According to the Health Promoting Hospitals and Health Services International Conference held in Berlin this year, 98 percent of emergency room nurses in the Unites States reported verbal harassment and 67 percent reported physical violence.  While in Canada, 84 percent of the nurses in the emergency department witnessed verbal harassment once in every shift.  While there are 90 percent of them claimed to experience verbal abuse at least once a week.  In Australia, there are 70 percent of nurses who experience violence at least five times a week.

Emergency department are experiencing violence and it has been escalating year after year.  So how are the hospitals coping and resolving this concern?

To come up with solution regarding this problem, it is important to define emergency room violence and differentiate it from other forms of violence.  Emergency room violence is different since it involves patients, family, relatives and close friends.  These violent acts came from feelings of frustrations, vulnerability and lack of control over health emergencies.

Violence prevention training for hospital staff is one step in reducing the incidence of violence in hospital emergency rooms.  Potentially violence patients and visitors can be recognized by the hospital staff by attending training in violence prevention.

Some preventive measures and procedures are already being undertaken by the healthcare institutions to prevent this escalating violence.  Some security measures include metal detectors at entrances, photo ID cards for staff, badges for visitors, patient processing policies to lessen waiting time, controlled access to hospital buildings, secure telephone communications,  locked doors to emergency rooms, closed circuit TV monitoring and trained security guards.

Nursing Solutions Now (NSN) offer some protection tips to emergency department health care workers.  They have the D.O.G.G.S. or Defusing of Grievance Grants Safety.  To use the D.O.G.G.S. method, it is important to understand the mindset of the potentially violent person and that is by communication with the person.  It is necessary to practice active listening.  Avoiding confrontation is also one step to build trust and therefore provide help. It is important to allow the person to verbally vent out the emotions without comment or judgement.  Getting a suggestion from the aggrieved party is essential and the person’s suggestion might even be reasonable.  To preserve the person’s dignity, move toward a win-win resolution.

To further address these attacks and harassments,  the Nurses Association in the Unites States is promoting a bill  (A6186/S3441) aimed at violence against nurses.  With this bill A6186/S3441, any acts of assault that may cause physical injury to a registered nurse or licensed practical nurse while on duty will face Class C felony charges.  This same provision already exists for assaults made against policemen, firemen, peace officers, and emergency medical technicians.  The bill was passed by the US State Senate  last April 2, 2008 and is currently awaiting the decision of the Assembly.

Meanwhile in Canada, the Canadian Nurses Association (CNA) is exploring the effectiveness of their Criminal Code to address healthcare professionals experiencing violence. CAN promotes that the employers should enforce strategies to prevent, identify and address violent behaviours, examine the root cause of violence and take steps to address them and provide mandatory education and training to management and staff.

Different nursing organization could come up with different ways or tips to avoid and prevent emergency room violence.   But it is also important thing is developing or making sure that there is a backbone or law supporting our emergency nurses against possible violence in their workplace.  But the first step against violence is prevention.

As an emergency room nurse (E.R. nurse), the opportunity to work in different settings including urgent care centers and emergency departments are always present. A career as an E.R. nurse provides the excitement and adrenaline rush for registered nurses looking for action packed scenes inside the hospital.

Emergency room nurses are very much in demand and there are numerous ER nurse jobs available in different settings. It may even allow ER nurses to travel to exciting locations.

Emergency nurses would get an average salary (as of June 2008) according to www.nursezone.com is $59,227. A travelling ER nurse can expect to make at least as much or more every year including housing, insurance and other benefit due to the high need of their expertise and skills and understaffed facilities.

Travel nursing was developed in response to the nursing shortage. With travel nursing, nurses are relocated for short term nursing positions. Travel nurses are offering incentives ranging from relocation assistance and furnished housing to stipends and bonuses to qualified registered nurses and health professionals.

But there are additional costs of being a traveller. Costs would included additional licensing costs and travelling costs. These costs can be reimbursed based on the company, recruiter and of course, your negotiation skills.

Nurses often dream of combining their medical growth and seeing the world. But a nurse should always be prepared. A successful traveller requires good financial planning, a flexible outlook, knowing what companies and recruiters to deal with and how to negotiate.

