Emergency Practices IN Responding TO Critically Ill Patients:

Basis FOR An Evidence-Based Practice

PSYCHOLOGY AND EDUCATION: A MULTIDISCIPLINARY JOURNAL

Volume: 39
Issue 10
Pages: 1372-1387
Document ID: 2025PEMJ3833
DOI: 10.70838/pemj.391007
Manuscript Accepted: 05-12-2025
 Psych Educ, 2025, 39(10): 1372-1387, Document ID:2025PEMJ3833, doi:10.70838/pemj.391007, ISSN 2822-4353
Research Article

Emergency Practices in Responding to Critically Ill Patients:

Basis for an Evidence-Based Practice
Manuel P. Fajardo,* Priscilla R. Baun
For affiliations and correspondence, see the last page.
Abstract
This study utilized a descriptive research design to assess the emergency room (ER) practices of nurses in responding
to critically ill patients in selected Hospitals in Eastern Pangasinan during the second semester of Academic Year
2024–2025. A total of 60 ER nurses were selected as respondents. Data were gathered through a validated survey
questionnaire composed of two parts: demographic profile and nursing practices in emergency response. Statistical
tools such as frequency, percentage, weighted mean, and Analysis of Variance (ANOVA) were used to analyze the
data. Ethical standards including informed consent, confidentiality, and respect for autonomy were strictly observed
throughout the research process. Results revealed that most respondents were female (75%) and aged 26–35 years
(58.3%). The majority were single (60%), with a bachelor’s degree in nursing (83.3%), while 16.7% held a master’s
degree. In terms of position, most were staff nurses (86.7%), while others were nurse supervisors or charge nurses
(13.3%). Regarding length of service, 43.3% had 1–5 years of experience in the ER, 36.7% had 6–10 years, and 20%
had more than 10 years. Over half of the respondents (65%) had attended three or more relevant emergency nursing
seminars or trainings.The study found that the emergency room practices of nurses in responding to critically ill
patients were rated as “Often Practiced,” indicating consistent adherence to emergency response protocols. High
practice areas included initial assessment, airway management, and coordination with physicians, while areas for
improvement involved advanced interventions and documentation under pressure. Significant differences in
emergency practices were found when grouped by years of ER experience, number of training courses attended, and
the category of facility, indicating these factors play a vital role in the proficiency of ER nurses. No statistically
significant differences were observed based on age, sex, civil status, educational attainment, or position. Based on the
findings, it is recommended that hospital administrators enhance continuing professional development programs,
particularly for nurses with fewer years of experience and limited training exposure. Investments in training and
standardized protocols across facility types may bridge competency gaps and strengthen the overall quality of
emergency care. Future studies may incorporate patient outcomes as additional variables to correlate with nursing
practices.
Keywords: emergency nursing, critically ill patients, descriptive research, purposive sampling, weighted mean,
ANOVA, ethical research, nursing practices, emergency room response

Introduction
Critical care is the process of looking after patients who either suffer from life-threatening conditions or are at risk of developing them.
The emergency room is an area with high staffing ratios, advanced monitoring can be offered to improve patient morbidity and
mortality. However, effective intensive care demands an integrated approach that stretches beyond the boundaries of the emergency
room. It requires prevention, early warning and response systems, a multidisciplinary approach before and during, as well as
comprehensive follow-up or good quality palliative care. Care management is the optimization of a patient's physiology, the provision
of advanced support, and the identification and treatment of underlying pathological processes. This is best achieved through a
multidisciplinary team approach, with shared responsibility between the admitting ‘parent’ team and a specialized critical care team
coordinated by a critical care physician. Early recognition of acutely ill patients is a challenging task but can potentially improve
outcomes (Jackson and Cairns 2020).
Kuyler and Johnson (2023) healthcare practitioners, especially nurses, play an integral part in providing communication support,
meeting the biomedical needs of the patient and creating a positive environment to improve patient personhood. At times nurses may
have personal assumptions or may not fully understand the unique needs of critically ill patients. Components such as workload, non‐
nursing‐related responsibilities, degree of job satisfaction or burnout and years of experience can hamper nurses' ability to provide
person‐centered care. Nurses’ ability to support perceived personhood of patients during person‐centered care is integral to the
betterment of the patient. Patients’ experiences of nursing care can often be affected if they perceive their personhood as not being
valued by nurses.
ER nurses must quickly evaluate patients upon arrival, determine the severity of their condition, and prioritize care accordingly. Strong
critical thinking skills are essential for making split-second decisions. Emergency rooms can be chaotic, with multiple patients requiring
immediate attention. Emergency nurses excel in rapid assessment, prioritizing patient care, and initiating life-saving interventions while
working under pressure. They require strong communication skills to collaborate with teams and educate patients/families, along with
critical thinking to make quick decisions (Malak 2022).
As mentioned in the articles at Queen Margaret University (2017), emergency room nurses are trained to provide highly skilled care
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Research Article

