Sofia is in her first nursing job in an emergency department (ED).

Sofia is in her first nursing job in an emergency department (ED).

She was given the standard 3-week unit orientation and an additional week buddying with a senior nurse because she is a new graduate. She was advised to sign up for the next ACLS (Advanced Cardiac Life Support) class which will occur in a month’s time. She was working days, her third 12-hour shift (0700-1900) when Ben, a patient, approached her from the waiting room. He yelled at her, “I have been waiting for three hours in this damn place and I’m in terrible pain and I’ve lost a lot of blood from my cut. If someone doesn’t look after me right now, I’m going to sue you and the hospital and the doctors.” As Sofia starts to walk away from Ben, he grabs her arm and says, “I’m not kidding!” Sofia is very upset by the patient’s anger and his words. She speaks to the charge nurse who says, “You gotta be tough to work in ED.” Sofia is aware that they are short-staffed today, she has missed her lunch break and the influx of patients seems unending. She asks the charge nurse if the Security Guards should be alerted. The charge nurse responds, “Nah, he’s on his lunch break.” Using the RNAO Healthy Work Environment best practice guidelines, identify and define the issues of concern in this case. Use the physical, cognitive, and professional components as a starting point for discussion of the 3 levels – Individual (micro), organization (meso), and external factors (macro).