A broad new role in emergency nursing
The Emergency Department at BWH sees an incredible range of patients. Many present with serious problems, a reflection of the patient population that our hospital tends to serve. But health problems often don’t magically disappear after we stabilize the emergency. Many patients need follow-up care and services that go beyond urgent care.
In the past year, the ED has taken on a dynamic new role — the facilitation of the care of patients during their visit to the ED, as well as the care following the urgent clinical needs. Four experienced emergency nurses, working as patient care facilitators, form this new service that provides a stronger bridge between emergency care and other clinical and social services, both within and outside the hospital.
Care coordination is at the core of our job. For example, when the ED gets an “expect” call from an outside physician or hospital, we alert specialty care units, such as Neurosurgery for a head trauma case. This ensures everyone is ready for the patient’s arrival in the ED.
If patients need to be admitted, we call ahead to the appropriate floor to pave the way. Most emergency patients, however, are discharged and many still need further care. One such example is the recent visit by an elderly woman who suffered a bone fracture in a fall at home. Recognizing the need, our service assessed her house set-up and her dietary needs and, working with social workers assigned to the ED, linked her to visiting nurse services, nutritional counseling and physical therapy.
Another case requiring our role might be a patient who does not have a personal care physician, or whose condition requires prompt management by a specialist. To help such patients efficiently navigate the BWH system, we often will call the specialty clinics to ensure appointments are made.
BWH is a national pacesetter in this new role for emergency nurses. But though our main focus has shifted to facilitating post-discharge care, we don’t lose touch with urgent clinical care, jumping in when more hands are needed.
Perhaps the nicest part of our job is the personal dimension. We have time to hold the patient’s hand, to reduce uncertainty and stress. We interact with the entire family about future steps, guiding them to choices that will promote the patient’s physical and emotional comfort in the days ahead.
Jeannette Meyers, RN
Patient Care Facilitator
Emergency Department