There is a growing demand for ER nurses in Canada and their shortage, especially due to the pandemic is a subject of interest to the entire healthcare fraternity. ER nurses offer direct and individualized care to patients on the basis of applying scientific nursing principles. Canadian nurses’ unions and labor economists over the years have sounded the alarm that the number of eligible nurses was falling short of demand in the country, particularly with the aging population. The current COVID-19 pandemic has simply intensified the nursing shortage and it will need strategic preparation to make work life sustainable for employees in this occupation to develop a large workforce.
An emergency room (ER) nurse is a health care expert who offers urgent care to patients suffering from critical injury, trauma, illness, and severe medical conditions. Nursing employment is growing quickly in Canada, and the demand for qualified ER nurses is high (Canadian Nurses Association, 2020). However, the frequently stressful and fast-paced occupation requires individuals with more advanced skills than traditional nursing skills. A health and safety profile and risk assessment for ER nurses in a Canadian workplace is very important issue that needs further investigations.
The Nature, Context, and Dimensions of ER Nurse
ER nurses in the Canadian workplace are care practitioners who assist doctors during medical emergencies. They are expected to help doctors perform medical operations and attend to patients’ experiencing a critical injury, trauma, and allergic reactions (Stewart, 2022). Other routine duties and responsibilities include cleaning lacerations, administering medication, and taking blood work. Therefore, they are accountable for creating a patient care plan, especially after an in-depth evaluation of patients’ condition, illness, or injuries.
The major skills and qualifications required to do this job include an active registered nurse (RN) license, knowledge of emergency medicine, and the capacity to work diligently with a team and patients (Mackinnon et al., 2018). The certification required to do the job is issued by government organizations, ensuring high integrity and qualifications. For example, the Canadian Nurse Association provides ER Nurse Certified credential (ENC), and candidates qualifying must pass exam and be registered nurses with 2 years’ experience in emergency nursing (Select Medical Connections, 2018). This implies that a candidate should first be licensed as a registered nurse in the Canadian workplace to qualify as an emergency room nurse. Recently, the Emergency, Practice, Interventions, and Care Canada (EPICC), which offers a curriculum suitable for Canadian Emergency Nursing, has become the new certification in this profession.
The Canadian Center for Occupation Health and Safety (CCOHS) is equal to Occupational Health and Safety (OHS) in Canada, and its dimensions entail offering legislation enforcement and resources for all employers to stay compliant with safety measures (CCOHS, 2022). Concerning the working environment and terms and conditions of employment, nurses are assured of high quality of work-life, fair compensation and promotions, and continuing education opportunities to advance their competency. However, ER nurses in Canada are exposed to hazards in regard to OHS problems, and this has been a subject of concern, which required continuous risk assessment. A copy of ER Nurse Description is summarized in Appendix 1 at the end of this document.
The Nature, Context, and Dimensions of the Industry
The Canadian Ministry of Health is devoted to assisting people to stay healthy by delivering first-class care to patients whenever they need it. Health Canada (HC) is an establishment accountable for national health policy and it controls other agencies such as Public Health Agency of Canada (PHAC). These agencies work closely to promote people’s welfare and create employment opportunities for different health care workers. The National Nursing Assessment Service for Canada is the sector responsible for hiring nurses. As of 2019, approximately 91% of regulated nurses were female in the country, which implies the profession is highly dominated by women (Canadian Nurses Association, 2020). Despite the increased exposure to hazards, injuries and diseases, this profession is not dirty and the high risks are continuously dealt with every day to make the work environment safe and better for everyone.
The characteristics of ER Nurse Profession can be observed clearly through competition, unionization, and market forces, for instance, PESTEL. First, Canada faces high competition for globally qualified nurses. According to Bramham (2022), one out of eight nurses worldwide practice in a country where they were not born and based on the WHO, the shortage of nurses in 2018 was 5.8 million (Canadian Nurses Association, 2020). These figures have risen in Canada and around the world, particularly due to the COVID-19 outbreak, which has affected health care workers, including nurses (Canadian Nurses Association, 2020). Besides, the immigration policies of Canada favor health care employees because their applications are accelerated under the qualified employees’ program (Oldland, et al. 2020). Similarly, the live-in caregivers program facilitates a quick path to foreign nurses’ permanent residency and is the same route used by several Filipino nurses. Hence, there is a high competition in the nursing occupation, which is good for delivering high-quality services to patients.
