Questioning nursing competences in emergency health care

Medical and technologic developments entail new competence demands in emergency health care, and it follows that head nurses must recognize and create prerequisites, as well as evaluate the competence of registered nurses. The aim of this study is to describe head nurses' conceptions of emergency nursing competence needs and their responsibility for creating prerequisites of competence development in emergency nursing.

A 24-item questionnaire was sent to all the head nurses (N = 79) of all the existing emergency departments in Sweden. The response rate was 73%, and in the analysis of the data, descriptive statistics were used.

According to the head nurses, basic nursing education does not provide sufficient emergency nursing competence. Consequently, there is a need for supplementary formal emergency nursing education. Furthermore, most of the head nurses have inadequate strategies for evaluating competence development, and economic and personnel resources are insufficient to meet the educational needs. A minority of the head nurses consider that they have full responsibility for creating the prerequisites of the competence development of nurses.

To ensure sufficient nursing competence in emergency health care organizations, there is a need to establish competence demands in emergency nursing and evaluate strategies for competence development. The establishment of a Swedish emergency nurses association would be important for the development of national guidelines of emergency nursing as well as to facilitate the interpretation and concretizing of rules and legislation and to promote questions related to research, development, and education in emergency nursing. With national guidelines and recommendations, the head nurses' responsibilities for the development of nurses' skills would be clarified.