{"title":"Emergency nurses' experiences of caring for critically ill patients requiring intensive care in the emergency department.","authors":"Duygu Akbaş Uysal, Ebru Ekiz","doi":"10.1016/j.ienj.2025.101697","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Emergency departments' red zones are complex clinical environments requiring both emergency interventions and intensive care-level services, representing a critical area of focus in this special issue on emergency critical care. Nurses working in these settings face multifaceted challenges, including role ambiguity, time constraints, and limited resources. However, few studies have explored these experiences through theoretical models.</p><p><strong>Objective: </strong>This study aims to provide an in-depth exploration of nurses' experiences delivering intensive care-level care to critically ill patients in the red zones of emergency departments, within a theoretical framework.</p><p><strong>Method: </strong>Using a phenomenological qualitative approach, semi-structured interviews were conducted with 21 emergency nurses from various regions in Turkey. Data were analyzed using Braun and Clarke's six-step thematic analysis, and findings were conceptually interpreted through Meleis's Transition Theory and Tanner's Clinical Judgment Model.</p><p><strong>Findings: </strong>Four main themes and eleven subthemes emerged, including challenges in clinical judgment, role incompatibilities, and systemic shortages. Guided by Meleis's framework, findings indicate that adherence to intensive care standards and clinical education enhances competence, confidence, and reflective practice, informing nursing practice and policy.</p><p><strong>Conclusion: </strong>Nurses in emergency department red zones face multifaceted challenges, including the demands of multitasking, complexities in decision-making, and structural limitations in providing care for critically ill patients. The study emphasizes that clinical judgment is shaped not only by individual competencies but also by the availability of systemic support. These results underscore the necessity of establishing clear clinical guidelines, implementing structured team-based care models, and developing practice-oriented training programs to facilitate nurses' transition between emergency and intensive care settings.</p>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"101697"},"PeriodicalIF":1.8000,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Emergency Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ienj.2025.101697","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Emergency departments' red zones are complex clinical environments requiring both emergency interventions and intensive care-level services, representing a critical area of focus in this special issue on emergency critical care. Nurses working in these settings face multifaceted challenges, including role ambiguity, time constraints, and limited resources. However, few studies have explored these experiences through theoretical models.
Objective: This study aims to provide an in-depth exploration of nurses' experiences delivering intensive care-level care to critically ill patients in the red zones of emergency departments, within a theoretical framework.
Method: Using a phenomenological qualitative approach, semi-structured interviews were conducted with 21 emergency nurses from various regions in Turkey. Data were analyzed using Braun and Clarke's six-step thematic analysis, and findings were conceptually interpreted through Meleis's Transition Theory and Tanner's Clinical Judgment Model.
Findings: Four main themes and eleven subthemes emerged, including challenges in clinical judgment, role incompatibilities, and systemic shortages. Guided by Meleis's framework, findings indicate that adherence to intensive care standards and clinical education enhances competence, confidence, and reflective practice, informing nursing practice and policy.
Conclusion: Nurses in emergency department red zones face multifaceted challenges, including the demands of multitasking, complexities in decision-making, and structural limitations in providing care for critically ill patients. The study emphasizes that clinical judgment is shaped not only by individual competencies but also by the availability of systemic support. These results underscore the necessity of establishing clear clinical guidelines, implementing structured team-based care models, and developing practice-oriented training programs to facilitate nurses' transition between emergency and intensive care settings.
期刊介绍：
International Emergency Nursing is a peer-reviewed journal devoted to nurses and other professionals involved in emergency care. It aims to promote excellence through dissemination of high quality research findings, specialist knowledge and discussion of professional issues that reflect the diversity of this field. With an international readership and authorship, it provides a platform for practitioners worldwide to communicate and enhance the evidence-base of emergency care.
The journal publishes a broad range of papers, from personal reflection to primary research findings, created by first-time through to reputable authors from a number of disciplines. It brings together research from practice, education, theory, and operational management, relevant to all levels of staff working in emergency care settings worldwide.
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