Erken S, Güntürkün F, Özkan B. (2015). The situation of the nurse's knowing, adopting and fulfilling their responsibilities: İzmir sample. Journal of Education and Research in Nursing, 12 (3), 215-223.
• Kleinpell R, Scanlon A, Hibbert D, Ganz F, East L, Fraser D, et al (2014). Addressing Issues Impacting Advanced Nursing Practice Worldwide. The Online Journal of Issues in Nursing, 19(2), 5.
• McCoy M, Johnstone J. (2008). Nurse practitioners in the emergency department: a critical review of the literature. HNE Handover: For Nurses and Midwives, 1(2).
• Najimi A, Goudarzi AM, Sharifirad G. (2012). Causes of job stress in nurses: A cross-sectional study. Iranian Journal of Nursing and Midwifery Research, 17(4), 301.
• Neades BL. (1997). Expanding the role of the nurse in the accident and emergency department. Postgraduate Medical Journal, 73(855), 17-22.
• Olajide TA, Asuzu CM, Obembe AT. (2015). Physician-Nurse Conflict in Nigeria Hospitals: Causes and Modes of Expression. British Journal medicine and Medical Research, 9(10), 1-12.
• Orkun N, Eşer İ, Çelik, GG. (2017). History of emergency nursing. IU Journal of Health Services Vocational School, 5(1), 16-25.
• Overview of the healthcare ındustry in Turkey. Turkish Union of Chambers and Exchange Commodities (TOBB). Retrieved from: https://www.tobb.org.tr/saglik/20171229-tss-genel-bakis-tr.pdf
• Parker JM, Hill MN. (2017). A review of advanced practice nursing in the United States, Canada, Australia and Hong Kong special administrative region (SAR), China. International Journal of Nursing Sciences, 4(2), 196-204.
• Pittet D, Allegranzi B, Storr J, Donaldson L. (2006). Clean care is safer care’: The global patient safety challenge 2005-2006. Int J Infect Dis, 10(6), 419-424.
• Regulation Amending the Regulation of Nursing. Turkish Nurses Association. Retrieved from: http://www.turkhemsirelerdernegi.org.tr/tr/yasa-ve-yonetmelikler/yonetmelikler/19-nisan-2011-hemsirelik-yönetmeliğinde-değişiklik-yapilmasina-dair-yonetmelik.aspx
• Roche TE, Gardner G, Jack L. (2017). The effectiveness of emergency nurse practitioner service in the management of patients presenting to rural hospitals with chest pain: a multisite prospective longitudinal nested cohort study. BMC Health Services Research, 17(1), 445.
• Sheer B Wong FKY. (2008). The development of advanced nursing practice globally. Journal of Nursing Scholarship, 40(3), 204-211.
• Soudagar S, Rambod M, Beheshtipour N. (2015). Factors associated with nurses’ self-efficacy in clinical setting in Iran, 2013. Iranian journal of nursing and midwifery research, 20(2), 226-231.
• Theofanidis D, Sapountzi-Krepia D. (2015). Nursing and caring: an historical overview from ancient Greek tradition to modern times. International Journal of Caring Sciences, 8(3), 791-800.
• Tye CC. (1997). The emergency nurse practitioner role in major accident and emergency departments: professional issues and the research agenda. Journal of Advanced Nursing 26(2), 364-370.
• Ulrich CM, Taylor C, Soeken K, O’Donnell P, Farrar A, Danis M, et al. (2010). Everyday ethics: ethical issues and stress in nursing practice. Journal of Advanced Nursing, 66(11), 2510-2519.
• Who applies for emergency department in Turkey? Bianet Independent Communication Network. Retrieved from: https://m.bianet.org/bianet/siyaset/198673-turkiye-de-acile-kim-basvuruyor.
• Wynd CA. (2003). Current factors contributing to professionalism in nursing. Journal of Professional Nursing, 19(5), 251-261.
• Zurn P, Dal Poz MR, Stilwell B, Adams O. (2004). Imbalance in the health workforce. Human Resources for Health, 2(1), 13.