Of course, salary for travel nurses widely varies. Salary is based on the location, need of the hospital or the nursing unit. Perceived staffing needs by the unit manager and still, on the ability of the traveller to negotiate. Generally, areas in the southern United States pay less than areas in the north or west. Housing costs can also have an impact on the salary as well, since housing can be part of the benefits a travel nurse will receive. In terms of picking out the location an E.R. nurse wants to practice her profession, she would need to consider the process of applying a nursing license in the state to be assigned.

Currently, 17 states belong the Nursing Licensure Compact. With this Compact, a nurse who is under any of these 17 states may practice in other states. They would have to follow the laws and regulations of the state in which they are practicing.

A travelling E.R. nurse is can have a staff position which is frequently in critical care settings. Many jobs or positions available as a travel nurse would be in critical care. It is also essential for a registered nurse who wants to be travel nurse to possess background in critical care. Adaptability, flexibility and capable of easily making friends are also some characteristics present in a travelling E.R. nurse.

Some drawbacks in being a travelling E.R. nurse is that there is often little or no time to get oriented at the new location and moving from place to place every three months (average). Issues in obtaining licensure and paying taxes are also some major drawbacks in this profession.

A travelling E.R. nurse with this kind of profession would have the chance to meet new people. She would even have the chance to grow personally and professionally since exposure to different working conditions is inevitable. This opportunity provides a venue for E.R. nurses to experience different facilities and enhance their medical knowledge at the same travel around the country, even the world! It is the best of both worlds.

Emergency nursing is a specialized field of the nursing profession. In this field, nurses are equipped and trained to deal with patients in critical phase of their illness and injury. Emergency room nurses are capable of treating patients in this phase without any or complete diagnosis.

Emergency room nurses are used to fast paced environment. Since the emergency department of a hospital, is usually overcrowded emergency room nurses can be seen multitasking to balance and prioritize patients and their time. How dangerous is it to be working in a hospital?

With increasing reports of emergency department violence, emergency nurses are placed among police officers and other peace officers. The Massachusetts Bureau of Labor Statistics reported more than 4.000 health care professionals to experience verbal and physical assault while working in the ER (2005).

Different steps are being undertaken to address the escalating umber of violence experienced by emergency room staff. Legislations in increasing the penalty for perpetrators are awaiting decision from the Assembly. Various programs and trainings to resolve violence are commencing in hospitals and other health care institutions.

So what else is dangerous about being an emergency nurse?

According to the International Hazard Datasheets on Occupation as released by the International Labour Organization, there are seven main dangers emergency nurses can be exposed to.

1. Emergency room nurses, as part of their responsibilities; cleans, disinfects and sterilize medical equipment. They may be exposed to agents that may damage the skin, mucous membranes and respiratory system.
2. Emergency room nurses can also be exposed to anesthetic gases, drugs and radiation.
3. Emergency room nurses may be injured by shard objects like needles, blades and other similar objects.
4. They may contact with hot surfaces, faulty electrical equipment and may cause skin burns.
5. Sick patients in the emergency room present a risk of infection from body fluids.
6. Emergency room nurses may suffer from musculoskeletal problems and back pains due to handling heavy patients. Continuous work while standing and walking may cause fatigue and leg problems.
7. Emergency room nurses also may suffer from stress and burnout caused by shift and night work and by other psychological and organization factors.

The Emergency Nurses Association recognizes the increasing number of emergency nurses experiencing stress. The emergency care environment can be very stressful and physically and emotionally traumatic for the health care workers and nurses.

ENA recognizes the following contributing factors in the increasing stress levels of emergency room nurses.

1. Critical incidents that can cause strong emotion and may interfere with the ability to perform the duties. Incidents like mass casualties, disasters, unexpected death of a child or co-worker can be attributing factors.
2. Long term demands can also be a stressor. Long work hours, job insecurity, poor communication and an increased potential for a workplace violence fall under this factor.

ENA sees that unresolved issue of stress can result into absenteeism, sleep disorders, burn out, emotional difficulties and health problems.

So how can these repercussions be avoided?

International Labor Organization (ILO) provided several pointers to keep the emergency department safe for the emergency room health workers. Nurses should comply with all safety instructions and conduct periodic inspection of electrical medical equipment. Keeping all passages clearly visible and uncluttered is also another tip. Following appropriate procedures in infection control and handling and disposing sharp objects is necessary.

