Year

2010

Degree Name

Master of Nursing (Research)

Department

School of Nursing, Midwifery & Indigenous Health - Faculty of Health & Behavioural Sciences

Abstract

Objective: This thesis examines the opinions of emergency nurses towards the possible primary care patient. It aims to explore what emergency nurses consider the reasons possible primary care patients present to an Emergency Department for treatment. This thesis also compares these nursing perceptions to those of patients. Background: Literature speaks of health professionals’ opinions towards patients who present to an Emergency Department who could potentially be seen by a General Practitioner or Medical Centre. This patient population are termed ‘possible primary care patients’ in this research. There is no literature that discusses nurses specifically and how nurses view the intention of this group of patients for presentation to an Emergency Department. With this in mind and with an interest in Emergency Departments and in particular emergency nurses, the researcher chose to focus on the beliefs of emergency nurses working in Emergency Departments within the former Illawarra Health Service towards primary care patients. For the purpose of the research, the patient population being examined were the possible primary care patients identified by the following criteria: any patient given a triage category 4 or 5 who self-presents, is not a planned return visit, and is unlikely to be admitted according to the Triage nurse assessing the patient. Methods: Nursing staff working in the five Emergency Departments within the former Illawarra Area Health Service were given questionnaires to ascertain their perceptions of the reasons possible primary care patients present to an Emergency Department for care. Data were also collected about their department, sex, age, position held in the department, and length of time the nursing staff member had been working in an Emergency Department. These data were analysed to determine any differences in perception based on these variables. Findings: Four key themes emerged from the data analysis. These were: despite demography, nurses generally considered free service provision to be the leading reason that possible primary care patients choose an Emergency Department for care; nurses holding positions of advanced practice or management did not consider cost to be an overwhelming factor for possible primary care patients when choosing to come to an Emergency Department when compared with nurses working as Registered Nurse (RN) or Enrolled Nurse (EN); rural nurses consider access to General Practitioners to be lacking; and nurses and patients have polar views of why possible primary care patients come to an Emergency Department for service delivery. Conclusions: Emergency nurses consistently believe that possible primary care patients choose to present to an Emergency Department because it is a free service. This agreement occurs despite various demographic differences. There were evidenced differences regarding reasons for presentation to an Emergency Department between nurses and presenting patients. Nurses focused on free delivery of medical care and lack of access to General Practitioner services. Patients however focused on the urgency of their illness/injury believing it needed immediate care.

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