a&e nursing

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A lot of nurses do not like to work in a&e. Tell me why and how a&e can improve their image so more people will work agency shift with us.

We are often told when we request trained or untrained staff from the agencies that there is no-one willing to work in a&e, why?

All views welcome



6,620 Posts

What is A&E? Is that your emergency ward? (just asking)


170 Posts


Yep A&E stands for Accident and Emergency for us in the UK..

Same as the Emergency Room (ER) for those in the US..




1,049 Posts

Specializes in midwifery, ophthalmics, general practice.

I only worked A&E as a student so maybe not the right person to comment, though I did work at moorfields A&E- does that count? as a student I got really fed up cleaning!! everytime something exciting happened- you know what students are like!- we were sent to clean or coffee! so dont think I learnt a great deal, just felt like a nuisance most of the time. maybe I was!!!!! and now think I am too scared! which is silly cos as an NP I am sure I would be useful!!!



73 Posts

Wen I qualify I want to be either an A&E nurse or an ITU nurse so I'm maybe a little biased... Theres a role for nurses and docs in the A&E but unless your a member of staff NA (and full time) your seen as an extra pair of hands I think, an extra pair of hands with no talent behind them... maybe?


267 Posts

When you work agency, you have to cover your back since you're not on staff and don't have your colleagues to stick up for you if something goes wrong. My agency colleagues and I always took a ward shift if offered the choice between that or A&E/Cas/Em. Adm. The fast pace of those wards means that if you are not used to working there, sometimes things can get missed or forgotten. Sometimes you just can't keep up with what needs to be done, and it's scary. If anything goes pear-shaped, it's too easy for the permanent staff to say 'must have been the agency nurse'. Please don't go flaming me for that statement, I've been in the room when it's happened and I've had it happen to me when it was NOT my fault.

On the wards, there is routine and some semblance of order (generally, although we all have hell days). A&E might thrill some people but scares the bejesus out of others. All the admissions and investigations and higher incidence of arrests etc count - just seems easier to go with the bedbaths and drug rounds.

Just my tuppence worth. I worked A&E and Flying Doctors as a student, and did a lot of shifts on Em. Adm as an agency nurse. As refreshing as it was to get off the ward, I always felt I needed more ward experience before I would be safe to work in that environment for long periods.

As for NAs in A&E, a lot of them have extra training now to do things like BMs, ECGs, phlebotomy etc so unless you're on staff, there really is nothing except the very basics for you to do.


597 Posts

Specializes in Cardiolgy.

I am currently a student nurse, and work agency shifts as an AN, so far I have refused all the shifts on A&E, I think this is because as a student in the Trust were I am training, we are not allowed in A&E until our third (and final) year, and this makes it seem a lot more daunting.

I am not sure if I would like to work in A&E, as al ot of people compare it to fast surgical ward, and to be honest at the moment I am leaning more towards working in medical elderly.

Tony, why did you decide to work A&E? and what is it really like?


p.s. sorry for the OT nature of this post

tony summers

70 Posts

Hi Whisper

Most students don't do A&E until the third year, so I would not worry this.

I always wanted to work a&e, have an army background, and always found working on the wards very boring.

I find a&e very interesting because it does constantly change and you need to constantly aware of many things and have alittle knowledge of every speciality, so you are permantly challenged to do things. 90% of a&e work is very repetitive and routine, but there is always the thrill that you do not know when something is going to change to upset the applecart and you then need to think on your feet and impromise rather than follow normal rules. I enjoy attempting to live up to this challenge. I just love this speciality and would not change what i do for the world.



19 Posts

I think a lot of people don't want to work in A&E because of all the articles in the nursing and general press about violence and the numbers of A&E nurses abused and assaulted.

Many hospitals have to employ security guards in their departments. I work a lot of weekend shifts as a sister in PACU, the majority of patients coming to us via A&E on nights and weekends are for problems due to drugs, drink or crime (it is a large hospital in a major city).

There are lots of fights in the A&E and they frequently have to call the police. I have been down there with friends and family and have witnessed the verbal abuse and threats of violence that the staff have to endure.

I loved my placement in A&E as a student and gained a lot of valuable experience, but no way would I want to do it permanently.

At the end of the day we all have different preferences of where we would like to work, and it wouldn't be good if we all like the same thing!

I think you need to undertake a big marketing exercise to attract staff (permanent as well as agency). Ensure that any students have an enjoyable placement and that they experience caring for lots of different patients. Make sure that the permanent staff are welcoming and enthusiastic, and that there is a structure to the placements. Let everyone know there is support for dealing with violence and abuse, and how they will learn to reduce the risk.

Maybe you could organise a study day aimed at agency staff where you could explain the "reality" and dispel the "myths". You could also cover the skills needed as maybe many of the agency staff don't know what to expect and don't realise that it is not all fast-paced life & death action!

Good luck!!


267 Posts

::You could also cover the skills needed as maybe many of the agency staff don't know what to expect and don't realise that it is not all fast-paced life & death action!::

Maybe not, but in my admittedly limited experience, it is fast-paced admit, investigate, discharge/move to wards. If you're not up to speed with processing patients the non-stop machine that is A&E can be daunting. If you do happen to have a bit of fast-paced life and death action, you're still left with the backlog when it's over and that can be ultra-stressful in itself.

For what it's worth, I LOVED my placement in A&E while I was a student, and wanted more than anything to work there. The more experienced I get now as an RN, the less confident I am that I would cope in that environment. I think that says more about me than A&E though :D

tony summers

70 Posts

As a&e nurse i've been physically assaulted several times and been on the end of many verbal assaults, which happens more and more now that i am in charge of the department on occasion.

Still i love a&e and wouldnot change job, it may be wrong but i now see as part of the territory to be verbally assaulted, and i get a great pleasure from have people removed from the department because of it, especially after telling them that i do not have to put up it this kind of treatment. With the physicall always prosecute and see often respectable people squirm as they come to court for over stepping the mark.

i appreciate that when people come to a&e they are often scared and in pain but they seem to think this entitles them to be rude and abusive to the very people that are trying to help them. They get a rude awaking when they find the police arriving to discuss with them their behaviour and on many occasion removing them totally from the hospital.

A&E is fast paced at times but alot of this has to do with government targets, especially about getting people out of the department within 4 hours. Staff are getting so geared up doing this that basic care can be forgotton because it doesnot fit in with this time scale and everyone rushes around doing the bare essentials and that is it.


26 Posts

Thanks for this thread tony.

I'm a student hoping to work in A&E or critical care. The agency won't place 1st year students in A&E because they don't feel it's right as we don't get any of the skills training till 2nd year.

As agency staff you do tend to get the cr4p but often because it's what needs doing and it makes more sense than a skilled A&E assistant being tied up.

I think people watch too many episodes of Casualty and expect it to be all drama and blood so don't feel able to walk into that and be a NA.

Perhaps if you have agencies you use regularly you could get some staff that are interested to come and do a taster/training day so you have agency staff who have a clue when you need them. I know I would have jumped at the chance.

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