2 research outputs found
The impact of overcrowding on the practice environment for emergency department nurses
Overcrowding in the Emergency Department (ED) occurs when there is an
imbalance between resource supply and demand. In other words, the ED is challenged to
provide quality care within acceptable time frames. Overcrowding literature illustrates
that ED overcrowding has become so common that it is now considered normal, which
begs the question: are terms such as "overcrowded" still pertinent to the current context
of the ED environment in which overcrowding is a normal state?
A recent and growing body of Canadian literature describes negative workplace
environments in acute care facilities, but there is as yet no literature that examines
overcrowding in relation to workplace environments in the ED. This interpretive
descriptive study examines the relationship of overcrowding to the practice environment
of emergency departments. Data were collected over six months and included in-depth
interviews with ten experienced emergency department nurses. These data illustrate the
negative impact of overcrowding on the emergency department environment. Emergency
department overcrowding has occurred in parallel with fundamental restructuring of the
health care system, creating a new era environment. This new environment is
characterized by chronic overcrowding and an equally chronic shortage of resources.
Within this environment nurses face several new challenges, such as understanding the
discourse of overcrowding, reconciling conflicting values, and navigating the cycles of
tension that arise from this new situation.
Many of the changes to the ED have resulted from changes imposed elsewhere in
the system, such as the closure of acute care beds. EDs are consequently in a state of
transition as health care providers attempt to put the pieces back together. Within this new era environment many challenges have emerged and data analysis suggests that new
era EDs support negative workplace environments.
It is crucial that policy makers be well informed when making decisions that
impact EDs. In order to be able to influence policy makers it is essential that nurses be
proactive and involved in charting the course for the future. It is also necessary for
organizations to invest in leadership by creating appropriate positions at appropriate
levels so that leaders can be visible and available to create vision and help nurses through
the transition to the new era environment. This study argues for the need to create an
increased body of research that will inform policy makers about how ED overcrowding
negatively affects the practice environment.Applied Science, Faculty ofNursing, School ofGraduat