Preparing for Your Placement in Accident & Emergency

Accident & Emergency is one of the busiest places in the hospital. Your placement will be a unique opportunity to experience emergency and unscheduled care in a controlled environment.

During your placement you will be exposed to a multitude of medical conditions and it will be a unique opportunity to develop skills, knowledge and gain confidence in dealing with these.

A&E placements can also include insight visits to a variety of areas including; fracture clinics, plaster rooms, critical care areas and your local ambulance service.

Some A&E Departments are a combined adult and paediatric service – you may be expected to care for these patients too.

What to Expect from your Placement

Accident & Emergency will include a variety of patients from a variety of specialities who will be suffering from a variety of conditions – A&E, if nothing else, is varied and like the proverbial ‘box-of-chocolates’.

Accident and Emergency Departments are generally split into multiple areas, this is a brief overview of what you can expect in each area. 

Resus – Patients who have been brought in with a life threatening illness or are likely to require input from intensive care. This can include; cardiac arrests, trauma patients, overdoses, respiratory arrests etc.

Triage – Patients are assessed, usually by a Nurse, on their arrival to the department – this will include a set of baseline observations and a brief history. The patient will then be signposted or ‘streamed’ to the correct area – this will determine the patients priority and time they will be seen in.

Majors – Usually for patients who have attended with a complex or urgent medical condition such as COPD or heart failure. Elderly patients with limited mobility tend to be seen in this area.

Minors – Patients who have attended A&E with minor illness and ailments such as coughs, colds and vomiting and are ambulatory.

Injuries  – Patients who have attended with suspected broken arm or leg will be seen in the injuries area. This area is usually closely linked with x-ray and plaster room.

First and foremost, do not worry – you will be surrounded by very experienced Nurses, Doctors and allied healthcare professionals. A&E, generally speaking, is a very safe and controlled environment with very experienced and senior staff at the helm.

Your mentor won’t expect you to have an in-depth knowledge of A&E interventions if this is your first placement but they will expect you to ask questions and participate in care.

Expect to deal with a lot of sensitive issues while on placement, some of these might ‘hit close to home’, communicate with your mentor and ensure patient confidentiality at all times.

Preparing For Your Placement

There are a few things you can do to prepare for your Accident & Emergency Department placement;

Try and visit your placement before you start. Emergency Departments can be intimidating places. Visit the area you have been assigned to before you start and ask if there is anything you should be aware of prior to starting.

Identify your learning needs and outcomes. Identify these early and be aware of the skills you want to develop or learn – this will help you get the most from your placement.

Brush up on your anatomy and physiology. Familiarise yourself with the physiology and function of core systems, it will bode you well.

Look at ABCDE assessments and their importance. This systematic approach is used for everything within Critical Care – everything from handover to invasive treatment is based around an ABCDE model.

Research triage systems. Every hospital uses a different triage system although most are based around the Manchester Triage System.

Getting The Most From Your Placement

You’ll either love your A&E placement or you won’t. So it is important that during your placement you focus on transferable skills you can learn and/or improve on in this area, relish the opportunity to deliver global (holistic) care in this environment and understand the complexities of why patients attend A&E.

Spend time with all members of the team; Doctors, Nurses, Nurse Practitioners, Physios, Social Care, Specialist Nurses and the countless others!

Download the BNF app and consider buying a Clinical Skills Nursing Survival Guide.

The final and most important piece of advice I can give you is to ask questions and get involved.