In terms of unionization, the Canadian Federation of Nurses Unions (CFNU) represents the interests of thousands of unionized nurses as well as students in the country (Mackinnon, et al. 2018). This union advocates for all members and supports the nursing occupation across all sectors. The PESTEL analysis is a tool used to monitor the external environment and its impact on business performance and consists of political factors, economic factors, social factors, technological factors, and environmental factors.
Political Factors: The government of Canada has shown concern in terms of guaranteeing sustainable practices for the health care sector. This has been demonstrated through devotion to a universal publicly funded health care system, which caters to all people’s needs and protects the health workers against violence (Joshua & Karkada, 2017). In addition, political stability has empowered the government to improve both public health and health care in a manner that adheres to jurisdictional policies.
Economic Factors: Like other sectors, Canada’s healthcare industry is largely affected by numerous economic factors, including interest rates, inflation, and unemployment. A slight change in these factors interferes with how the public spend money, further affecting policy spending (Thakur, 2021). Therefore, the government has ensured increased investments to support a safe environment for healthcare employees and economic sustainability.
Social Factors: The healthcare sector relies on the proper understanding of public values and changes in demographics to render services to the public (CCOHS, 2022). The majority of ER nurses are aware of these changes and beliefs and cultural norms of the public and this helps them render improved services even in the emergency room.
Technological Factors: Gathering valuable data in healthcare is vital to inform doctors and nurses about resource planning and assess the effectiveness of care. The Canadian Emergency Department Information System serves to collect useful data (Canadian Nurses Association, 2020). However, while emergency uses utilize the tool to collect important patient data routinely, their understanding of the implications and purposes for amassing these data is sub-optimal.
Environmental Factors: The unfavorable impact on the environment because of the infective disposable items from the emergency rooms is a threat to both healthcare workers and the public. The government has intervened through funding to develop a sustainable system across healthcare facilities to reduce environmental contamination problems.
Healthcare organizations in Canada share a wide range of risks, including regulatory, clinical and privacy, and environmental. It is interesting to note that these risks vary from one hospital to another depending on the size, structures and complexity of the institution. Different tools, such as inspection, consultant, peer review reports, and observations, are used to identify risk patterns and incidents in emergency rooms and hospitals.
Risk Matrix Table
|Chemical hazards||Originate from exposure to systemic toxins, immune agents, neurotoxins and carcinogens.||Low risk|
|Biological hazards||Includes biological substances that threaten ER nurses, for example, virus, toxin, and microorganism||Medium risk|
|Physical hazards||Refers to agents that cause harm even without contact. They include radiation, stress, heat, and noise hazards.||High risk|
|Psychological & psychosocial||The psychosocial hazard affects the psychological well-fare of employees and the capacity to stay focused in the workplace. They are connected to risks, workplace violence and occupational stress.||High risk|
Analysis of Risks
Although there are major efforts to lower risks in the healthcare workplace, some risks present a high probability as indicated in the table above. Proper handling of chemicals is recommended to avoid direct contact with substances that cause harm to the human body. Radiations can be avoided by keeping distance from the source and maintaining time exposure accurate. The reliance on matrix risk assessment method as a tool to assess and rank the level of risk has been widely adopted across the Canadian healthcare sector. This risk analysis technique systematizes the practice of grading the risk by offering a visualization for the probability of an event happening and its effects in case it resurfaces (Kaya, et al. 2019). The risk matrix helps healthcare sectors / managers establish priority levels based on corrective control available to lessen its impacts among the employees.
Treatment of Risks
Risks are managed by tracking the missing test results to improve consultations, relying on effective communication with patients to lower improper medication consumption, and not filling expired prescriptions to stop abuse. Furthermore, flexible work shifts reduce employee stress and adherence to policies to ensure zero tolerance of violence in the workplace (Mackinnon, et al. 2018). The use of modern equipment properly reduces chemical exposure while suitable clothing and wearing PPEs lessens the chances of getting biological hazards from patients.
Monitoring and Controlling Risks
The process of monitoring and controlling risks entails employing response strategies and tracking the identified risks. Every new risk is recognized and dealt with to improve the risk management procedure.
