The whirlwind world of an ED NUM

An emergency ward NUM is a senior clinical resource and an important link between nurses and hospital management

The pace on the emergency ward at St George Hospital is hectic all the time. As NUM of the department, Shane Jackson is under relentless pressure to process the flow of patients from ambulances and to the wards, while managing the workloads of nursing staff.

He explains: ‘Patients are coming in from ambulances constantly. At one end I have ambulance officers applying pressure to get patients admitted within 30 minutes, so I have to work to get patients either discharged or moved to the wards to free up a bed. The problem is there are often no beds in the wards, so then they are under pressure to move patients on. It’s an endless, exhausting cycle.’

Shane has worked as an NUM in the emergency ward for the past seven years and describes his role as ‘a sandwich role’ between staff and management. ‘At one end I am under great pressure to get patients processed, but I am also responsible for my staff and I need to ensure they are not overloaded and under unreasonable pressure.

‘As NUM I am responsible for the ED overall including patients, nurses, clerical, and orderly staff after hours. I often feel caught in the middle and the pressure falls on me.

‘Being NUM in emergency is different to being an NUM in other wards. I’m able to maintain more of a clinical role than NUMs on the wards because I’m on the floor the majority of time, coordinating patient flow from ambulances and walk-in presentations to the wards, and I relieve nurses during their meal breaks.

‘I am a senior clinical resource for nursing staff and nurses from other wards ring me for advice on patient treatment all the time,’ said Shane.

For nurses wanting to advance their careers, Shane stresses the importance of maintaining a focus on education and professional development. ‘I encourage my nursing staff to undertake training and education in order to fast-track their nursing careers,’ he said.

A level 2 NUM, Shane is in the final stages of a Master of Health Services Management degree from the University of Western Sydney. He has post-graduate qualifications in emergency ward nursing and has undertaken numerous courses run by the area health service and hospital to enhance his clinical practice and management skills.

  • 1pm. Shane arrives for afternoon shift on the emergency department. The immediate task is to check the staff allocation for that shift. ‘I need to ensure we are adequately staffed with an appropriate skills mix.’
  • 1.30. Shane receives a full handover from the dayshift NUM. He is updated on the status of patients and acuity levels in all sections of the department.
  • 3pm. Shane checks all patient admissions are up-to-date. He also checks staff are lined up for the night shift.
  • 4.45. An ambulance arrives and Shane is under pressure to admit the patient.
  • 5.20. Shane liaises with the wards to develop strategies for moving patients to the wards.
  • 4.45. An ambulance arrives and Shane is under pressure to admit the patient.
  • 5.20. Shane liaises with the wards to develop strategies for moving patients to the wards.
  • 8pm. Shane provides high-level clinical care to patients.
  • c9pm. Shift end. A job well done!