for injured or severely ill patients with complex, life-threatening conditions. Patients can deteriorate rapidly, and nurses are deeply
involved in all stages of their care. They are generally the very first – and ongoing – point of contact and providers of care for patients
for the duration of their hospital stay. Emergency room nurses perform an integral and varied role as part of a multidisciplinary care
team, providing direct, hands-on care in medical settings. Common nursing responsibilities include: all physical care given to patients
– bedside care, administering medication, taking baseline blood samples, changing catheters, intravenous insertion and infusion, for
example electrolytes or analgesia, mechanical ventilation management, and any other care detailed in the patient’s care plan. Nursing
responsibilities include constant and ongoing monitoring and assessment of patients’ conditions, including close monitoring of heart
rate, blood pressure, oxygen levels and other vital signs using specialist equipment, ordering, interpreting and evaluating diagnostic
tests and results, assisting with sedations, surgeries and other procedures, and maintaining detailed records of patient condition, care
and treatment.
Technology has brought various innovations on how healthcare providers acquire information, work, and communicate. These
innovations are most common in the emergency department. Among the important innovations in the emergency department, imaging
methods and diagnostic tests are now performed at the bedside. The main purpose of bedside imaging methods and diagnostic tests is
to achieve rapid results and initiate appropriate treatment in a short time. Technological development provides fast access to diagnostic
tests and rapid results as well as facilitates access to specialist physicians. Patients’ data can be transmitted to advanced centers by
telemedicine application, and consultation services can be obtained. Bedside consultation is also possible, thanks to the telemedicine
application supported by robotic technology. Biosensors, mobile applications, technological products used in patient registration and
follow-up process, and voice response systems used in patient monitoring after discharge are among other technological innovations
used in emergency departments (Simsek et al., 2021).
Being in critical condition is a life-threatening multisystem process that can result in significant morbidity or mortality. In most patients,
critical illness is preceded by a period of physiological deterioration; but evidence suggests that the early signs of this are frequently
missed. All clinical staff have an important role to play in implementing an effective ‘Chain of Response’ that includes accurate
recording and documentation of vital signs, recognition and interpretation of abnormal values, patient assessment and appropriate
intervention. Early warning systems are an important part and can help identify patients at risk of deterioration and serious adverse
events. Assessment of the critically ill patient should be undertaken by an appropriately trained clinician and follow a structured
ABCDE (airway, breathing, circulation, disability and exposure) format. This facilitates correction of life-threatening problems by
priority and provides a standardized approach amongst professionals. Good outcomes rely on rapid identification, diagnosis and
definitive treatment and all doctors should possess the skills to recognize the critically ill patient and instigate appropriate initial
management (Bennet et al. 2019).
In the study of Trisyani (2023) on the competency skills of emergency room nurses revealed 8 core competencies of emergency nurses:
Shifting the nursing practice, caring for acute critical patients, Communicating and coordinating, covering disaster nursing roles,
reflecting on the ethical and legal standards, Researching competency, Teaching competencies and Leadership competencies. The
interconnection of the 8 core competencies has resulted in 2 concepts of extending the ED nursing practice and demanding the advanced
ED nursing role.
Critically ill patients are a population at high risk for more frequent and more severe medication-related events. Critically ill patients
receive twice the number of medications that non-critically ill, hospitalized patients receive, thus increasing the opportunity for adverse
drug events to occur. ICU patients are more likely to have drug-drug interactions, drug accumulation due to failing organs, and a
sensitivity to drug responses resulting from their labile status. The complexity of the patient’s drug regimens and the environment
provide a risk for patient harm. Critically ill patients are also more likely to develop drug-induced events such as acute kidney injury
and coagulopathies. Some adverse drug reactions such as headaches, nausea, and confusion are only detectable through conversations
with the patient. In the ICU, critical care patients are often unable to articulate their own concerns, so a patient’s caregiver’s insight
becomes essential for providing useful context for ongoing processes. For example, if a patient appears to have cognitive status
impairment, it is difficult to understand what type of improvement would be expected without understanding their baseline.
Emergency nursing is a specialty in which nurses take care of critically ill patients during the acute phase of their illness or injuries
focusing on appropriate triaging and timely interventions to save the lives of patients. Nurses attending to patients with potentially life-
threatening conditions are required to possess capabilities in emergency care. Early recognition of acutely ill patients in hospitals is a
challenging task but can potentially improve outcomes. The use of early warning scores and ‘track and trigger' systems has now been
widely implemented in many countries. Rapid optimization of care on the ward and early senior involvement are essential to minimize
any deterioration and reduce the need for subsequent critical care admission. These emergency care functions require nurses to obtain
advanced education and specialized competencies in handling emergency conditions. Updating knowledge to enhance the confidence
of nurses through training can be an important tool in the delivery, timely assessment and resuscitation of trauma patients. Nurses who
get emergency care education and training are equipped with important knowledge and capacities to effectively manage critically ill
patients (Karikari et al., 2023).
Some monitoring of critical care patients depends on direct observation and physical examination and is intermittent, with the frequency
depending on the patient’s illness. Other monitoring is ongoing and continuous, provided by complex devices that require special

