1. The emergency nurse initiates accurate and ongoing assessment of physical, psychological
and social problems of patients within the emergency care system.
a. Obtains initial focused subjective and objective data through history taking, physical
examination, review of records and communication with health care providers, significant
others and caretakers, as appropriate.
b. Uses assessment techniques and criteria that are pertinent to the patientís age-specific
physical, psychological, and social needs.
c. Documents relevant data for every patient as appropriate to the nature and severity of
illness or injury.
d. Communicates significant data to appropriate personnel throughout the patientís emergency
2. The emergency nurse analyzes assessment data to formulate nursing diagnoses and identify
collaborative problems for each patient.
a. Identifies nursing diagnoses/potential complications based on signs and symptoms recognized
during a focused, systematic assessment.
b. Documents nursing diagnoses/potential complications on each patient.
3. The emergency nurse formulates a plan of care for the emergency patient based on assessment
data and nursing diagnoses/potential complications.
a. Develops a plan of care for each patient, in collaboration with the patient, significant
others and other health care providers, based on current scientific knowledge and in
accordance with the established standards of emergency nursing care.
b. Identifies priorities for nursing interventions.
c. Communicates plan of care to other health care providers to ensure continuity of care.
4. The emergency nurse implements a plan of care for the emergency patient based on assessment
data and nursing diagnoses/potential complications.
a. Implements plan of care for each patient
b. Provides necessary education regarding procedures, treatment regimens, and identified
outcomes to each patient and significant others.
c. Accurately implements physician orders in accordance with each patientís priority of care.
d. Performs appropriate patient monitoring and documents patientís response to intervention.
e. Demonstrates prioritization and organizational skills in caring for multiple complex
f. Seeks assistance/guidance when confronted with nursing procedures not yet mastered.
5. The emergency nurse evaluates and modifies the plan of care based on observable patient
responses and attainment of expected outcomes.
a. Evaluates and documents patientís response to interventions and changes in patientís
condition and revises plan of care as appropriate in collaboration with the physicians and
other health care providers.
6. The emergency nurse assists the patient and significant others to obtain knowledge about
illness and injury prevention and treatment.
a. Explains written instructions regarding aftercare, follow-up and referrals to patients and
their significant others.
b. Documents patientís understanding of discharge plan of care.
c. Notifies physician and/or appropriate resource personnel of any barriers to patient
compliance with discharge plan of care.
d. Assists patients and significant others in the identification of factors that place them
ďat riskĒ for illness and injury.
7. The emergency nurse collaborates with other health care providers to deliver
patient-centered care in a manner consistent with safe, efficient and cost-effective resource
a. Assigns tasks or delegates care based on the needs of the client and the knowledge and
skill of the provider selected; appropriate delegation to less experienced RNs and CAís
b. Assists the patients and significant others in identifying and securing appropriate
services available to address health-related needs; social service consultation, home care
services, case management consultation, mandatory reporting.
c. Ensures that supplies and equipment are readily available and in working order: completion
of equipment checklists as assigned.
d. Ensures that patient charges are accurate and reflect the care that the patient received:
pharmacy, level of care charges.
e. Implements safety procedures for each patient in accordance with that patientís specific
needs: namebands, siderails, and appropriate level of observation provided.
f. Demonstrates knowledge and compliance with practices that protect the health care provider
and reduce the spread of infection in the emergency care setting: use of standard precautions,
g. Recognizes the potential for violence in the emergency setting and institutes appropriate
action: use of Protection Services, CPI techniques.
8. The emergency nurse triages each patient and determines priority of care based on physical,
psychological and social needs as well as factors influencing patient flow through the
emergency care system.
a. Performs focused assessment of chief complaint on each patient in a timely manner according
to established triage guidelines.
b. Documents triage assessment, including appropriate subjective and objective data.
c. Differentiates severity of patient complaints and assigns appropriate triage acuity
d. Identifies and initiates nursing interventions per established protocol.
e. Reassures the patient according to acuity and established procedures and revises the acuity
level based on new information or changes in assessment data.
f. Maintains open communication with Charge Nurse and Attending Physician regarding patient
acuity, flow, and bed availability. Institutes ďmodified triageĒ when appropriate.
g. Provides information about the patientís condition to the patient and significant others as
appropriate. Maintains crowd control.
9. The emergency nurse engages in activities and behaviors that characterize a professional
a. Accepts accountability and responsibility for maximizing department operations and patient
outcomes using sound judgement.
b. Adjusts staff assignments according to assessed nursing capabilities and responsibilities,
patient acuity/level of need, volume and flow within the department.
c. Identifies self as a resource person who willingly shares knowledge and skills with
colleagues and others.
d. Provides peers with constructive feedback regarding their practice.
e. Demonstrates and provides unified leadership in the department by encouraging staff to
discuss issues with appropriate management personnel who can assist with problem solving.
f. Demonstrates knowledge of department operational policies including, but not limited to:
informed consent for treatment, patient transfer, COBRA legislation, patient confidentiality,
patient restraint and the departmentís scope of practice.
10. The emergency nurse recognizes self-learning needs and is accountable for maximizing
professional development and optimal emergency nursing practice.
a. Attends 50% RN/department staff meetings annually.
b. Attends 50% inservices offered in the department annually.
c. Maintains BLS, ACLS certification
d. Attends Emergency Department RN Competency Review Course annually.
e. Attends hospital-based Education Fair annually.
f. Pursues continuing education/certifications in the specialty of emergency nursing to
enhance nursing practice.
g. Participates on at least one department based committee and/or assists in facilitating
formal or informal learning experiences for professional peers and students in a courteous,
h. Participates in Quality Improvement initiatives to measure and improve quality of care.
1. Graduation from an NLN accredited school of nursing
2. Current registration in the Commonwealth of Massachusetts
3. Interpersonal skill in interacting with patients, families, and a multi-disciplinary team
of health-care personnel.
4. Minimum of 3 years medical-surgical nursing experience (ED experience preferred)
5. Successful completion of stated competencies
6. ACLS certification
7. Recommended Requirements:
a. Membership in professional organization, ie: ENA
b. Certification in Emergency Nursing (required after 2 years of employment)