‘Have good judgement, but don’t be judgemental’

Miriam Kasztura trained as an emergency nurse in Australia - now she works to improve outcomes for frequent attenders to the ED

What is your job?

I am an advanced practice nurse working part-time in a nurse-led walk-in clinic for young adults on a University campus.

I also work part-time for a project to implement a new interprofessional model of care for frequent users of emergency departments (EDs) in Switzerland.

What are your main responsibilities?

In the primary care job, I am responsible for seeing patients. We also carry out assessments of risk behaviours and health promotion interventions.

In my second job, I coach teams from different EDs in developing and adapting the model to ensure it fits their needs and improves patient outcomes.

Why did you become an emergency nurse?

I stumbled into it. I am Swiss and trained in Switzerland. When arriving in Australia as a graduate nurse I undertook a short stint in an ED and was impressed by the professionalism of the nurses, as well as the great team spirit. That’s where it started.

I knew these skills would be useful for working in humanitarian health, which I always wanted to do.

What might you have done otherwise?

At nursing school I was interested in psychiatric nursing, but after some work placements I realised that this was not for me.

What do you enjoy most about your job?

In my current jobs I like that I use a variety of skills, from clinical to research and from project management to pedagogy.

What I enjoy most is that ED nursing brings us into contact with a range of people, which is challenging but also enriching.

How and where have you developed your emergency care skills?

I have had the opportunity to learn and develop my ED skills with highly competent colleagues in two hospitals in Australia.

We learned with simulations and completed internationally recognised training, for example in advanced trauma life support (ATLS), regularly. I also developed skills through formal education in my specialty training.

I had fewer resources, technological tools and staff in my humanitarian aid work, but it strengthened my clinical skills.

How did you progress through your career?

I completed BSc training in Switzerland and then left for Australia, where I quickly got into emergency nursing.

I stayed for almost five years, took the opportunity to specialise in ED nursing and completed a master’s degree in public health.

I then worked for the international medical organisation Médecins Sans Frontières (MSF).

I have completed more than 14 assignments in complex humanitarian emergencies and have been involved with or have led responses to displaced populations, conflict settings, disease outbreaks and chronic crises.

I have also completed a MSc in nursing in Switzerland so I can get back into clinical work there.

What inspires you?

I am especially inspired by the nursing colleagues I met while working for MSF. Their courage and dedication are exemplary.

What do you do in your free time?

I like to experience nature, I believe it is good for my mental health, but when it is cold I take out my yoga mat more often. I also like sewing and knitting, but have too little time for them.

And of course I read lots of books, anything from non-fiction geopolitical context books to Scandinavian crime novels.

What makes a good emergency nurse?

Having good clinical judgement, but not being judgemental towards patients.

What advice would you give a nurse who is starting out in emergency care?

Observe, listen and ask many questions to colleagues.

What is likely to affect emergency nurses most over the next 12 months?

I think ED nurses will increasingly see people with complex health and social needs that traditional ED care cannot meet.