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Research Article

training and experience to operate. Most such devices generate an alarm if certain physiologic parameters are exceeded. Every
emergency department should strictly follow protocols for investigating alarms. Monitoring usually includes measurement of vital
signs (temperature, blood pressure, pulse, and respiration rate), quantification of all fluid intake and output, and often intracranial
pressure and/or daily weight. Blood pressure may be recorded by an automated sphygmomanometer, or an arterial catheter can be used
for continuous blood pressure monitoring. A transcutaneous sensor for pulse oximetry is used (Berry, 2022).
Monitoring critically ill patients involves continuously observing and measuring key physiological parameters like heart rate, blood
pressure, respiratory rate, oxygen saturation, temperature, and level of consciousness, using a combination of non-invasive and invasive
techniques, to detect early signs of deterioration and guide appropriate medical interventions to maintain vital organ function and
optimize patient outcomes (Romare, 2022).
The medical management of the critically ill patient focuses predominantly on treatment of the underlying condition (e.g., sepsis or
respiratory failure). The importance of initiating early prophylactic treatment for complications arising from care in the intensive care
unit setting has become increasingly apparent. As survival from critical illness has improved, there is an increased prevalence of post
intensive care syndrome—defined as a decline in physical, cognitive, or psychologic function among survivors of critical illness.
Management of critically ill patients has predominantly focused on treatment of the underlying condition. Common conditions leading
to intensive care unit admission include respiratory failure, acute myocardial infarction, cerebral infarction/intracranial hemorrhage,
and sepsis (Martinez etal, (2022).
Barreto and Dezierba (2024) mentioned that medication administration to critically ill patients primarily involves using the intravenous
(IV) route due to the potential for erratic absorption through other routes, and requires careful consideration of drug selection, dosage
adjustments based on rapidly changing physiological states, and close monitoring to minimize adverse effects, all while prioritizing
the "five rights" of medication administration to ensure safety; where patients are closely monitored. Recognition of the risk of incidents
related to the use of equipment in health care which compromises patient safety is a necessity for professionals who work in this area,
especially nurses, because of the fast incorporation of technologies in the care they provide. The magnitude of the issue of incidents
involving equipment and potential harm to patients has been disseminated to warn the healthcare community about the evaluation of
these risks to help formulate new measures that favor safety in the use of equipment. In critical care, the intravenous route of drug
administration is more common and often more desirable than the enteral route. Intravenous drug delivery assures 100% bioavailability
even when tissue or organ perfusion is compromised.
The causes for the occurrence of adverse effects involving technologies in intensive care refer to the apparatuses themselves, problems
in their functioning, mistakes by the healthcare team, such as inappropriate use, and other issues, for instance, the violation of the
proper procedures to handle the tools. These causes were mentioned in other studies, in which two reasons were predominant in
incidents with equipment. The first one was the inappropriate use of equipment. A study about the use of intermittent pneumatic
compression devices in critical patients revealed errors in the application in patients, mainly in placing the sleeves in the legs. Another
investigation, which focused on the evaluation of programmed adjustments in infusion pumps and its comparison with medical
prescriptions, pointed discrepancies (Ribiero et al. 2018).
Caring is the essence and core of nursing. Current studies on the effect of gender on nurses’ perception of caring have been inconsistent.
In the study of Aktar (2023) it found that majority of nurses were having favorable attitude toward caring for the critically ill patients,
and there was no significant association of the attitude. Majority of critical care nurses have favorable attitude. If they have supportive
environment at workplace, their willingness to work toward quality care. Higher educational attainment generally leads to improved
care for critically ill patients as individuals with greater education tend to have better health literacy, allowing them to understand
complex medical information, actively participate in decision-making, and better adhere to treatment plans, potentially resulting in
improved outcomes for critically ill patients; however, this can vary depending on the specific healthcare setting and patient population
(Orwelius 2024).
In the study of Kuyler, (2023) suggests that a higher number of years in service among nurses can generally lead to improved care for
critically ill patients, as experienced nurses often possess greater clinical expertise, decision-making skills, and a deeper understanding
of complex patient situations, which can result in better patient outcomes and more efficient care delivery in critical care settings;
however, factors like workload, burnout, and ongoing training also play a significant role. Flaubert (2021) mentioned that when
comparing the care provided by nurses in public and private hospitals for critically ill patients, private hospitals generally have more
resources and advanced technology available, which can lead to a higher level of specialized care for critically ill patients compared to
public hospitals; however, the quality of nursing care itself can vary significantly depending on individual nurse competency, hospital
policies, and overall staffing levels in both sectors.
In the study of Tong et al., (2023) found female nurses higher on caring than male nurses, after completely controlling for the other
factors. Results showed that both male and female nurses agreed that caring was to deal with three kinds of relationships, namely nurses
and people, nurses and themselves, nurses and society. There were gender differences in the connotation of caring between nurses and
themselves, but not in the connotations of caring between other relationships. A nurse's position within a healthcare hierarchy can
significantly impact the care of critically ill patients, with factors like experience level, decision-making authority, and workload
influencing the quality of care provided, potentially leading to variations in patient outcomes depending on who is primarily responsible
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for the patient's care (Doering 2023).