To resolve the stress emergency nurses are experiencing, ENA supports the development and utilization of critical incident stress management. ENA also supports the use of personal stress management strategies like relaxation, meditation, exercise, group therapy, guided imagery, massage or humor therapy.

ENA also recognizes the impact of workplace violence and the need for a program which would include education, prevention, appropriate security measures, identification of incidents, reporting and protocols.

Emergency nurses have a very rewarding job and at the same a dangerous one. These are all the sacrifices they have to put up the serve the people.

You rushed a friend at 10:00 in the evening to the nearest hospital due to unbearable chest pain. But at the emergency department, you were greeted with a number for patients waiting to be attended to. It took 30 minutes before your friend was taken care of by the emergency nurses.

You wonder, what is this shortage about emergency nurses? Aren’t there enough people who would like to take care of sick people anymore?

According to a study conducted by the researchers from Cambridge Health Alliance as reported in Health Affairs, wait times went up an average of 4.1 percent per year for all patients. Unfortunately for heart attack patients, the wait stretched to 11.2 percent every year. Blacks, Hispanics, women and patients in urban hospitals have longer wait times that others.

So how long exactly are these percentages? For patients diagnosed with heart attacks, the waiting time in 1997 was 8 minutes, but in 2004 it rose to 20 minutes. Patients who needed attention within 15 minutes, according to the nurses who evaluated them, have to wait 10 minutes back in 1997. But in 2004, it went up to 14 minutes. Emergency room wait in urban hospitals was 30 minutes. While non-urban hospital emergency room wait is within 15 minutes.

So why are the numbers increasing?

Emergency visits rose by 78 percent from 1995 to 2003. But the number of the emergency departments to accommodate this rise fell by 12.4 percent from 1995 to 2003. The number of patients rushing in to the emergency department to get medical attention can be attributed to the fact that there is an increase of underinsured and uninsured patients. The aging American population is also a factor.

According to the EMTALA or the Emergency Medical Treatment and Active Labor Act, everyone has the right to be seen and attended to in the emergency department, whether they are able to pay or not. This served as safeguard for the underinsured and uninsured citizens.

There were several accounts of patients dying in the emergency room waiting area because of overdue waits even with critical undiagnosed conditions. Recently, a 19 year old woman died on the Kings County Hospital Center Psychiatric Emergency Department floor. The incident was recorded by the hospital’s camera. It took an hour before someone took notice of the woman, but the patient was already dead. The hospital was said to be understaffed.

Different measures are being taken to resolve the crisis in emergency departments and avoid unfortunate events like this. Most resolutions are being directed to the Congress. Some of the proposed means to be taken are:

1. Quickly approving the $50 million in extra funding for hospitals that provide uncompensated care to uninsured patients.
2. Significantly increase a funding for disaster preparedness in hospitals.
3. Establish an agency in the Department of Health and Human Services for emergency and trauma care, and create a demonstration program to promote a coordinated regional approach to emergency care

Dr. Andre Wilson, Chief of Emergency Medicine in William Beaumont Hospital in Royal Oak in Michigan released a study on the effect of the straight back approach in reducing emergency room wait time. On this approach, the patients are immediately moved from the triage to an emergency room treatment area without going through the waiting room. There is need for the patient to go though with the minimal registration procedure and have the patient chart available immediately. With this procedure, the Beaumont Hospital was said to have the satisfaction rating from their patients increased. This also thought to increase the hospital’s revenues.

Hospitals are taking measures on reducing the staffing shortages their emergency department are increasing. Emergency room nurses are much in demand nowadays to cope with the increasing number of sick patients requiring medical attention. we could have as many emergency room nurses, but the key issue is how to provide health care for everybody available at all times with minimal amount of wait.

Emergency nursing cares for individuals of all ages in critical condition of their illness or injury without preliminary diagnosis. It encompasses all ages and medical specialties. Preventive care education and injury prevention is becoming a larger role for emergency nurses.

According to Kristine M. Alpi, the Associate Library Director Samuel J. Wood Library and C. V. Starr Biomedical Information Center, emergency nursing is one of the fastest growing specialties in the nursing profession. In 2000, there was a whooping 95,000 registered nurses employed in the United States alone. With this large number of emergency room nurses there is a need for an organization that will gather and look after these medical professionals.

