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To explore the experiences of Emergency Department nurses when caring for patients presenting to the Emergency Department with mental health issues.
Qualitative descriptive study.
Ten nurses with experience caring for mental health patients participated in face-to-face, semi-structured interviews. Nurses were recruited if they were employed at a single tertiary Emergency Department in the Northern Territory, Australia. Interviews were audio-recorded, transcribed, and analysed using thematic analysis. The COREQ checklist guided reporting.
The four key themes were: systemic factors; emotional impact and staff culture; influence of communication; education and training. Systemic factors, such as overcrowding, staff shortages, long stays, and unsuitable Emergency Department environments, restricted therapeutic care and increased patient distress. The emotional impact of caring for mental health patients, combined with reactive workplace culture and stigma, contributed to moral distress and burnout. Clear communication and teamwork supported care, while limited mental health education left nurses underprepared and reliant on informal learning. Participants emphasised the need for clear protocols, targeted training, and structured support to enhance patient outcomes, nurse confidence, and well-being.
Emergency Department nurses face systemic, cultural, and educational barriers that compromise patient care while contributing to stress, fatigue, and burnout. Addressing these challenges through integrated care pathways, targeted education, and staff support is essential to improve patient outcomes and sustain the nursing workforce.
Data from this study identifies there is an urgent need to implement practical strategies to reduce challenges for nurses in caring for patients presenting to the ED with mental health issues.
This study revealed that systemic pressures, emotional fatigue, and limited training hinder effective care. This research can inform hospital leaders, policymakers, and educators to improve support, training, and care pathways within ED settings.
The authors have adhered to the COnsolidated criteria for REporting Qualitative research (COREQ).
No patient or public contribution was made.
To critically synthesise current literature on the nurses' experiences in providing care for people presenting with mental health issues to the emergency department (ED).
Mental health-related presentations to EDs are increasing. Understanding nurses' experiences of providing care for this patient group will inform future strategies to enhance the care delivered in the ED.
CINAHL, MEDLINE, APA PsycInfo and Psychology and Behavioural Sciences Collection were searched from 2009 to 2024 for peer-reviewed qualitative papers exploring emergency nurses' perspectives of providing care for people with mental health issues, published in the English language. Quality was appraised using the JBI Critical Appraisal tool. This review follows the PRISMA checklist for reporting.
Nine papers, reporting eight studies, were included in the review. Three themes emerged: attitudes towards mental illness, education limitations impacting confidence and structural barriers impacting care quality. The review reveals a disconnect between nurses' compassionate intentions and barriers such as unconscious stigma and prioritising physical illness over mental health concerns. The findings highlight the need for targeted mental health education to enhance ED nurses' confidence and competence. Inadequate local mental health policies also impact care delivery, contributing to suboptimal patient outcomes.
This review provides a deeper understanding of ED nurses' experiences of caring for people with mental health issues. A need to implement a multifaceted approach to mental health education, clear policies to guide care delivery and systems that promote prioritisation of patients presenting with mental health concerns was identified.
Insights into nurses' experiences can shape future ED practices and enhance outcomes for patients. Building ED nurses' capacity to deliver high-quality mental health care is critical.
As a review paper, no patient or public consultation took place.
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