Emergency Service/Department as an (Un)Favorable Nursing Practice Environment

Emergency services/departments are complex environments, characterized by high nursing workload and unpredictable patient flow. National and International organizations recommend that health care institutions should develop strategies to promote favorable nursing practice environments. The Practice Environment Scale of the Nursing Work Index is a widely used assessment tool.

Quantitative, cross-sectional study that aimed to evaluate nurses' perceptions of the nursing practice environment in a Portuguese emergency service/department using the Practice Environment Scale of the Nursing Work Index. Data were collected through an electronic form after Ethics Committee approval.

Data were obtained from 78 nurses. The nursing practice environment was perceived as a "mixed environment." The dimensions "nurse manager ability, leadership, and support of nurses," and "collegial nurse-physician relations" were perceived as "favorable," whereas the dimension "staffing and resource adequacy" was perceived as "unfavorable." The dimensions "nurse participation in hospital affairs" and "nursing foundation for quality of care" were perceived as neither "unfavorable" nor "favorable." Nurses with postgraduate education had a less favorable perception of collegial nurse-physician relations when compared with those who only have a nursing degree.

The emergency service/department was perceived as a "mixed environment." There are several items and dimensions assessed through the Portuguese version of the Practice Environment Scale of the Nursing Work Index that could, and should, be the targets of concrete interventions to optimize the nursing practice environment and improve health outcomes in this service and institution. This study may represent the first step toward significantly changing the emergency service/department environment and improve the nursing working conditions.