Nursing care management in emergency patients: a narrative review
Keywords:
Cuidados de enfermería; Urgencias médicas; Servicio de urgencia en hospital; Gestión en salud; Competencia clínicaAbstract
Healthcare workers in emergency settings know firsthand how much care quality depends on how it is managed. This narrative review examines the historical, theoretical and practical foundations of nursing care management in emergency patients, with emphasis on the Latin American and Cuban context. PubMed, SciELO, Infomed and the Virtual Health Library were consulted, including publications between 2019 and 2025 in Spanish, English and Portuguese. Results show that the process demands advanced technical competencies, agile clinical reasoning and interprofessional teamwork, grounded in theoretical frameworks that recognize Henderson's and Watson's models as current references. Humanizing care—understood not as a complement but as an essential condition of caring—faces structural tensions from overcrowding, staffing shortages and moral load experienced by nursing professionals. The review concludes that emergency care management operates on an inseparable triad: updated knowledge, technical-clinical skills and humanistic sense; deficits in any component deteriorate quality and safety of care. The relevance of the Nursing Care Process as a methodological tool organizing, planning and evaluating care in these settings is reaffirmed.
Downloads
References
1. Organización Mundial de la Salud. Situación de la enfermería en el mundo 2020: invertir en educación, empleo y liderazgo. Ginebra: OMS; 2020. Disponible en: https://www.who.int/publications/i/item/9789240003279
2. Sandín Chávez G. Concepción del servicio de urgencia desde la mirada de la Enfermería. Rev Cubana Enfermería. 2023;39(1). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-03192023000100037
3. Sousa KHJF, Damasceno CKCS, Almeida CAPL, Magalhães JM, Ferreira MA. Humanization in urgent and emergency services: contributions to nursing care. Rev Gaucha Enferm. 2019;40:e20180263. doi: 10.1590/1983-1447.2019.20180263
4. Marriner Tomey A, Raile Alligood M. Modelos y teorías en enfermería. 8ª ed. Barcelona: Elsevier; 2018.
5. Henderson V. The nature of nursing. New York: Macmillan; 1966.
6. Watson J. Nursing: the philosophy and science of caring. Revised ed. Boulder: University Press of Colorado; 2008.
7. Gunawan J, Aungsuroch Y, Watson J, Marzilli C. Nursing administration: Watson's theory of human caring. Nurs Sci Q. 2022;35(2):235-243. doi: 10.1177/08943184211070582
8. Afonso SR, Padilha MI, Neves VR, Ramírez Elizondo N, Ferretti F, Alves KS, et al. Critical analysis of the scientific production on Jean Watson's theory of human care. Rev Bras Enfermagem. 2024;77(2):e20230231. doi: 10.1590/0034-7167-2023-0231
9. Valencia Contrera M, Rodríguez A. Reflexión de la humanización de la atención: teoría de Jean Watson y propuesta de su aplicación. BENESSERE Rev Enfermería. 2021;6(1):1-12. doi: 10.22370/bre.61.2021.3037
10. Sili EM, Nascimento ERPD, Malfussi LBHD, Hermida PMV, Jatobá de Souza DIA, Lazzari DD, et al. Cuidado humanizado na Unidade de Terapia Intensiva: discurso dos profissionais de enfermagem angolanos. Rev Bras Enfermagem. 2023;76(2):e20220474. doi: 10.1590/0034-7167-2022-0474
11. Trisyani Y, Emaliyawati E, Prawesti A, Mirwanti R, Mediani HS. Emergency nurses' competency in the emergency department context: a qualitative study. Open Access Emerg Med. 2023;15:165-175. doi: 10.2147/OAEM.S405923
12. Jesús JA, Balsanelli AP. Relación entre las competencias profesionales de los enfermeros en emergencias y el producto del cuidado de enfermería. Rev Latino-Am Enfermagem. 2023;31:e3938. doi: 10.1590/1518-8345.6585.3938
13. Manero-Solanas M, Navamuel-Castillo N, López-Ibort N, Gascón-Catalán A. Development of competencies in emergency nursing: comparison between self-assessment and tutor evaluation before and after a training intervention. Nurs Rep. 2024;14(4):3550-3560. doi: 10.3390/nursrep14040259
14. Oh WO, Jung MJ. Triage—clinical reasoning on emergency nursing competency: a multiple linear mediation effect. BMC Nurs. 2024;23:274. doi: 10.1186/s12912-024-01919-8
