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  • 01 August 2023
  • 7 min read

Overcoming The Challenges Of The Emergency Department As An NQN

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    • Richard Gill
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  • 398
Staff shortages impacting patient care“By supervising Newly Qualified Nurses throughout the process of acute illness and trauma management, the journey to safe and autonomous practice is greatly supported.”

In recent years, the emergency departments of the NHS have become increasingly busy, with staff shortages impacting patient care. This has led to many units accepting applications from Newly Qualified Nurses. Rachel discusses how NQNs in this field can build up their clinical skills and qualifications, allowing EDs to remain safe and efficient.

As patient volume and acuity continues to multiply at an unprecedented rate across NHS emergency departments, staff recruitment remains insufficient to accommodate this demand. In light of these pressures, many units have opted to expand applications for nursing positions to newly qualified staff, with a view to securing safer nurse to patient ratios and care delivery.

This article considers the ways in which Newly Qualified Nurses pursuing this field of practice may rapidly advance their clinical skills to reduce discrepancies in skill mix and ultimately improve service provision within ED.

Pre-Registration Experience

Arguably, the process of acquiring and building upon the competencies required for working in emergency medicine is best initiated at the earliest possible stage of nurse training. Not only is this experience advantageous in setting Newly Qualified Nurses apart from other ED applicants, but also generates sound foundational knowledge to ease transition into this field post-qualification.

Alongside clinical placements and academic study, a practical way for Student Nurses to access this exposure is by undertaking agency shifts as a clinical support worker. Bank organisations such as NHS Professionals allow Pre-Registration Nurses, authorised by an appropriate senior, to complete auxiliary shifts at emergency departments within an assigned Trust. For those hoping to attain a qualified position in ED following graduation, engaging in this work can contribute to development of fundamental emergency nursing skills such as venepuncture and cannulation.

Of equal importance, nursing students are encouraged to further understand the value of support staff in facilitating and complimenting the role of an ED Nurse. In this way, effective multidisciplinary working is fostered prior to qualification, a desirable and transferable skill for all emergency workers.

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Mentorship In Emergency Departments

After securing a Staff Nurse post within ED, it is integral for Newly Qualified Nurses to ensure they are assigned a clinical mentor throughout the probationary period. Typically, this is a senior or more experienced member of the nursing team. This individual can provide new starters with a means of assessment and feedback, an indispensable element of becoming a competent emergency practitioner.

By supervising Newly Qualified Nurses throughout the process of acute illness and trauma management, the journey to safe and autonomous practice is greatly supported. Underpinned by the most contemporary guidelines and recommendations, this clinical guidance allows gaps in knowledge and practical competencies to be identified, enabling swift rectification of these limitations, and fostering vital critical thinking skills.

As a result, the safety and quality of emergency care delivery is upheld, as well as the overall flow and efficiency of the department.

Line Manager Support

in addition to this supervision, it is also beneficial to engage in performance reviews at consistent intervals of the induction process, led by the unit manager, to identify areas for development perhaps previously overlooked.

Utilising the key ideology of reflection recommended by The National Institute of Clinical Excellence (2023), ED managers can encourage Newly Qualified Nurses to consider how their future practice may be improved by drawing upon recent clinical experiences.

As part of this exercise, elements of pastoral care are facilitated, as challenging or traumatic exposures can be mutually unravelled to promote resilience and emotional wellbeing. Undeniably, these respective qualities are essential in preserving the remainder of the aforementioned inadequate staffing levels, improving job satisfaction, and reducing risk of professional burnout.

By supervising Newly Qualified Nurses throughout the process of acute illness and trauma management, the journey to safe and autonomous practice is greatly supported.

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Emergency Training Courses

Finally, a variety of ED-specific courses are available throughout the NHS, providing further opportunity for Newly Qualified Nurses to hone their expertise in emergency practice.

Leading to professional qualifications that demonstrate the fundamental life-saving skills expected of an Emergency Nurse, these courses allow those new to the field to engage in simulation and assessment of critical illness.

Intensive study days designed to cultivate a competent and proactive emergency workforce, for example ‘Acute Illness Management’, assist newly qualified staff across all specialties in detecting deterioration and initiating appropriate interventions, to counterbalance contemporary issues around length of hospital stay and mortality.

More specifically, training opportunities such as Immediate, Advanced and Trauma Immediate Life Support offer ED Nurses various professional benefits, including the potential for career progression and roles within practice education. Engagement with these resources is consistently proven to alleviate the pressures associated with transition into both emergency department and ward-based nursing positions.


In correlation with the ageing population, funding and staffing shortages, the burden placed upon Emergency Nurses in the current climate is rapidly escalating. As Newly Qualified Nurses are increasingly welcomed into emergency departments throughout the NHS, it is of the utmost importance to implement the interventions outlined in this article.

Variance in capacity for autonomous practice amongst ED Nurses may therefore be narrowed, encouraging both career development and improved patient outcomes.

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About the author

Since qualifying in 2021 as a Registered Nurse, I have worked exclusively in the emergency department, both at a district general hospital and now a major trauma centre. I believe there is no better setting for nurses to rapidly develop their skills in clinical decision making and managing the acutely unwell patient.

    • Richard Gill
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  • 398

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