United across the pond

Our health care systems might be different, but a Stateside emergency nurse says that our values give us a common bond.

Our health care systems might be different, but a Stateside emergency nurse says that our values give us a common bond.

Last year, 19-year-old Cara Farella survived a near-fatal asthma attack. While she cannot remember the details of her ordeal, she easily recalls how nurses who cared for her made her feel. ‘I was far from home but I felt safe, relaxed and filled with hope that I would conquer my asthma,’ she says. ‘The nurses who cared for me were respectful. They didn’t think less of me because I was not always compliant. They understood I was still learning to deal with this new disease.’

What is amazing to me is that Cara was treated in both UK and US emergency departments (EDs) in the same month. And despite the 4,000-miles between Chelsea and Westminster Hospital in Central London and Lutheran General Hospital outside Chicago, her experiences – and her perceptions of the care she received – had little to do with the country she was in.

Separated by several time zones are nurses with the passion to care, the desire to heal, the drive to improve, and in many cases, the grace to help patients and their families grieve. Our healthcare systems may look different, but the authenticity with which we all care is the same.

Likewise, our challenges are almost identical and although thousands of miles apart, we share similar human problems.

David Cameron has promised an ‘all-out assault on poverty,’ with one eye on social reforms to include better mental health services. Similarly, in the US, care of behavioural health patients in the ED was selected as the number one issue related to direct patient care by delegates at the 2015 Emergency Nurses Association’s General Assembly.

Shared concerns

Another shared concern is improved staffing ratios: 39% of emergency nurses in the US say improved staffing ratios is the second most important clinical aspect of practice. In addition, nurses in both countries worry about our ageing workforce, lack of administrative support, technology overload, and the effect of low morale and burnout.

The solution lies in all of us reclaiming the profession of nursing. Perhaps Florence Nightingale said it best: nursing requires presence and attention… in order to form a relationship that can move the patient toward health or a peaceful death.

But how do we achieve this when so many variables stand in our way? The answers are not easily understood. Some points are clear: along with positive patient outcomes, we must strive for nurses’ improved mental and physical wellbeing as well as professional satisfaction. We must also strive to be present with patients while our human communication is becoming more impersonal; as technological advances help support our work we must better understand how these very same processes are keeping us away from the bedside.

Neither of our nations’ nurses can do it alone. Globally, nurses must unite to develop actionable strategies to tackle these issues that are challenging our profession and putting patients at risk of poor outcomes. And in the US, the Emergency Nurses Association (ENA) is working hard to play its part.


Dedicated to defining the future of emergency nursing through advocacy, education, research, innovation and leadership, the ENA advocates for patient safety, develops industry-leading practice standards and guidelines, and helps to craft emergency healthcare public policy.

Though based in the US, we are a growing resource to the global emergency nursing community with more than 42,000 members worldwide. Together with our colleagues around the world, we can minimise the fallout from international threats, such as the Zika virus. We are committed to partnering with and supporting our international colleagues, and we are proud to offer tools to ensure all ED nurses have access to the most comprehensive resources available.

The ENA has four institutes dedicated to developing clinical and academic resources: the Institute for Quality, Safety and Injury Prevention, the Institute for Emergency Nursing Research, the Institute for Emergency Nursing Education and the Institute for Emergency Nursing Advanced Practice. We are proud to be a strong global partner in shaping and supporting emergency nursing’s present and future.

Emergency nursing faces great challenges and our leaders and clinicians must find creative solutions. No one organisation has all the answers but, collectively, we have the best chance of success.

About the author

Kathleen Carlson is president of the Emergency Nurses Association, United States.

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