According to the Critical Care Nurses Association of the Phil., (2024) Critical care nursing is the specialty within nursing that deals
specifically with human responses to life-threatening problems. These problems deal dynamically with human responses to actual or
potential life-threatening illnesses.
The framework of critical care nursing is a complex, challenging area of nursing practice. It utilizes the nursing process applying
assessment, diagnosis, outcome identification, planning, implementation, and evaluation. The critical care nursing practice is based on
a scientific body of knowledge and incorporates the professional competencies specific to critical care nursing practice and is focused
on restorative, curative, rehabilitative, maintainable, or palliative care, based on identified patient’s need. It upholds multi and
interdisciplinary collaboration in initiating interventions to restore stability, prevent complications, achieve and maintain optimal
patient responses. The critical care nursing profession requires a clear description of the attribute guidelines and nursing practice
standards in guiding the critical care nursing practice to fulfill this purpose. With the advances in sophisticated biomedical technology
and knowledge, critical care nurses are able to continuously monitor and observe patients for physiological changes to confront
problems proactively and to assist patients achieve and maintain an optimum level of functioning or a peaceful death.
Research Questions
This study examined the emergency practices in responding to critically ill patients in selected hospitals in Eastern Pangasinan.
Specifically, it sought to answer the following questions:
1. What is the profile of the respondents in terms of their.
1.1 age;
1.2 sex
1.3 civil status
1.4 highest educational attainment;
1.5 number of years in the service;
1.6 position;
1.7 number of relevant training in critical nursing, and
1.8 category of health facility?
2. What are the emergency practices among nurses in responding to critically ill patients along;
2.1 monitoring life support equipment;
2.2 administer emergency care;
2.3 patient evaluation
2.4 medication management; and
2.5 responding to challenges?
3. Is there significant difference in the emergency practices of nurses in responding to critically ill patients with their profile
variables?
4. Based on the findings, what proposed innovative program can be formulated to enhance the emergency practices of nurses
in responding to critically ill patients?
Methodology
Research Design
The study utilized the descriptive method of research with the questionnaire as data gathering tool to determine the emergency practices
of emergency room nurses in responding to critically ill patients. Descriptive research is useful when the goal is to discover traits,
frequencies, trends, and categories, according to McCombes (2019). The descriptive survey method enables the researcher to collect
information, describe the respondents' demographics, and ascertain their impressions of the consequences.
Participants
This study was conducted in selected hospitals in Eastern Pangasinan during the second semester of Academic Year 2024–2025. The
focus was on the emergency practices of nurses assigned in the emergency room (ER). A total of 60 ER nurses participated in the study,
selected through purposive sampling. The population was specifically delimited to nurses on active duty in the emergency departments
of the chosen hospitals during the data collection period.
The distribution of respondents is as follows:
Conrado F. Estrella Regional Medical and Trauma Center – 28 nurses, representing 46.67% of the total population.
Eastern Pangasinan District Hospital – 20 nurses, representing 33.33% of the total population.
Tayug Family Hospital – 12 nurses, representing 20.00% of the total population.

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These hospitals were selected as study sites due to their active emergency departments and accessibility for the researchers.
Research Instrument
The study utilized a survey questionnaire based on previous studies and articles related to the study. Part I focused on the profile of the
respondents in terms of their age, sex, civil status, highest educational attainment, number of years assigned in the emergency room,
position, relevant training on emergency room nursing, and category of health facility. Part II determined the practices of emergency
room nurses in responding to critically ill patients.
The questionnaire was utilized to gather data from the respondents. The items found in the questionnaire were taken from several
articles and research studies related to challenges encountered by the emergency room nurses and their coping strategies. However, it
was subjected to validation from experts in the field of emergency nursing namely: a faculty researcher, an instructor teaching
emergency nursing and emergency room nurses. The combined rating was highly valid.
Procedure
Before the actual gathering of data, the researcher secured permission from the Dean of Institute of Graduate and Advanced Studies to
conduct the study. When permission was granted from the Institute of Graduate and Advanced Studies, the researcher requested and
coordinated with the Chief of Hospitals through the Chief Nurses for the permission of conducting the study. After securing the
permission, the researcher secured consent from the respondents. Gathering of data was done personally by the researcher on the
Second semester of 2024-2025.
The researcher ensured that ethical precautions and procedures are met. In the whole process of this study, the researcher considered
ethical precautions to follow:
This researcher treated the respondents as autonomous agents with the right to self-determination and the freedom to participate or not
to participate in the research. Self-respect for people indicated and regarded as autonomous, anonymous and private as well as the right
for self-preservation and the freedom to participate or not to participate to the research.
This research endeavors to fairly treat his subjects in terms of the benefits and the risks of the research. The principle of fair justice and
transparency was strictly observed by the researcher.
This researcher granted the respondents their right to privacy and use of freewill to have the freedom to determine the time, extent, and
general circumstances under which their private information will be shared with or without the help from others. The respondent’s
right to exercise freewill and right to privacy was provided; that any personal data and private information given were guarded by the
researcher with utmost care and strict confidentiality.
Data Analysis
For Problem No.1 on the respondent’s profile, frequency and percentage was used. The frequency was determined based on the number
of respondents who answered or checked a particular item on the questionnaire. For problem No. 2 on the emergency practices of
nurses in responding to critically ill patients, the weighted mean was used. Weighted means are the means of a set of values wherein
each value or measurement has a different weight or degree of importance. For Problem No. 3 on the significant differences between
the effectiveness of emergency room nurses in responding to critically ill patients across their profile variables, Analysis of Variance
(ANOVA) was used to test the difference.
Results and Discussion
This section presents the tabulation of the information gathered with the corresponding evaluation and elucidation on the study on
responding to critically ill patients.
Respondent’s Profile
Table 1 presents the profile of the respondents in terms of their age, sex, civil status, highest educational attainment position, number
of years in service, and number of relevant seminars/ trainings and category of facility.
Age. It can be gleaned from the table that most of the respondents are in the age bracket of 31–40 years old (63.3%), followed by 21–
30 years old (23.3%). This indicates that most ER nurses are young adults, which according to Erikson’s psychosocial theory, is a stage
where individuals are energetic, adaptable, and capable of forming meaningful professional relationships. Their age may influence their
physical stamina, decision-making speed, and openness to training—all vital when responding to critical situations. This suggests that
the ER workforce is mostly composed of nurses who are in their prime working years, likely contributing positively to patient outcomes.
Sex. Most respondents were male (51.7%) slightly edging out females (48.3%). In emergency settings, where tasks may involve
physical exertion, such as lifting or transferring patients, male nurses are often presumed to have a physical advantage. However, the
almost equal distribution also reflects gender diversity, which can contribute to a balanced skill set and collaborative dynamics in
emergency teams

