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ER Nurses

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Wanted: E.R Nurses

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.

Emergency Room Nurses: Always on Duty

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

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

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

(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.

E.R. Nurses Shorthanded

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

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.

Warning: Hazards of Being an E.R. Nurse

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

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

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.

Travel and Medicine: Tourist E.R. Nurse

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 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

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

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.

E.R. Nurses in a Maze

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

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

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.

Nursing - the E.R. Nurses

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

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.

E.R. Nurses Getting Hurt

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

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.

Organized: The ER Nurses' Organizations

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

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.

U.S. Trade In: E. R. Nurses and Health Professionals

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

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

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.

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