Emergency department nurses' perceptions and experiences of providing care for older people.

Emergency department nurses are challenged to provide safe, quality care to older people; however, nurses' perceptions of their role and experiences are seldom investigated. This focus-group study investigated emergency department nurses' perceptions and experiences of caring for older people, using four focus groups of nurses with a minimum three months' experience in the emergency department and a demographic survey. Data were thematically analyzed. Two themes emerged. The first was the clash of expectations between nurses and family/carers related to safety and quality of nursing care. Older people were perceived to be vulnerable in the emergency department, and nurses were frustrated that competing priorities decreased their ability to ensure them safe and quality care. Nurses felt family/carers were disappointed with care provided, and might not empathize with or understand their predicament. The second theme concerned nurses' perception that family/carers could provide a safety net for the older person in the emergency department in times of high workload. Nurses need support to care for older people in the emergency department to ensure safe and optimal care, and a shared understanding of care provision between nurses and family needs development.

Nurses' experiences and expectations of family and carers of older patients in the emergency department.

BACKGROUND: Older people are often accompanied by family/carers to the emergency department (ED). Few studies investigate nurses' experiences of interacting with these family/carers. AIM: This study was an exploration of the experiences and expectations that ED nurses have of family and carers accompanying the older adult patient. METHOD: Focus group interviews (four, n = 27) were conducted and interviews were audio-taped, transcribed and then thematically analysed. RESULTS: Three themes emerged relating to the way nurses judged family/carers of the older person, with the main theme the importance of time. Family/carers were evaluated as supportive and helpful when they saved nurses time and demanding and obstructive when they cost nurses time. A second theme was the family/carer as a knowledge resource. Nurses evaluated family/carers according to whether they could provide timely and useful information on the older patient. The third theme centred on nurses' evaluations of family/carers getting in the way of assessing or treating the patient, by their physical presence and demands and by limiting open communication with the patient. CONCLUSION: Emergency nurses have clear expectations of older patients' families and/or carers. Future research must determine how nursing roles can sustain positive interactions with older patients' families and/or carers in the ED.