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Table 1. Distribution of Respondents in terms of their

Profile Variables
Profile Variables Frequency Percentage
Age (in years)
21 – 30 14 23.3
31 – 40 38 63.3
41 – 50 6 10.0
51 and above 2 3.3

Sex
Male 31 51.7
Female 29 48.3

Civil Status
Single 25 41.7
Married 26 43.3
Separated 3 5.0
Widow 6 10.0

Highest Educational Attainment

Bachelor’s Degree 38 63.3
With Master’s units 15 25.0
Master’s Degree 7 11.7

Position
Staff Nurse 39 65.0
Triage Nurse 8 13.3
Charge Nurse 11 18.3
Nurse Supervisor 2 3.3

Number of Years Assigned in the ER

1–2 23 38.3
3–4 24 40.0
5 and above 13 21.7

Number of Relevant Training in Critical Nursing

1–2 18 30.0
3–4 17 28.3
5 and above 25 41.7

Category of Health Facility

Private 21 35.0
Public 39 65.0
Civil status. Most of the respondents were both married with a frequency of 26 or 43.3 percent followed by singles with a frequency
of 25 or 41.7 percent, widow with a frequency of 6 or 10 percent and separated with a frequency of 3 or 5 percent. It revealed that the.
Highest educational attainment. It revealed that majority of the respondents were bachelor’s degree holder with a frequency of 38 or
63.3 percent, followed by those with masteral units with a frequency of 15 or 25 percent, and MAN graduates with a frequency of 7 or
11.7percent. It showed that the majority did not pursue higher level of learning. This might be related to the fact that their salaries are
not competitive, so some nurses fail to enroll in the masteral or doctoral program.
Position. It can be gleaned from the table that majority of the respondents were staff nurses with a frequency of 39 or 65 percent, charge
nurses with a frequency of 11 or 18.3 percent, triage nurse with a frequency of 8 or 13.3 percent and nurse supervisor with a frequency
of 2 or 2.2 percent. It showed that most respondents were staff nurses because in the emergency room the staff nurses are most in
number compared to nurse supervisor and charge nurses.
Number of years in service. It showed that most respondents were in service for 3-4 years with a frequency of 24 or 40 percent, 1-2
years with a frequency of 23 or 38.3 percent, and 5 years and above with a frequency of 13 or 21.7 percent. It revealed that the
respondents were in service at different number of years, and most were in the service for a few years getting their experiences on
emergency nursing.
Number of relevant training/seminars attended. It revealed that most of the respondents attended 5 and above trainings/seminar with a
frequency of 25 or 41.7 percent, 1-2 with a frequency of 18 or 30 percent, and 3-4 with a frequency of 17 or 28.3 percent. It showed

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that the respondents had attended many seminars or training courses which is needed, especially in a special area like the emergency
room. The findings are confirmed by Karikari et al., (2023) that nurses attending to patients with potentially life-threatening conditions
are required to possess capabilities in emergency care. Updating knowledge to enhance the confidence of nurses through training can
be an important tool in the delivery, timely assessment and resuscitation of trauma patients.
Category of facility. It can be seen that majorityof the respondents were in a public facility with a frequency of 39 or 65 percent, and
in the private health facility with a frequency of 21 or 35 percent. It clearly showed that there were more emergency room nurses in
public hospitals compared to the private health facility.
Emergency Practices in Responding to Critically Ill Patients along Monitoring Life Support Equipment
Table 2 presents the emergency practices of Nurses in Responding to Critically Ill Patients along Monitoring Life Support Equipment.
It revealed that all the indicators were rated “Highly Practiced” and item 7 the highest” administer and monitor oxygen delivery
equipment and masks, such as oxygen masks and nasal cannulas, are vital in providing the necessary support to maintain adequate
oxygen level,” with a weighted mean of 4.92, or “Highly Practiced.” It revealed that they do a lot of monitoring, particularly on the
airway as priority in giving care. According to Jackson and Cairns 2020), the emergency room is an area with high staffing ratios,
advanced monitoring can be offered to improve patient morbidity and mortality, the provision of advanced support, and the
identification and treatment of underlying pathological processes.
Table 2. Emergency Practices in Responding to Critically Ill Patients along Monitoring Life Support Equipment
Indicators WM DE
1. Preventive maintenance, calibration and documentation is regularly done 4.83 HP
2. safe use of potentially hazardous equipment in the area 4.83 HP
3. Visual inspection is frequently done looking for missing components and physical damage 4.85 HP
4. capable of providing mechanical ventilation and simple invasive cardiovascular monitoring 4.85 HP
5. ensure that the equipment is kept in good working order and functionality 4.88 HP
6. handle tools/equipment with care to keep infection control and ensure patient and health workers safety 4.85 HP
7. administer and monitor oxygen delivery equipment and masks, such as oxygen masks and nasal cannulas, are
4.92 HP
vital in providing the necessary support to maintain adequate oxygen levels.
8. monitor patients effectively from simple diagnostic and treatment tools to advanced life-saving devices, 4.78 HP
9. Capable of providing sustainable support for invasive hemodynamic monitoring and equipment for critically
4.85 HP
ill patients
10. Capable of providing immediate resuscitation for the critically ill 4.83 HP
Average Weighted Mean 4.85 HP
Legend: 4.50 – 5.00: Highly Practiced (HP); 3.50 – 4.49: Practiced (P); 2.50 – 3.49: Moderately Practiced (MP); 1.50 – 2.49: Slightly Practiced (SP); 1.00 – 1.49: Not Practiced (NP)

