The accident and emergency department : nurses' priorities and patients' anxieties.
This study investigated the sources of anxiety for patients in the Accident
and Emergency Department and explored how patients' anxiety was
influenced by their experiences in the department and the attitudes,
behaviour and communication patterns of nurses and other staff.
The research was carried out in twO Accident and Emergency
Departments and consisted of three stages. Stage One employed structured
interviews with 96 patients to identify sources of anxiety for patients in the
Accident and Emergency Department and to examine the relationship
between anxiety and the patient variables of age, sex, condition and
department. In Stage Two in-depth interviews were conducted with 21
qualified nurses to explore their perceptions of their work and patients.
Stage Three was an observational study, involving 23 patients, which
examined the nature of nurse-patient communication in the Accident and
Emergency Department. A Symbolic Interactionist framework was used in
order to understand events from the perspective of those involved.
Patients appeared to view their stay in the Accident and Emergency
Department as an event occurring within the wider context of their daily
lives and were concerned with social factors related to admission and the
consequences of their illness or injury. Nurses held a different perspective
and were more concerned with physical care and the organisation of the
patients' stay in the department. In contrast to the patients, the nurses were
concerned with short-term problems. Interaction between nurses and
patients consisted predominantly of brief encounters which focused on the
patients' illness or injury and their progress through the department. There
was little attention explicitly directed towards dealing with patients'
anxieties. A complex range of factors - interpersonal, cultural,
interprofessional and structural - were found to influence communication.
A number of recommendations are made identifying ways to enhance
nurses' ability to deal with patients' anxieties.