OHS Implications, Discussion and Reflections
OHS guidelines and training have a higher influence on risk management across healthcare organizations, with a key focus on employees’ safety at the workplace. The risk factors in the healthcare environment and the employees’ determinants of health make up accidents, hearing loss, cancers, diseases, and stress related disorders. Therefore, major improvements are required to promote patient and healthcare workers’ safety in the healthcare sector. There is also the need to develop a social climate that supports quick operation and improved productivity.
The ongoing pandemic has burdened health workers in Canada and across other countries beyond limitations. Given the rising cases, health workers are expected to gauge their preparedness in response to the deadly crisis and establish new standards to ensure better service delivery to patients. Issues related to health hazards and specifically personal protection equipment, the demand for healthcare employees and nurses’ shortage fall under crucial considerations worldwide (Stewart, 2022). While the government efforts to support the healthcare industry has been effective, it is significant to implement novel training and education measures to increase enrolments based on postgraduate nursing courses in the country. The Canadian healthcare system should become accountable for managing, assessing and overcoming the current health crisis.
The government of Canada has made huge efforts to improve the healthcare sector and other industries through funding programs. These funds help different healthcare organizations to purchase medical equipment, adjust to the latest technological devices, apps, and system to facilitate better care to patients in emergency departments. The increased adoption of technology has increased efficiency and shaped how services are rendered. ER nurses in the country require adequate support from the government and their institutions to continue facilitating high-quality services in their emergency departments. Nurses’ response to urgent situations should not come with huge risks and so effective approaches should be strictly introduced to control all health-related hazards. The COVID-19 pandemic has exposed the weaknesses of the healthcare system and the risks and hazards faced by healthcare employees. This should serve as a benchmark from where appropriate policies are implemented to protect the well-being of all employees in the sector. Most of the accidents and OHS that endanger this occupation are high levels. For instance, nurses confront excess exposure to infectious diseases, including COVID19, radiation, back injuries, and toxic substances, risky environment, and intensive use of modern technologies in their line of duty (Oldland, et al. 2020). Moreover, they are directly subjected to stress, workplace violence and harassment, slips and fall, and equipment injuries. All these belong to large physical, biological, chemical, and psychosocial hazards classification.
Bramham, D. (2022). Daphne Bramham: Canada risks losing the global competition for foreign nurses. Vancouver Sun. Web.
Canadian Nurses Association. (2020). Nursing Statistics. Web.
CCOHS. (2022). Canadian Centre for Occupational Health and Safety. Government of Canada. Web.
Joshua, R. & Karkada, S. (2017). A review of Occupational Health Hazards and its Consequences among Nurses. International Journal of Nursing Research and Practice, 4(2), 28-33.
Kaya, G., Ward, J. & Clackson, J. (2019). A framework to support risk assessment in hospitals. International Journal for Quality in Health Care, 31(5), 393-401.
Mackinnon, K., Butcher, D. & Bruce, A. (2018). Working to full scope: The reorganization of nursing work in two Canadian community hospitals. Global Qualitative Nursing Research, 5(1), 1-14.
Oldland, E., Botti, M., Hutchinson, A. & Redley, B. (2020). A framework of nurses’ responsibilities for quality healthcare – Exploration of content validity. Science Direct, 27(2), 150-163.
Select Medical Connections. (2018). ER Nurse Certification: EPICC sets a new standard. Web.
Stewart, A. (2022). Canada headed for nursing shortage beyond anything we’ve ever experienced: Experts. Global News. Web.
Thakur, V. (2021). Framework for PESTEL dimensions of sustainable healthcare waste management: Learning from COVID-19 outbreak. Journal of Clean Production, 10(2).
ER Nurse Job Description
Duties and Responsibilities:
- Administer medication prescribed by the doctor
- Stabilizing incoming patients
- Quickly evaluating patient needs
- Coordinate with emergency healthcare professional to assist patients
- Maintain updated patient records
- Relocate stable patients to other facility wings
Skills, Qualifications and Certification:
- Vast knowledge of emergency medicine
- Time management skills. Interpersonal skills, empathy, and sensitivity
- Willingness to learn novel procedures and progression in emergency care
- Experience operating medical equipment
- Active Canadian RN license and over 2-year experience in emergency nursing
- Acquire Canadian Nurse Certified credential and the Emergency, Practice, Interventions, and Care Canada (EPICC).