Rehearsing for improvisation: Emergency nurses’ strategies in addressing uncertainty and change in the management of emerging infectious diseases

Abstract

Aim(s): Uncertainty and change are the inevitable challenges facing emergency nurses, as they are bound by the nature of emergency care. During an epidemic event, emergency care settings are intertwined with urgency, uncertainty, and change, which continuously pose challenges to emergency nurses on their capacity to act on their duties in a well-planned and systematic manner. However, there has been a paucity of understanding concerning emergency nurses’ actions and strategies to address the instabilities and vulnerabilities of the circumstance.The present study aimed to explore emergency nurses’ behaviours and strategies in addressing the challenges of uncertainty and change during an epidemic.

Method(s): A qualitative design based upon a Straussian grounded theory approach was selected as the method of inquiry. A total of 26 emergency nurses from Hong Kong were recruited in the study by purposive and theoretical sampling strategies. Semi-structured, face-to-face, individual interviews were conducted for data collection. The data were transcribed verbatim and analysed through the grounded theory coding procedures.

Result(s): Rehearsing for improvisation was revealed as the core category. Four interplaying sub-categories were identified under (1) lingering uncertainties and (2) ubiquitous changes, which are: (a) addressing the situation, (b) equipping for the impending battle, (c) acclimating to the evolving circumstances, and (d) navigating the new role and duties.

Conclusion(s): The findings delineate that emergency nurses were required to prepare and equip themselves with skills and strategies to improvise and adapt to the management of an epidemic event. The findings offer insights into the development of education and training schemes that allow emergency nurses to acquire and augment their abilities of decision-making and problem-solving in public health responses.