Trapped between doing and being: first providers' experience of "front line" work

A common focus in research studies within the Emergency Department (ED) is physician patient relations, experiences of the triage model and nurses' experiences of caring. Little has, however, been written about different first providers' experiences of working on the "front line" at the ED. The aim of this study was to describe and understand experiences of being the first provider on the "front line" at the ED, as expressed by nurse assistants, registered nurses and physicians. A reflective lifeworld research approach was used in four different caring situations. The data consisted of eight open-ended interviews with first providers. The analysis showed that being the first provider on the "front line" at the ED entails a continuous movement between providing and responding through performing "life-saving" actions and at the same time create a good relationship with the patient and the next of kin. Five constituents further described the variations of the phenomenon. The readiness to save lives creates a perceived stress of time pressure and the first providers adopt different strategies to cope with the work. Instead of leaving the first providers to find their own way to cope with the complex situation, there are needs for a redesigning of the internal work process within ED organizations.