“We are left with nothing to work with”; challenges of nurses working in the emergency unit at a secondary referral hospital: A descriptive qualitative study

Introduction In recent times, there has been an increasing burden in traumatic, medical, and surgical emergency conditions, placing more emphasis on the need for quality emergency care. This study aimed to explore the challenges experienced by nurses working in the emergency unit of a secondary referral hospital. Methods The study used an exploratory qualitative research design with a constructivist approach and a grounded theory method. Data were collected through in-depth interviews lasting between 30 to 45 minutes using a semi-structured interview guide. Inductive content analysis was used to analyse data. Results Eleven (11) participants were interviewed. The majority were female (9), aged between 31–40 years. From the inductive content analysis, four themes emerged. These were; 1) overcrowding in the emergency unit, 2) understaffing at the emergency unit, 3) lack of emergency equipment, 4) inadequate managerial support. Conclusion The study identified several major challenges confronting nurses working in the emergency unit which are linked with managerial processes and inadequate managerial support. These challenges need to be addressed to promote quality emergency nursing care. To foster a positive working environment, hospital management should validate and address the aforementioned concerns of the Emergency Department nurses.

Unusual presentation of a unilateral choanal atresia in an adult: a case report

<p class="abstract">Choanal atresia is an uncommon congenital abnormality of nasal airway characterised by the complete obliteration of choana. Unilateral choanal atresia is more common as compared to bilateral choanal atresia. A case of unilateral nasal obstruction in an adult which was initially diagnosed as chronic rhinosinusitis and was posted for endoscopic sinus surgery at a secondary referral hospital. Increased nasal bleeding during the surgery led to the surgeon abandoning the procedure and was referred to Mysore Medical College and Research Institute. On detailed evaluation, unilateral choanal atresia of right sided was noted. It was subsequently managed by endoscopic recanalization of the posterior choana. This case of unilateral choanal atresia in an adult is being reported here for the rarity of its presentation. A high level of clinical suspicion is necessary to diagnose such cases and to prevent avoidable complications during routine endoscopic surgeries. Resection of posterior part of nasal septum to create uni-choana negates the need for stenting post-operatively.</p>