15. Sánchez-Bermejo R, Herrero-Valea A, Garvi-García M. Los sistemas de triaje de urgencias en el siglo XXI: una visión internacional. Rev Esp Salud Publica. 2021;95:e202103047. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1135-57272021000100201
16. Dreher-Hummel T, Nickel CH, Nicca D, Grossmann FF. The challenge of interprofessional collaboration in emergency department team triage—an interpretive description. J Adv Nurs. 2021;77(3):1368-1378. doi: 10.1111/jan.14675
17. Milton J, Gillespie BM, Åberg D, Erichsen Andersson A, Oxelmark L. Interprofessional teamwork before and after organizational change in a tertiary emergency department: an observational study. J Interprof Care. 2023;37(2):300-311. doi: 10.1080/13561820.2022.2065250
18. Liu J, Ponzer S, Farrokhnia N, Masiello I. Evaluation of interprofessional teamwork modules implementation in an emergency department—a mixed-methods case study of implementation fidelity. BMC Health Serv Res. 2021;21:840. doi: 10.1186/s12913-021-06822-5
19. Mani ZA, Kuhn L, Plummer V. Emergency care in the context of armed conflict: nurses' perspectives of the essential core competencies. Int Nurs Rev. 2023;70(4):510-517. doi: 10.1111/inr.12870
20. Guerrero JG, Alqarni AS, Cordero RP, Aljarrah I, Almahaid MA. Perceived causes and effects of overcrowding among nurses in the emergency departments of tertiary hospitals: a multicenter study. Risk Manag Healthc Policy. 2024;17:973-982. doi: 10.2147/RMHP.S454925
21. Consejo Internacional de Enfermeras. Código deontológico del CIE para la profesión de enfermería. Ginebra: CIE; 2021. Disponible en: https://www.icn.ch/resources/publications-and-reports/icn-code-ethics-nurses
22. Wu S, Sun Y, Zhong Z, Li H, Ding B, Deng Q. The effect of moral distress on emergency nurses' job burnout: the mediating roles of hospital ethical climate and moral resilience. Front Public Health. 2025;13:1562209. doi: 10.3389/fpubh.2025.1562209
23. Boulton O, Farquharson B. Does moral distress in emergency department nurses contribute to intentions to leave their post, specialisation, or profession: a systematic review. Int J Nurs Stud Adv. 2024;6:100164. doi: 10.1016/j.ijnsa.2023.100164
24. Alanazy ARM, Alruwaili A. The global prevalence and associated factors of burnout among emergency department healthcare workers and the impact of the COVID-19 pandemic: a systematic review and meta-analysis. Healthcare. 2023;11:2220. doi: 10.3390/healthcare11152220
25. Zambrano Conforme RG, Toala Bravo HV, Choéz Macías JV. Enfermería en servicios de emergencia. RECIMUNDO. 2024;8(1):320-330. doi: 10.26820/recimundo/8.(1).ene.2024.320-330
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Bernardo Cruz Ledesma
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who have publications with this journal agree to the following terms: Authors will retain their copyrights and grant the journal the right of first publication of their work, which will be publication of their work, which will be simultaneously subject to the Creative Commons Attribution License (CC-BY-NC 4.0) that allows third parties to share the work as long as its author and first publication in this journal are indicated.
Authors may adopt other non-exclusive license agreements for distribution of the published version of the work (e.g.: deposit it in an institutional telematic archive or publish it in a volume). Likewise, and according to the recommendations of the Medical Sciences Editorial (ECIMED), authors must declare in each article their contribution according to the CRediT taxonomy (contributor roles). This taxonomy includes 14 roles, which can be used to represent the tasks typically performed by contributors in scientific academic production. It should be consulted in monograph) whenever initial publication in this journal is indicated. Authors are allowed and encouraged to disseminate their work through the Internet (e.g., in institutional telematic archives or on their web page) before and during the submission process, which may produce interesting exchanges and increase citations of the published work. (See The effect of open access). https://casrai.org/credit/
