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Clinical Domain

Helen McNeilly, Emergency Nurse Practitioner, Antrim Area Hospital View the video here

Most nurses in the Emergency Departments choose to work in a role which enables them to regularly deliver direct patient care providing safe effective person centered care on a day to day basis.  Through on-going education, continuous professional development,  (CPD) mentoring and supervision, Emergency Department Nurses can develop very specialist and autonomous clinical roles, including Emergency Nurse Practitioner (ENP), Advanced Nurse Practitioner (ANP), Medical Nurse Practitioner (MNP) and Emergency Nurse Consultant.

Click on the links below to read more about role opportunities in Clinical practice.

Click here to view Real Life Stories from Emergency Nurses in the above roles.

Click here for information on the Royal College of Emergency Medicine – Emergency Care Advanced Clinical Practitioner


  • Emergency Nurse

    Laura Dalzell Band 5 Staff Nurse Altnagelvin Hospital – read her story

    An Emergency Care Nurse is a nurse who has successfully gone through a period of preceptorship and has achieved the Level 1 Emergency Care Association (ECA) competencies.

    They are able to work with individual patients or groups of patients unsupervised within the emergency care setting.

    An Emergency Nurse is characterised by high degrees of knowledge and skills, which encompasses initial assessment and decision-making power to ensure that patients are prioritised in an appropriate manner while ensuring immediate interventions are commenced if required.

    In Emergency Departments, this is likely to include working with patients in the resuscitation room, those with major illness or injury and those with minor ailment presentations. They then work towards achieving  Level 2 Emergency Care Association (ECA) competencies.

    Click here to view NIPEC’s Preceptorship Framework

  • Emergency Nurse Practitioner

    Caroline Kosutic Emergency Nurse Practitioner Royal Belfast Hospital for Sick Children – read her story

    As a senior member of the Team the Emergency Nurse Practitioner (ENP) is an experienced emergency nurse who has undertaken a specific course of study at post-graduate level to gain the knowledge and skills to assess, diagnose and decide on the appropriate course of treatment for patients. ENPs practice autonomously, using a person-centred approach, within their expanded scope of clinical practice, for which they are accountable. A significant level of education and skills development takes place in clinical practice “on the job” including shadowing and being clinically supervised by senior medical staff allowing ENPs to build up clinical portfolios. ENPs work collaboratively with other Emergency Department staff and other members of the Multidisciplinary Team providing support and advice on Minor injuries / ailments. They play a key role in the delivery of teaching activities within the Emergency Department and contribute to policy and service development and service improvement initiatives. ENPs act as a role model and provide leadership for others. Northern Ireland through the Professional Framework for Emergency Care Nursing has developed a regionally agreed clinical skills development framework for ENPs.

    Listed below are courses relevant to the role:

    Ulster University

     

    View the Emergency Nurse Practitioner suggested clinical skills and development.

  • Medical Nurse Practitioner

    Jenny Cherry Medical Nurse Practitioner Ulster Hospital – read her story

    Medical Nurse Practitioners work in Emergency Departments alongside the clinical team to assess patients, order diagnostic tests, make diagnosis and initiate treatment for patients who attend the department with potential medical problem. Although not employed in every Trust in the HSC, the role of the Medical Nurse Practitioners primarily evolved to enhance the care for patients in the Emergency Department who are waiting for admission to medical wards, initiating early treatments and investigation  therefore reducing the patients overall time in hospital as much as possible. Medical Nurse Practitioners  also work with medical staff to assess, monitor and initiate treatments for medical patients admitted to hospital beds on non-medical wards.

     

     

     

  • Advanced Clinical Practitioner

    Olivia Wilson Advanced Clinical Practitioner – Nursing Royal Victoria Hospital – read her story

    The role of Advanced Nurse Practitioner: Emergency Nursing is new to Northern Ireland and demonstrates the advancement if nursing practice over the years. An Advanced Nurse Practitioner is a nurse who has undertaken a specific  course of study at post-graduate level .

    The Advanced Nurse Practitioner undertakes comprehensive health assessments, and manages a range of illnesses and conditions that frequently present in the Emergency Department. As an independent practitioner he/she is enabled to clinically assess, diagnose, prescribe, admit or discharge patients independently.

    Northern Ireland’s Department of Health (DoH) has developed an Advanced Nursing Practice Framework to provide clarity about the Advanced Nurse Practitioner.

    The Framework

    • Provides a definition of Advanced Nursing Practice
    • Highlights the associated professional support and supervision required by Advanced Nurse Practitioners
    • Identifies the core competencies and learning outcomes essential for the Advanced Nursing Practice role
    • Acts as a guide for Commissioners, workforce planners, Executive Directors of Nursing, education providers, employers and managers of nurses, including nurses themselves.

