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. 2019 Jan;28(1-2):235-244.
doi: 10.1111/jocn.14626. Epub 2018 Aug 13.

The ambulance nurse experiences of non-conveying patients

Erik Höglund  1   2 , Agneta Schröder  1   2   3 , Margareta Möller  1   2 , Magnus Andersson-Hagiwara  4 , Emma Ohlsson-Nevo  1   2
Affiliations

The ambulance nurse experiences of non-conveying patients

Erik Höglund et al. J Clin Nurs. 2019 Jan.

Abstract

Aims and objectives: To explore ambulance nurses' (ANs) experiences of non-conveying patients to alternate levels of care.

Background: Increases in ambulance utilisation and in the number of patients seeking ambulance care who do not require medical supervision or treatment during transport have led to increased nonconveyance (NC) and referral to other levels of care.

Design: A qualitative interview study was conducted using an inductive research approach.

Methods: The study was conducted in a region in the middle of Sweden during 2016-2017. Twenty nurses were recruited from the ambulance departments in the region. A conventional content analysis was used to analyse the interviews. The study followed the COREQ checklist.

Results: The ANs experienced NC as a complex and difficult task that carried a large amount of responsibility. They wanted to be professional, spend time with the patient and find the best solution for him or her. These needs conflicted with the ANs' desire to be available for assignments with a higher priority. The ANs could feel frustrated when they perceived that ambulance resources were being misused and when it was difficult to follow the NC guidelines.

Conclusion: If ANs are expected to nonconvey patients seeking ambulance care, they need a formal mandate, knowledge and access to primary health care.

Relevance to clinical practice: This study provides new knowledge regarding the work situation of ANs in relation to NC. These findings can guide future research and can be used by policymakers and ambulance organisations to highlight areas that need to evolve to improve patient care.

Keywords: ambulance nursing; care pathways; clinical decision-making; content analysis; experiences; health services research; nurse; qualitative study; refusal of care; self-care.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The NC process, as initiated by patients calling the emergency dispatcher and resulting in different referral options
See this image and copyright information in PMC

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