JOURNAL OF EMERGENCY NURSING/Research Abstracts

angulation with multiple sources, product and process trail auditing including double coding every third interview, the use of descriptive illustrations, and a comprehensive member check at the comple- tion of the study.

Results: Ethical situations experienced by the emergency nurses included confidentiality, justice issues, aggressiveness of treatment, compromised employees, and informed consent. Autonomy, the Basic Social Psychological Process, describes the social psychological process that helps the emer- gency nurse to resolve clinical ethical situations. The Basic Social Structural Process descr ibes the envi- ronment in which the phenomenon occurs. The emergency nurse's ethical decision making occurs within an environment of advocacy.

Implications: A conceptual model describing the nurses ' percept ion of the ethical situation and process used when resolving an ethical situation in the emergency clinical setting will be presented. Recommendat ions identifying actions nursing administration could implement to facilitate the emergency nurse's ethical decision-making abilities and patient advocacy role will be made. In addition, resources for facilitating the emergency nurse's ethi- cal decision-making skill will be identified.

7. Delivery of Non-Urgent Care in a Level I Trauma Center. Gail C. Mornhinweg, Ruth R. Voignier, Donna W. Carillo, Jill B. Keller, M. Lucinda Kessler, Delwin Jacoby. University of Louisville, School of Nursing, Louisville, KY 40292.

Purpose: A retrospective chart review of 2025 records was used to describe the client population and identify practice patterns of nurse practitioners in a fast track setting in an urban university, level I trauma center.

Methods: The sample included all nonurgent patients seen by a nurse practitioner (NP) on two ran- domly selected days per week for the first 14 months the fast track was in operation. Hospital policies and established protocols limited the population to per- sons ages 18 to 64 with selected chief complaints on triage. Data collected included demographics, employment, insurance, and mode of transportation to the emergency department . Additional data included chief complaint, discharge diagnosis, refer- rals, tests ordered, consultations requested, medica- tions prescribed, and durable equipment ordered.

Results: Results of the patient profile indicated that 78% were between the ages of 18 and 44 years, males (58.8%), single (78.6%), employed (52.5%), but

uninsured (63.9%), and nearly equal numbers of African-Americans (48.8%) and Caucasians (49.5%). Sixty-two percent came from zip codes immediately adjacent to the medical center. Chief complaints reported on triage were consistent with discharge diagnoses recorded by the NPs. The most frequently seen diagnoses were musculoskeletal injuries (38.6%) and dermatological problems (21.7%). Other common diagnoses included ENT (14.5%) and respiratory (9.3%). Successful triage to the fast track was evi- denced by the low percentage (2%) of patients who required referral back to the main emergency depart- ment. The NPs' orders for diagnostic tests, medica- tion, and assistive devices were consistent with the diagnoses.

Conclusion: Data from this study indicate that a large number of persons use the fast track for a vari- ety of nonurgent conditions. Many patients access the emergency department for their primary care needs even though less expensive care facilities are available. Nurse practitioners can provide an effec- tive way to care for patients with nonurgent condi- tions in a level I trauma center.

8. The Relationship of Certification to Job Satisfaction, Autonomy, and Salaries in Emergency Nurses. Corinne Wilhoit. 9709 Lakeland Road, Oklahoma City, OK 73162.

Purpose: This study explored the relationship of certification as a Certified Emergency Nurse (CEN) to job satisfaction, autonomy, and salaries in emergency nurses. With Stamps and Piedmonte's conception of job satisfaction as a framework, it was hypothesized that certified nurses would report (1) greater job sat- isfaction and autonomy than noncertified nurses, and (2) salary increase as a result of certification.

Design: One-time comparative survey of certified and noncertified ED nurses using a mailed question- naire.

Setting and sample: Eligible subjects were regis- tered nurses, male or female, who (1) worked at least 24 hours a week in the emergency department, (2) did not hold an administrative position, and (3) had a minimum of 1 year experience in the emergency department. A convenience sample was obtained from nurse managers at 17 acute care facilities in the Oklahoma City and Tulsa areas and from a mailing list of Certified Emergency Nurses in Oklahoma (n = 37) provided by the Board of Certification for Emergency Nursing.

Methodology: Eighty-six certified and 95 noncerti- fled nurses completed Stamps and Piedmonte's

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