Nursing resources in accident and emergency departments.

Accident and emergency (A&E) departments need to be able to respond quickly to any person seeking their services, 24 hours a day. The underlying philosophy of staffing A&E departments may be incongruent to today's nurse managers when attempting to provide a high quality, but cost-effective nursing service. Accident and emergency departments, by their very nature, have an unpredictable, demand-led workload, making the issue of effective staff utilization a complex one. A descriptive, comparative survey of issues affecting nurse staffing levels in A&E departments is presented. Personal, semi-structured interviews were conducted with A&E nurse managers, and with senior clinical nurses. The study examines a wide range of variables, and their effect on nursing resources in A&E. It also identifies the complexities surrounding the calculation of nursing establishments in A&E, and provides a snapshot picture of how departments were staffed at the time of the survey. The study successfully highlights the key factors to be contemplated when deciding upon nursing resources in A&E, and the uncertainty and disparity which currently exist on the subject.