The lowest item are numbers 1,2, and 10 “Preventive maintenance, calibration and documentation is regularly done,” “safe use of
potentially hazardous equipment in the area” and “Capable of providing immediate resuscitation for the critically ill”, with a weighted
mean of 4.83 or “highly Practiced.” It showed that the nurses were knowledgeable about giving resuscitations and proper care of the
equipment in the emergency room.
4.Overall, on the Emergency practices of nurses in Responding to Critically Ill Patients along Monitoring Life Support Equipment.got
an average weighted mean of 4.85 or “Highly Practiced.” It showed that the nurses perform monitoring life support equipment in the
ER. As cited in the articles at Queen Margaret University (2017), emergency room nurses are trained to provide highly skilled care for
injured or severely ill patients with complex, life-threatening conditions. Patients can deteriorate rapidly, and nurses are deeply involved
in all stages of their care. Areas for Continuous Improvement: Although all scores are high, items 1, 2, and 10 (preventive maintenance,
safe equipment use, and resuscitation capability) had the lowest scores (4.83). This could indicate areas where continued training or
reinforcement may be beneficial, even if they are still well-practiced.
Emergency Practices in Responding to Critically Ill Patientsalong Administer Emergency Care
Table 3 presents the Emergency practices of Nurses in Responding to Critically Ill Patients along administering emergency care. It
revealed that all the indicators were rated “Highly Practiced” and item 3 is the highest” monitor patients to check for life-threatening
conditions like breathing and circulation,” with a weighted mean of 4.88, or “Highly Practiced.” It revealed that the emergency room
nurses respond to the needs of chronically ill patients. As cited in the articles at Queen Margaret University (2017), nursing
responsibilities include constant and ongoing monitoring and assessment of patients’ conditions, including close monitoring of heart
rate, blood pressure, oxygen levels and other vital signs using specialist equipment, ordering, interpreting and evaluating diagnostic
tests and results, assisting with sedations, surgeries and other procedures, and maintaining detailed records of patient condition, care
and treatment.
Table 3. Emergency Practices in Responding to Critically Ill Patients along Administer Emergency Care
Indicators WM DE
Implement and monitor care plans for patients with various severe conditions 4.78 HP
quick decision-making abilities are done essential in ensuring positive patient outcomes 4.80 HP
monitor patients to check for life-threatening conditions like breathing and circulation 4.88 HP
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Research Article

seek medical assistance by calling for help from colleagues when needed 4.85 HP
Assess the situation and. maintains my composure 4.83 HP
Prioritize Basic Life Support (BLS) for my patients 4.87 HP
detailed communication procedures are followed during and after a specific emergency occurs. 4.77 HP
have a list of individuals to contact and their contact information, and how to act during an emergency 4.82 HP
Prepare emergency procedures for foreseeable hazards and threats 4.80 HP
prepare plans and procedures for responding in emergencies. 4.78 HP
Average Weighted Mean 4.82 HP
Legend: 4.50 – 5.00: Highly Practiced (HP); 3.50 – 4.49: Practiced (P); 2.50 – 3.49: Moderately Practiced (MP); 1.50 – 2.49: Slightly Practiced (SP); 1.00 – 1.49: Not Practiced (NP)