In the United States, the primary organization for emergency nurses is the Emergency Nurses Association (ENA). In 1970, Anita Door launched the Emergency Room Nurses Organization in Buffalo, New York. Another organization was formed by Judith Kelleher, the Emergency Department Nurses Association in California. These two groups merged in December 1, 1970 to become the emergency Department Nurses Association. It was renamed ENA in 1983.

In 1972, the Royal College of Nursing in the United Kingdom established an accident and emergency nursing group, which became the Accident and Emergency Nursing Association in 1990. The first international emergency nursing congress was held in 1985 in London.

In Hong Kong, emergency nurses can join the Hong Kong Society of Emergency Medicine as members. There are some countries that do not have an organization specifically for emergency nurses but allow E.R. nurses to become members of other organization focused on emergency work.

The following are several international organizations of emergency nurses:

• Belgium: Association Francophone des Infirmier(e)s d’Urgence
• Canada: national Emergency Nurses Affiliation , Inc. (NENA)
• Denmark: Danish Association of Accident and Emergency Nursing
• Italy: Nurses of Emergency (NOE)
• Malta: Malta Emergency Nurses Association
• Mexico: Mexican Association of Emergency Nurses
• Netherlands: Dutch Association of Accident & Emergency Nurses
• New Zealand: College of Emergency Nurses New Zealand
• Spain: Sociedad Espanola de Enfermeria de Urgencias
• Sweden: Swedish Association of Trauma Nurses

Emergency nursing organizations are very important in advancing the rights of the emergency health workers. ENA has been actively campaigning in educating the public about the violence emergency health workers are experiencing while they are in duty. ENA even has a statement regarding partner and family violence which leads to several cases of emergency patients victim of this kind of violence.

E.R. nurses joining these organizations will definitely benefit from them. These organizations would readily provide publication where there will be updates about medical technologies and procedures that will further educate our nurses. These organization also provide courses, training and education programs, even certification programs for the improvement of the organizational members.

Professional organizations, like the emergency nursing organization, provide a venue for nurses to learn and associate with their peers, mentors and nursing leaders. An emergency nursing organization membership can lead to increased awareness of nursing issues and support for collective actions among nurses. Learning, developing and improving is a life time process. Emergency nursing organizations offer nurses to improve and see their nursing career and future.

Organizations are formed to protect, defend, and advance a certain group’s advocacy or welfare. For emergency nurses, it is fortunate for them to have an organization that is not only geared towards improving their performance in the medical profession but build and safeguard their medical community as well.

Millions of patients walk into emergency rooms every year to get medical attention. With the proliferating of medical series, everybody seems to be amazed with the 24 hour action hospital department with emergency nurses running and treating critically injured victims.

But how does emergency room really works?

According to Dr. Carl Bianco, writer of How Emergency Room Works, the first step in the emergency room process is the triage. A triage is an emergency nurse who categorizes and prioritizes the patient’s condition. The triage categorizes the patient’s situation into three categories:

1. immediately life threatening
2. urgent, but no immediately life threatening
3. less urgent

The triage is also responsible in recording the patient’s vital signs which are temperature, pulse, respiratory rate and blood pressure. The triage also gets the brief patient history, medications, allergies to determine the appropriate category.

Registrations will be the next step. With the registration, additional information is obtained from the patient. Mainly insurance information, creation of medical record for reference while in the hospital. But for life threatening situations like car crash of life threatening cases, registration can be completed later on.

The patient will go next to the examination room where an emergency room nurse will get more detailed information about the sickness. There are certain hospitals that have divided their emergency department into areas dedicated to pediatric ER, a chest-pain ER, a fast track (for minor injuries and illnesses), trauma center (usually for severely injured patients) and an observation unit (for patients who do not require hospital admission but needs prolonged treatment or diagnostic tests).

After the nurse has completed her duty, the emergency physician will get a complete review of the information obtained from the patient. He then formulates a possible cause or diagnosis based on the symptoms.

Diagnostic tests are required when the physician sees that the patient’s symptom and physical examination failed to get a likely diagnosis. After conducting the diagnostic tests and was able to identify the probable diagnosis, necessary action or steps are undertaken to treat the patient.

