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Most Nova Scotians have had the experience of waiting in an emergency department for care, either as a patient or a loved one. Given that patients are presenting with urgent or life-threatening conditions, the wait can be stressful, and can affect health outcomes. In Nova Scotia, the Emergency Access Improvement Initiative aims to enhance emergency care for both patients and healthcare staff. These initiatives ensure that all Nova Scotians receive timely urgent care when needed. As part of this effort, waiting room care providers (WRCPs) are transforming the patient experience and improving the quality of care in emergency departments across the province.
Nancy Carver, a licensed practical nurse and a waiting room care provider at Dartmouth General Hospital since last September, brings to the role a nursing background spanning 20 years. She has worked in various fields, including plastics and burns, long-term care, VON (Victorian Order of Nurses), and Continuing Care.
A WRCP is a clinically trained healthcare professional assigned to monitor and care for patients in the waiting areas of the emergency department. Their primary role is to ensure that patients receive timely attention and care while they wait to be seen by a physician or other healthcare provider.
"I like being present and reducing patients’ stress levels,” said Carver. “It's rewarding to know that someone is watching over them. I also enjoy the task-oriented nature of the job; there's not a lot of downtime, and I like being busy.”
Crystal MacDougall, health services manager for the emergency department at Dartmouth General Hospital, said "A WRCP’s primary task is to reassess patients according to the Canadian Emergency Department Triage and Acuity Scale (CTAS), which is standard in our emergency department. We strive to meet benchmarks based on guidelines and patient acuity, and with the help of WRCPs, we are closer to achieving these standards.”
MacDougall elaborated further on their responsibilities, saying, "They go out to the waiting room, take vital signs, or inquire about pain levels, depending on the patient’s condition. If necessary, they bring patients into the waiting room care provider space for more private assessments. They can also escalate any changes in a patient’s condition to the physician or clinical lead nurse to ensure timely intervention."
Carver emphasized frequent communication with physicians, especially regarding EKGs and other critical patient data, ensuring timely responses and necessary medical orders.
Dr. Valerie Ross is the Head of Emergency Medicine at Cobequid Community Health Centre and has practiced in the emergency department since 2007.
“This is a relatively new initiative for our emergency department and a very welcome one. Some of our very experienced nurses have taken on this role.”
Dr. Ross explained that WRCP is decreasing the time that a patient needs to be in the department, which helps improve efficiency and patient satisfaction.
“It allows the triage nurses to work more effectively because once patients are triaged, there's another provider who can look after them while they're waiting to be seen. They feel attended to as soon as they walk in the door. This helps reduce interruptions, improve efficiency, and reduces complaints about wait times, while enhancing safety.”
Dr. Ross added, “By the time a patient is called in to see a physician, their blood work, X-rays, and other preliminary tests are already done, which significantly shortens the overall assessment time and speeds up the process for further tests like CT scans or ultrasounds.”
In the past year, WRCPs have been implemented in many emergency departments in the province. These dedicated professionals, including individuals like Carver, play a crucial role in enhancing the patient experience during the waiting period before seeing a physician.
Photo of Nancy Carver, Licensed practical nurse and waiting room care provider at Dartmouth General Hospital.