     

    View the DoH Advanced Nursing Practice Framework Document

  • Emergency Consultant Nurse

    GERALDINE BYERS – CONSULTANT NURSE

    Job/Role Summary

    In my role as Nurse Consultant, I am involved in the development of strategic aspects of emergency nursing as well as being involved in developments in emergency nursing at a more local level. My role regularly involves me engaging with a wide range of colleagues who interface with the Emergency Department in order to ensure that patient care is safe, timely and appropriate. I am also involved in working in partnership with higher and in service education providers in the development of education programmes specifically for Emergency Nurses.

    I have a particular interest in Quality Improvement and have lead on a number of initiatives including Sepsis management and Lean projects to maximize flows through ED. I have completed the Scottish Patient Safety Fellowship Programme which focuses on Quality Improvement methodology applicable to clinical practice which was really beneficial.

    Specific qualifications and experience required

    I commenced my career in Emergency Care in the Mater Hospital in 1990. Since then I have remained within the Specialty working in a variety of clinical roles including Staff Nurse MIH ED, Staff Nurse RVH ED, Sister RVH ED and Lead Nurse BCH ED. During my career I have completed a BSc Hons in Specialist Practice in Emergency Nursing and Masters in Public Administration. I have been an instructor on the Trauma Nursing Core Course (TNCC) for over 21years.

    Career Milestones

    Getting my G Grade Sister’s post in RVH ED was a memorable milestone in my nursing career. When I was a staff nurse starting off this was the only job I ever really wanted and aspired to. I know my parents were both extremely proud of me getting this job.Also obtaining a BSc Hons degree and Masters while working full time.

    What attracted you to the job

    I had spent very little time as a student nurse in Emergency Care so when I got my first post in the Mater Hospital, I didn’t really know what to expect. . The routine in A&E was very different from what I had been used to working in a ward setting, with the huge variation in patient presentations and the ever present ‘threat’ of the stand by phone going to ring at any minute. I had some fantastic support from my mentor in the Mater who ensured I completed a thorough induction and had exposure to all the various areas within the department. The thing that really struck me about Emergency Care was the sense of camaraderie between the entire team – clerical staff, porters, Doctors, Domestic staff and Nursing staff. This became especially evident when there was a difficult situation or a challenging resus that we had to deal with.

    Enjoyable aspects of the job/role

    Working in Emergency Care is like working in no other place. The pace you work at can change in an instant. Nurses in ED need to be able to deal with such a variety of situations from one minute to the next, whether this is dealing with bereaved relatives of a patient who has died in traumatic circumstances or dressing the wound of a young teenager who has been injured playing football. We have to be able to deal with patients and their families when they are anxious, frightened, worried or angry – in a calm professional manner. I feel it is a great privilege working in ED as we see patients at their most vulnerable – it is our job to make them feel safe.

    Important Success factors

    Always try and perceive things from the patient’s perspective in. We do things in ED as a matter of routine as we work in the environment every day. Many patients who come to us are often extremely worried and anxious – it is important that we are not dismissive of them or what their relatives are telling us.Also make sure you promote a good working environment for yourself and your colleagues. Human Factors – Empty your bucket at the door before you come on duty!

    Key skills that can be gained within this job/role

    The knowledge and skills you gain working as a Nurse in Emergency Care will act a fantastic foundation for wherever you decide to go in your nursing career. Prioritising clinical care, risk management, conflict resolution, dealing with challenging situations are some of the skills you will acquire working in ED. You will also develop excellent skills working as part of a close knit team and perhaps in leading the team. You will also learn about a wide range of clinical presentations and the appropriate management of these. As the Emergency Care Framework highlights, there are exciting opportunities to develop your career within Emergency Care through a variety of pathways. If you enjoy a challenge and are able to adapt to ever changing situations then Emergency Care is for you. It also helps to have a good sense of humour.

    Advice for those considering the type of job/role

    I would always advise nurses in ED to avail of every opportunity to develop themselves and to put themselves forward for new career challenges. Working as an Emergency Care Nurse Consultant has exposed me to working at a Strategic level, however the important thing for me has always been how such proposals will impact and be deliverable at the patient level.


A range of education programmes specific to nursing in the Emergency Care setting are available at Queens University, Belfast and the Ulster University, follow the links below to find out more information.

Please note that direct links to courses and programmes are not available as these are subject to change

Queens University, Belfast Ulster University