Sources used in this document:

ER nurses supply care in an assortment of settings. At the extreme end of the continuum they must swiftly assess and then stabilize patients who have life-threatening conditions and also be prepared to care for less critical situations. Of course in the ER care is provided along the total age range from infants to the elderly. Thus, nurses in the ER need to be prepared for a fast-paced changing environment. Although most ER nurses work in hospitals they are also found in a variety of other situations ranging from urgent care centers to prisons to sporting events. The workload of ER nurses constitutes a major issue for the morale and efficiency of ER nursing staff as well as the clinical outcome of the patient and patient satisfaction.

There is a great deal of empirical research outlining the factors that can lead to poor morale in ER nurses. Burnout and not feeling appreciated are major contributors to poor morale in ER nurses and are most affected by the nurse's perception of being overburdened by a harsh and demanding workload (e.g., Freeman & O'Brien-Pallas, 1998; Aiken et al., 2002). Carayon and Gurses (2005) outlined four categorizations of workloads in nursing that could affect morale: the unit-level, the job-level, the patient -level, and the situation-level workload. The four levels are not mutually exclusive. For instance, the situation and patient-level areas are embedded within the job-level and the job-level workload can be categorized under the unit-level. Thus, the unit-level would be the macro-level, whereas situation and patient levels could be thought of as micro-levels (Carayon & Gurses, 2005).

As America changed, healthcare has not necessarily followed. Individuals are living longer, and as they age, require different healthcare solutions. In the 1940s, when the average age of death was far lower, many of the cancers and other illnesses of modernity and age had not yet become epidemic (Saad, 2007). So too, with the advances in technology that can discover disease and cure prior to it becoming debilitating have increased as well. Instead, the system has built layer upon layer of bureaucracy that, instead of streamlining the system, causes more bureaucracy and backlog. So, instead of simply establishing a set of universal care that is part of an even bigger bureaucracy, perhaps it is time to set into practice money spent on preventative care and education at the earliest levels, so that as the population