The care of patients assessed as not in need of emergency ambulance care – Registered nurses’ lived experiences

Barrientos, Christian; Holmberg, Mats

doi:10.1016/j.ienj.2018.01.007

Cited by 20 publications

(15 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Unnecessarily conveying patients to an ED fostered dissatisfaction with oneself, the ambulance service and the wider healthcare system. According with our finding, a lack of formal support offered by non-conveyance guidelines has been mentioned in previous studies13 20; furthermore, ACs’ working environments and realities have previously been shown to differ significantly from existing non-conveyance guidelines 24 36 37. However, the results of our study provide a new insight into the possible consequences of using non-conveyance guidelines that have an unknown evidence base.…”

Section: Discussionsupporting

confidence: 73%

“…Frustration regarding inadequate education and having different expectations to one’s professional reality can create unfavourable circumstances during non-conveyance situations. Furthermore, an increased risk of developing compassion fatigue during non-conveyance assessments has been shown to correlate to increased frustration 20. Thus, developing favourable circumstances for ACs to perform safe non-conveyance assessments requires minimising frustration through adequate education and the creation of an evidence base on which future non-conveyance guidelines can be built.…”

Section: Discussionmentioning

confidence: 99%

“…Decision-making that accommodates patients’ needs for appropriate care is a complex process that should combine the perspectives and needs of patients, family members, ACs and the wider healthcare system 11 20–23. Furthermore, ACs have medical guidelines and, commonly, triage tools to use when performing assessments.…”

Section: Introductionmentioning

confidence: 99%

“…When performing non-conveyance assessments, ACs can experience difficulties and frustration regarding differing expectations and conflicting perspectives and demands 20 21. Furthermore, such situations can also place high levels of responsibility on ACs 21 24 25.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Assessing non-conveyed patients in the ambulance service: a phenomenological interview study with Swedish ambulance clinicians

et al. 2019

View full text Add to dashboard Cite

ObjectivesTo combat overcrowding in emergency departments, ambulance clinicians (ACs) are being encouraged to make on-site assessments regarding patients’ need for conveyance to hospital, and this is creating new and challenging demands for ACs. This study aimed to describe ACs’ experiences of assessing non-conveyed patients.DesignA phenomenological interview study based on a reflective lifeworld research approach.SettingThe target area for the study was Stockholm, Sweden, which has a population of approximately 2.3 million inhabitants. In this area, 73 ambulances perform approximately just over 200 000 ambulance assignments annually, and approximately 25 000 patients are non-conveyed each year.Informants11 ACs.MethodsIn-depth open-ended interviews.ResultsACs experience uncertainty regarding the accuracy of their assessments of non-conveyed patients. In particular, they fear conducting erroneous assessments that could harm patients. Avoiding hasty decisions is important for conducting safe patient assessments. Several challenging paradoxes were identified that complicate the non-conveyance situation, namely; responsibility, education and feedback paradoxes. The core of the responsibility paradox is that the increased responsibility associated with non-conveyance assessments is not accompanied with appropriate organisational support. Thus, frustration is experienced. The education paradox involves limited and inadequate non-conveyance education. This, in combination with limited support from non-conveyance guidelines, causes the clinical reality to be perceived as challenging and problematic. Finally, the feedback paradox relates to the obstruction of professional development as a result of an absence of learning possibilities after assessments. Additionally, ACs also described loneliness during non-conveyance situations.ConclusionsThis study suggests that, for ACs, performing non-conveyance assessments means experiencing a paradoxical professional existence. Despite these aggravating paradoxes, however, complex non-conveyance assessments continue to be performed and accompanied with limited organisational support. To create more favourable circumstances and, hopefully, safer assessments, further studies that focus on these paradoxes and non-conveyance are needed.

show abstract

Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Assessing non-conveyed patients in the ambulance service: a phenomenological interview study with Swedish ambulance clinicians

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Advanced Medical Life Support (AMLS) is a concept that helps the nurse to identify life‐threatening states early in the assessment and effectively manages a wide range of medical situations (National Association of Emergency Medical Technicians, ). Internationally as well as nationally, the number of non‐urgent patients using ambulance care increases (Barrientos & Holmberg, ; Rosén, Persson, Rantala, & Behm, ). More than 15% of the patients remain at home after assessment of ambulance staff.…”

Section: Introductionmentioning

confidence: 99%

Ambulance nurses' experiences of deciding a patient does not require ambulance care

et al. 2019

View full text Add to dashboard Cite

Aim To describe ambulance nurses' experience of deciding a patient does not require ambulance care. Design An inductive, empirical study with a qualitative approach. Methods Data collection was conducted through semi‐structured interviews, and collected data were analysed with qualitative manifest content analysis. Data were collected during the spring 2017, and eight ambulance nurses participated. Results The findings are presented in one main category, which is “Not very ill but a difficult decision” with totally three subcategories. The ambulance nurse's experience of making the assessment when the patient has no need for ambulance care is like walking the balance of slack line. This means that the assessment can be both easy and very difficult but something that definitely requires experience, knowledge and dedication.

show abstract

Older patients’ perceptions of the Swedish ambulance service: A qualitative exploratory study

Rantala¹,

Sterner²,

Frank³

et al. 2023

Australasian Emergency Care

View full text Add to dashboard Cite

The care of patients assessed as not in need of emergency ambulance care – Registered nurses’ lived experiences

Cited by 20 publications

References 26 publications

Assessing non-conveyed patients in the ambulance service: a phenomenological interview study with Swedish ambulance clinicians

Assessing non-conveyed patients in the ambulance service: a phenomenological interview study with Swedish ambulance clinicians

Ambulance nurses' experiences of deciding a patient does not require ambulance care

Older patients’ perceptions of the Swedish ambulance service: A qualitative exploratory study

Contact Info

Product

Resources

About