Normally, a scene from the ER can be chaotic and confusing for a victim of patient’s family. A long line of patients wanting to be examined could a dreadful sight. There are some people who tried to get medical attention to no avail. Donna Mason, an emergency nurse gave CNN five things to remember in an ER:

1. Inform your doctor is you will be going to the emergency room.

2. Use the ambulance specifically for threatening situations. There would be instances that whenever emergency personnel can see that the patient can actually walk and chose to arrive with the emergency room to get attention, they asked the patient to step down and wait.

3. If the triage is not being helpful in addressing the case, speak up and look for the person in charge.

4. It is important to control temper at all times. It is also important not to lie about your symptoms just to get attention ahead of the others.

5. If things are really getting bad and nobody from the emergency department is helping, look for a house phone and inform the issue to the hospital administrator or patient advocate who is available 24 hours.

Emergency room experience can be tough and rough. It is necessary for us to understand the how things work to understand why some emergency room or departments will take a while to address patient issues. Emergency rooms are a mazes filled with emergency room nurses who I wager will be more than happy to take care of the patients.

Emergency nurses are starting to get hurt.

According to the Health Promoting Hospitals and Health Services International Conference held in Berlin this year, 98 percent of emergency room nurses in the Unites States reported verbal harassment and 67 percent reported physical violence.

While in Canada, 84 percent of the nurses in the emergency department witnessed verbal harassment once in every shift. While there are 90 percent of them claimed to experience verbal abuse at least once a week. In Australia, there are 70 percent of nurses who experience violence at least five times a week.

Emergency room nurses are falling victims to increasing violence in the emergency department of hospitals.

The Emergency Nurses Association conducted a study and 86 percent of all the ER nurses involved in the survey had some form of violence committed against them while they are on duty.

Last 2005, the Massachusetts Bureau of Labor Statistics reported that there are 4,000 hospital employees assaulted while working in the ER. In the same year, ER doctors in Michigan reported that 28 percent has experienced physical assault while 75 percent received verbal assaults.

Patients themselves could be the perpetrators of this violence occurring in emergency departments. Intoxication and long delay in the waiting room are common things that might fire up a patient.

Based on one of the largest studies made on the issue made on 2004 in Minnesota, patients committed almost all of the physical assaults and two-thirds of the verbal harassments.

Visitors as well as physicians and other staff members are responsible for the other assaults and harassments. It is only possible to receive aggression from the patient’s family members. If the patient was involved in a traumatic incident, his family members’ anxiety levels could be very high and may overwhelm them.

The most common assaults against nurses could sometimes result into serious injury. Typical assaults would include spitting, hitting, kicking, hair pulling and attack using an object or weapon.

There would be incidents that would result into serious injury, an example would be an ER nurse who lost her baby when kicked by a patient in the stomach. Drug or alcohol, psychiatric conditions, neurological problems and a history of violence are factors for such violent acts.

Between 1980 and 1990, there were 26 physicians, 18 registered nurses, 27 pharmacists, 17 nurses’ aides, and 18 other health care workers were killed on the job (U.S. Department of Labor). While there were 221 hospitals in America and Canada that reported 42 homicides, 1,463 physical assaults, 67 sexual assaults, 165 robberies, and 47 armed robberies in 1995 according to the International Association for Healthcare Security and Safety.

There are also behavioural clues is a patient or visitor is likely to be abusive. Postures tend to be tensed while speech is load and can be threatening or insistent. Aggressors would constantly drop threats or plans of violence.

There are also certain diagnoses associated with violent behaviour like substance abuse, acute psychoses, acute organic brain syndrome, personality disorders and partial complex seizures.

The time is also relevant.

Incidents which occur on a night shift are more likely to produce violent patients. In a study conducted by University of California at Irvine, 31.8 percent of violent incidents occurred between 11 p.m. and 7 a.m. while only 13.3 percent of the patient volume was seen during these hours.

So what are the public doing about this?

Nursing organizations and unions are constantly working to draw the attention and educate the public on this issue. They are also lobbying for a legislation in increasing the penalties against perpetrators. Programs are being developed in healthcare institutions to address this issue. Security has been reinforced in hospitals to prevent the escalating violence in emergency departments.

Emergency nurses are the first one to give first aid to hurt and injured people. Now seems the time to help them stop getting hurt.

Emergency room nurses are nurses specialized in emergency and disaster situations. They are responsible for giving first or preliminary medication or treatment for patients on critical stage of their illness and injury. Emergency room nurses are noted for their speed, efficiency, ability to multitask and provide medical care. But how can one become an emergency room nurse?