The lowest item is number 7 “detailed communication procedures is followed during and after a specific emergency occurs”, with a
weighted mean of 4.77, or “Highly Practiced.” It showed that the nurses follow certain protocols in the emergency room. This confirms
what Kuyler and Johnson (2023) mentioned that healthcare practitioners, especially nurses, play an integral part in providing
communication support, meeting the biomedical needs of the patient and creating a positive environment to improve patient
personhood.
Overall, on the emergency practices of Nurses in Responding to Critically Ill Patients along administer emergency care got an average
weighted mean of 4.82 or “Highly Practiced.” It showed that the nurses performed such measures in responding to critically ill patients.
Nurses have an important role to play in implementing an effective ‘Chain of Response’to critically ill patients that includes accurate
recording and documentation of vital signs, recognition and interpretation of abnormal values, patient assessment and appropriate
intervention. Early warning systems are an important part of this and can help identify patients at risk of deterioration and serious
adverse events (Bennet et al. 2019).
Emergency Practices in Responding to Critically Ill Patients along Patient Evaluation
Table 4 presents the Emergency Practices of nurses in Responding to Critically Ill Patients along patient evaluation. It revealed that all
the indicators were rated “Highly Practiced” and item 1 is the highest” monitoring blood pressure and hourly urine output,” and “Heart
rate, taking into account factors such as rate depth and regularity are noted” with a weighted mean of 4.88, or “Highly Practiced.” It
revealed that the nurses perform the necessary procedures and proper monitoring of intake and output, monitoring vital signs and even
when its abnormal in nature. Berry, (2022) mentioned that monitoring usually includes measurement of vital signs (temperature, blood
pressure, pulse, and respiration rate), quantification of all fluid intake and output, and often intracranial pressure and/or daily weight.
Blood pressure may be recorded by an automated sphygmomanometer, or an arterial catheter can be used for continuous blood pressure
monitoring. A transcutaneous sensor for pulse oximetry is used (Berry, 2022).
Table 4. Emergency Practices in Responding to Critically Ill Patients along Patient Evaluation
Indicators WM DE
monitoring blood pressure and hourly urine output 4.87 HP
Heart rate, taking into account factors such as rate depth and regularity are noted 4.87 HP
checking for the skin color and pallor 4.85 HP
check for See-saw’ respirations, seen as paradoxical chest and abdominal movements 4.73 HP
monitor abnormal breath sounds (noisy breathing such as a stridor involving a high-pitched sound, wheezing or
4.82 HP
snoring)
watch out for complete airway obstruction 4.85 HP
knowledgeable about various factors that can affect the airway, such as breathing, cardiovascular, or neurological
4.80 HP
problems
Checking the patency and evaluate the risk of
4.82 HP
deterioration in patients' ability to protect their airway with an effective cough and gag reflex
analyze client's response relating to nursing activities 4.80 HP
note down medical history, physical examination, routine laboratory tests and other diagnostic procedures 4.85 HP
Average Weighted Mean 4.83 HP
Legend: 4.50 – 5.00: Highly Practiced (HP); 3.50 – 4.49: Practiced (P); 2.50 – 3.49: Moderately Practiced (MP); 1.50 – 2.49: Slightly Practiced (SP); 1.00 – 1.49: Not Practiced (NP)

The lowest item is number 4 “check for See-saw’ respirations, seen as paradoxical chest and abdominal movements,” with a weighted
mean of 4.73, or “Highly Practiced.” It showed that the nurses do practice observations on the patient particularly the vital signs. Berry
(2022 cited that monitoring critically ill patients involves continuously observing and measuring key physiological parameters like
heart rate, blood pressure, respiratory rate, oxygen saturation, temperature, and level of consciousness, using a combination of non-
invasive and invasive techniques, to detect early signs of deterioration and guide appropriate medical interventions to maintain vital
organ function and optimize patient outcomes.
Overall, on the Emergency practices of Nurses in Responding to Critically Ill Patients along patient evaluation got an average weighted
mean of 4.83 or “Highly Practiced.” It showed that the nurses perform patient monitoring as part of their nursing responsibility to make
sure their patients will recover from their illnesses. Monitoring critically ill patients involves continuously observing and measuring
key physiological parameters like heart rate, blood pressure, respiratory rate, oxygen saturation, temperature, and level of
consciousness, using a combination of non-invasive and invasive techniques, to detect early signs of deterioration and guide appropriate
medical interventions to maintain vital organ function and optimize patient outcomes (Romare, 2022).
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Emergency Practices in Responding to Critically Ill Patients along Medication Management

Table 5 presents the Emergency practices in Responding to Critically Ill Patients along medication management. It revealed that all the
indicators were rated “Highly Practiced” and items 1, 7, 9, and 10 are the highest” administer medications as prescribed,” “ensure that
medications are given in its correct route,” “determine dosage amounts and concentration level,” and “maintain the supply of
medications at bedside” with a weighted mean of 4.88, or “Highly Practiced.” It revealed that the emergency nurses are experts in
giving medications to patients observing the rights in giving medicines. This is confirmed by Barreto and Dezierba (2024) where they
mentioned that medication administration to critically ill patients primarily involves using the intravenous route due to the potential
for erratic absorption through other routes, and requires careful consideration of drug selection, dosage adjustments based on rapidly
changing physiological states, and close monitoring to minimize adverse effects, all while prioritizing the "five rights" of medication
administration to ensure safety; where patients are closely monitored.
Table 5. Emergency Practices in Responding to Critically Ill Patients along Patient Evaluation
Indicators WM DE
administer medications as prescribed 4.88 HP
insert IV catheters, infusion pumps, and IV sets, allowing for safe and controlled delivery of treatments. 4.87 HP
Create a complete list of the patient's prescribed medicines 4.87 HP
Educate patient or watcher about each medication at time of administration 4.87 HP
Administer medication utilizing the rights like Right patient. Right drug. Right dose. Right time. Right route. Right
4.87 HP
reason. Right response. Right documentation
know the actions and indications of all medications administered, including safe dosage ranges, adverse reactions,
4.83 HP
monitoring parameters, and nursing implications
ensure that medications are given in its correct route 4.88 HP
verify that the route is appropriate for the medication and the patient. 4.87 HP
determine dosage amounts and concentration levels. 4.88 HP
maintain the supply of medications at bedside 4.88 HP
Average Weighted Mean 4.87 HP
Legend: 4.50 – 5.00: Highly Practiced (HP); 3.50 – 4.49: Practiced (P); 2.50 – 3.49: Moderately Practiced (MP); 1.50 – 2.49: Slightly Practiced (SP); 1.00 – 1.49: Not Practiced (NP)

