The experience of patients who present to a New Zealand emergency department with minor illness and injury: an interpretive phenomenological inquiry

Abstract

The Hospital Emergency Department (ED) is intended for the treatment of seriously ill or injured patients. Patients who seek health care from the ED for minor or non-urgent health problems are referred to as "inappropriate attenders", because they are using the ED service inappropriately. This is regarded by ED service providers as a problem. Although there is a substantial volume of literature which addresses this issue, it is mostly from a provider perspective; the voice of the "inappropriate attenders" has been overlooked. This study seeks to understand the experience of people who seek help for minor illness or injury from a hospital ED using an interpretive phenomenological approach. Eight people (seven with a minor injury, one with a minor illness) were interviewed, and from the transcribed interviews, narratives describing each participant's experience of minor illness or injury were written. From the narratives, six themes emerged: 'worry'; 'waiting'; 'should I be here?'; 'they were very good, but...'; 'absence'; and 'life goes on.' These themes characterize the overall experience of the participants as they worried about the implications of their symptoms, waited for care in the ED, experienced doubt concerning the validity of seeking care in the ED, perceived shortcomings in the quality of their treatment but were reluctant to criticize, and recovered from their illness or injury. The theme of absence is of particular relevance for nursing practice. This theme is characterised by the lack of an authentic, caring nursing presence in the participant's narratives. The concept of personal integrity is used to illuminate meaning within these themes and understand why those themes are significant. By understand the experience of minor illness and injury, emergency nurses can bring an authentic nursing presence to the care of patients presenting to ED with a minor illness or injury.