Of course, formal education and training is required to become an emergency nurse. Emergency room nurses should have the skill to manage basic life support since they are the ones responsible for the patient while the doctor or the physician is unavailable. One interested in becoming an emergency room nurse should be a graduate from an accredited nursing school. The licenses should be legal and in good standing. Emergency room nurses should be willing to engage in nursing Practice Act.

It is important to have at least an experience in emergency medicine. He or she should also have the ability to lead in midst of crisis. An 80 percent should be at least achieved on competency tests. A current certification from Advanced Cardiac Life Support or ACLS should also be possessed by the soon-to-be emergency nurse. Emergency rooms are definitely fast paced environments. There would be physical demands that an emergency nurse should know how to cope with this. Some of these physical demands are:

1. Lifting 50 lbs.

2. Standing and walking for long periods.

3. Bending, leaning and stooping without any hindrance.

4. Good skill in stress coping

5. Fine motor skills

6. Paying attention to details.

7. Working accurately around frequent interruption

There would some emergency departments that would require the nurses to possess an RN degree. RN program is two year associate degree program. Advanced training such as the BSN or Master of Science in Nursing may be required for supervisory or administrative function related to the emergency department.

The U.S. Bureau of Labor Statistics projected an increase of more than 27 percent in the next decade for emergency room nurses. The American Association of Colleges and Nursing noted that in 2006 there was an average understaffing of emergency room nurses by of 8.5 percent.

There can be three types of emergency nurses. In the United States, there is a Certified Emergency Nurse (CEN) who is a licensed registered nurse. A CEN has already demonstrated know-how in emergency nursing. The Certification is valid for four years and it can be renewed by passing another examination or completing 100 continuing education units in the specialty.

Meanwhile, an Emergency Nurse Practitioner (ENP) who are mainly located in United Kingdom. And ENP can independently assess, diagnose, investigate and treat wide range of common accidents and injuries. ENPs have undergone a training in advanced nursing which is completely medical in nature. Their training would include taking full medical history and examination, x-ray interpretation, prescribing, suturing and plastering.

Emergency Care Practitioner, also in United Kingdom, is a specialist nurse or specialist paramedic who works in the pre-hospital setting dealing with emergency problems. The primary responsibility of an Emergency Care Practitioner is to assess, diagnose and treat patient in the home in an emergency setting.

Emergency nurses are very much in sought-after. Healthcare professionals are being needed in numerous hospitals especially emergency departments are experiencing staff shortages. A lot can be asked from us if we are decided to become emergency nurses. It can be emergency nursing or other job, what’s important is continuous learning with whatever field we have chosen.

Nurses are responsible, along with other health care workers or professionals, for the treatment and caring for the injured and acutely or chronically ill people.

Nurses attend to varieties of life and death matters in different health care settings. Emergency room nurses or ICU nurses specialize in rapid assessment and treatment, since every second counts in emergency cases. A nurse in this setting administers medication and assists physicians attending emergency room tasks related to medical care. Emergency room nurses are also responsible for keeping patient records.

Emergency nursing is a specialty of the nursing profession. Emergency nurses should always be ready to treat wide variety of illnesses ranging from throat infections to heart attacks or victims of severe trauma. The types of patients that show up in hospital emergency departments often depend on things like the weather, highway accidents, industrial accidents, fires and hundreds of unfortunate events. Emergency nurses are expected to care for patients of all ages.

Emergency nurses should be familiar with the policies of the facilities their working for, as well as procedures and protocols. The emergency department has a fast paced environment, as a nurse for this department, emergency nurses are needed to utilize their skills in time management. It does not only refer to prioritizing patients but also prioritizing the nurses’ time. Time management will enable nurses to confidently complete their duties. It is very important for an emergency room nurse to be able to do multitasking.

According to Nurses for Healthier Tomorrow (NHT), a coalition of nursing and health care organizations, there are three major roles an emergency nurse should carry out:

(1) Patient Care.

Emergency nurses should care for patients and families in hospital emergency departments, ambulances, helicopters, urgent care centers, cruise ships, sport arenas, industry, government, and anywhere someone could have a medical emergency.

(2) Education.

