Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Forensic nursing is an evolving specialty designed to address the unique, intersecting health and legal needs of patients who are victims, suspects, and perpetrators of trauma. The "Forensic Nurse Hospitalist" is proposed as a new term to describe the role of the nurse who is qualified by licensure and education as a specialist in forensic nursing and practices specifically in the hospital setting. ⋯ The purpose of this paper is to highlight the need and importance of the forensic nurse hospitalist and describe the multifaceted responsibilities of the role as a transformational leader in health care today. It is vital that health care systems employ forensic nurse hospitalists to deliver expert patient care, offer specialized consultation and collaboration, and implement systemwide policy and educational initiatives to best meet the needs of patients who have experienced intentional or unintentional trauma.
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Workplace violence is a serious occupational problem among nurses in emergency departments. The aim of this study was to better understand workplace violence experienced by triage nurses. ⋯ Nurses reported that high exposure to workplace violence in triaging had significant consequences on their psychological well-being and on their behavior at work and at home. Violence, perceived as a personal and/or professional injury owing to insufficient organizational support, led professionals to experience feelings of resignation and to believe that abuse was an inevitable part of the job. Nevertheless, in our study, the precipitating factors were investigated, suggesting several possible solutions to limit this phenomenon.
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Review
Drug Overdose, Loss of Consciousness, and Compartment Syndrome: A Life-Threatening Combination.
Acute extremity compartment syndrome is considered an orthopedic emergency that has serious consequences if a correct diagnosis is not made rapidly. Patients who lose consciousness due to a drug overdose are known to collapse onto their extremities. The limbs are compressed for hours, placing them at an increased risk for acute extremity compartment syndrome and its sequelae. ⋯ However, it differs in relation to the muscles affected, physical assessment strategy, and accurately determining the amount of the time from onset of injury to the presentation of symptoms. The purpose of this article is to facilitate emergency department nurses' understanding of the complexities of overdose compartment syndrome, combined with the importance of early recognition of the condition. In addition, the authors review the pathophysiology, the traditional and innovative diagnostic techniques, and the current treatment options available for overdose compartment syndrome.
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The Dynamic Appraisal of Situational Aggression (DASA) is an assessment tool that has been validated to predict violent or aggressive behavior in psychiatric inpatient settings. Its validity has not been established for use in the emergency department. ⋯ The DASA has predictive validity for use in evaluating behavioral health patients in the ED setting in an urban academic medical center. The tool is capable of predicting violence or aggression within a time frame conducive to the implementation of noninvasive measures. The DASA should be tested in other ED settings to further establish its predictive validity.
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A high degree of suspicion for spinal injury after trauma is commonplace in an emergency department, and spinal immobilization is considered an accepted intervention to prevent the progression of a potential injury. This systematic review was conducted to gain insight into the best research evidence related to nursing interventions for patients with trauma presenting with a suspected spinal injury. ⋯ Patients would benefit from a more selective and cautious approach to spinal immobilization. Emergency nurses should use the evidence to facilitate informed decision-making in balancing the benefits of spinal immobilization against harm when considering the needs and values of the patient.