Emergency nurses should provide education to the public through programs that promote wellness and prevent injuries. Some of the educational programs such as alcohol awareness, child passenger safety, gun safety, bicycle and helmet safety and domestic violence prevention are usually conducted by nurses.

(3) Leadership and Research.

Emergency nurses also may work as administrators, managers, and researchers to improve emergency health care.

For all of the demands of emergency nursing, an emergency nurse should be prepared at all times to provide patient care for almost any situation. Some emergency nurses tend to specialize in trauma, pediatrics, geriatrics and injury prevention. Nurses are not only attendants in hospitals and clinics, they may also be involved in medical and nursing research.

Another important responsibility of the emergency room nurse is to continually be aware of their working environment; maintain proper supplies and appropriate medical equipments necessary in caring for the patients. As part of their job duties, emergency room nurses engage in educational activities to promote the nursing profession and keep them up to date on today’s advanced diagnostics, technologies, medical equipment and safety techniques.

Emergency nurses are very much in demand nowadays. Emergency nursing is a profession that requires adept skill in caring for ill and injured people with speed, efficiency and leadership.

Doing all of these medical tasks while attending to other duties requires skill in multitasking. That is why emergency room nurses are always up on their toes, always on duty. With all the responsibilities and duties being performed by an emergency nurse it is essential not to lose the thing that made us go into this profession, compassion and love for life.

There are several hospitals in the United States that are experiencing immense shortages of registered nurses, emergency nurses and other health care professionals.  There is approximately a whooping 80 to 85 percent of American hospitals mention shortage while 15 percent expresses concern about the severe shortage they are experiencing.

According to the United States Department of Health and Human Services, United States  will need 2.8 million nurses.  This estimated demand will be a million more than the projected supply of nurses.  U.S. is not quickly replacing nurses at the same phase they are leaving the profession.

Currently, the average age of nurses working in America is 45 years old.  By year 2010, and estimated 40 percent of all the working registered nurses will be more than 50 years old.  Between 2010 and 2020, the largest group of registered nurses in the United States labor force will be between 50 to 60 years old.  By this time, the nursing shortage would be exceeding 36 percent.

What’s happening to United Case is not an isolated case.  Several countries are already reporting similar problem.  In Ontario, Canada (Toronto Star) lost 14,000 of its 81,000 nurses due to retirement last 2004.  While as early as December 2000, the World Health Organization already reported that Poland was graduating more than 10,000 nurses annually.  But the figure dropped to 3,000.  In Chile, out of 18,000 nurses in the country, only 8,000 are working in the field.

So what are the steps being done by the United States government to address this problem?

In April 2008 a bill was proposed in the United States House of Representatives by Congressman Robert Wexler from Florida and co-sponsored by Representative James Sensenbrenner (R-WI).  This bill is called F.R. 5924 of The Emergency Nursing Supply Relief Act.  As of the day, this bill has currently 11 co-sponsors.

Basically, this bill will allow additional visas to be set- aside for foreign trained nurses and physical therapists.  The H.R. 5924 would  save 20,000 employment based visas in each of the next three years for foreign trained registered nurses and physical therapists.

This bill will also provide funds to help U.S. nursing schools expand the domestic supply of nurses by coming from the  $1,500 fee for those who would be applying for the visa.  This would also establish a three-year pilot program aimed in keeping U.S. nurses in the workforce.

Immigrant visa applicants will need to attest that they do not owe their country of residence a financial obligation that was incurred for their education so that they would remain in that country. Both the American Hospitals Association (AHA) and the American Society for Healthcare Human Resources Administration support expressed their support for the bill.

Due to visa retrogression, a lot of foreign professionals who are interested in working in the United States are turned down. The U.S. government makes only a certain number of immigrant visas (green card) available each year and these are allocated among the various immigrant visa categories.

Recently, there are more immigrants approved for employment-based immigrant visas and has run out of visa numbers causing temporary backlog or retrogression. The U.S. has a waiting list for employment-based visas for nurses, and its nurse education programs turned away more than 150,000 qualified applicants last year due to lack of faculty and clinical space.

With the H.R 5924., it aims that the nursing shortages will be resolved.  With this bill, the visa retrogression could be lift for nurses and physical therapists who have applied prior to September 30, 2011.  Hopefully, we’ll see more therapists, nurses, E.R. attendants and nurses, and other health professionals taking care of the nation.