The lowest item is number 6 “know the actions and indications of all medications administered, including safe dosage ranges, adverse
reactions, monitoring parameters, and nursing implications “”, with a weighted mean of 4.73, or “Highly Practiced.” It showed that the
nurses were aware on the actions of the drugs they give to patients depending on the doctors’ orders. Berry (2022) cited that every
emergency department should strictly follow protocols for investigating alarms. Monitoring usually includes measurement of vital
signs (temperature, blood pressure, pulse, and respiration rate), quantification of all fluid intake and output, and often intracranial
pressure and/or daily weight.
Overall, on the Emergency practices of Nurses in Responding to Critically Ill Patients along medication administration got an average
weighted mean of 4.87 or “Highly Practiced.” It showed that the nurses are skillful enough to handle medication administration because
that is part of their skills in the clinical setting. The complexity of the patient’s drug regimens and the environment provide a risk for
patient harm. Critically ill patients are also more likely to develop drug-induced events such as acute kidney injury and coagulopathies.
Some adverse drug reactions such as headaches, nausea, and confusion are only detectable through conversations with the patient
(Kluers Wolters 2017).
Emergency Practices in Responding to Critically Ill Patients Along Responding to Challenges
Table 6 presents the Emergency practices of nurses in Responding to Critically Ill Patients along responding to challenges It revealed
item 1 is the highest” assess patients quickly and administer rapid interventions to stabilize and treat patients’ critical condition” with
a weighted mean of 4.62, or “Highly Practiced.” It implies that nurses must act fast when adverse events arise. She must be quick in
assessing and managing emergency situations. Bennet et al., (2019) mentioned that nurses have an important role to play in
implementing an effective ‘Chain of Response’ that includes accurate recording and documentation of vital signs, recognition and
interpretation of abnormal values, patient assessment and appropriate intervention. Early warning systems are an important part and
can help identify patients at risk of deterioration and serious adverse events.
Table 6. Emergency Practices in Responding to Critically Ill Patients along Responding to Challenges
Indicators WM DE
assess patients quickly and administer rapid interventions to stabilize and treat patients’ critical condition 4.62 HP
implement protocols that put the safety and well-being of their staff and patients at the forefront 4.48 P
Support the patient and their families 4.48 P
Consider alternative explanations for the patient's behavior 4.48 P
Allow the patient or watcher reasonable, uninterrupted time to vent the concern 4.60 HP
explain to them that the behavior is because of an illness 4.48 P
build rapport, employing de-escalation techniques, understanding triggers, and utilizing a person-centered approach 4.57 HP
Let them express their feelings of anger and/or hurt usually accompany conflict situations. 4.52 HP
Maintain composure to think clearly and avoid rush decisions under pressure. 4.42 P

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Allow them the opportunity to give a clear picture of what they are trying to say 4.60 HP
Average Weighted Mean 4.53 HP
Legend: 4.50 – 5.00: Highly Practiced (HP); 3.50 – 4.49: Practiced (P); 2.50 – 3.49: Moderately Practiced (MP); 1.50 – 2.49: Slightly Practiced (SP); 1.00 – 1.49: Not Practiced (NP)

The lowest item is number 9 “Maintain composure to think clearly and avoid rush decisions under pressure”, with a weighted mean of
4.42, or “Practiced.” It showed that the nurses observe calmness and just perform what is needed by their patients.
Overall, on the Emergency practices in Responding to Critically Ill Patients along responding to challenges an average weighted mean
of 4.53 or “Highly Practiced.” It showed that the nurses maintain their composure despite the challenges in their workload.
Summary on the Emergency Practices Room Nurses in Responding to Critically Ill Patients
Table 7 presents the summary on the Emergency practices in Responding to Critically Ill Patients. It revealed that all items were rated
Highly Practiced but the highest is on medication management, with a weighted mean of 4.87, or “Highly Practiced,” followed by
Monitoring Life Support Equipment, Administer Emergency Care, and patient evaluation. It revealed the importance of medication
management to critically ill patients. As mentioned by Barreto and Dezierba (2024) mentioned that medication administration to
critically ill patients primarily involves using the intravenous route due to the potential for erratic absorption through other routes, and
requires careful consideration of drug selection, dosage adjustments based on rapidly changing physiological states, and close
monitoring to minimize adverse effects, all while prioritizing the "five rights" of medication administration to ensure safety; where
patients are closely monitored.
The lowest aspect is along responding to challenges with a weighted mean of 4.53, or “Highly Practiced.” It showed that the nurses are
prepared to any eventuality in responding critically ill patients. Aside from medication management nurses must detect early signs of
deterioration and guide appropriate medical interventions to maintain vital organ function and optimize patient outcomes (Romare,
2022).
Table 7. Summary on the Emergency Practices in
Responding to Critically Ill Patients
Aspect WM DE
Monitoring Life Support Equipment 4.85 HP
Administer Emergency Care 4.82 HP
Patient Evaluation 4.83 HP
Medication Management 4.87 HP
Responding to Challenges 4.53 HP
Overall Weighted Mean 4.78 HP
Legend: 4.50 – 5.00: Highly Practiced (HP); 3.50 – 4.49: Practiced (P); 2.50 – 3.49: Moderately
Practiced (MP); 1.50 – 2.49: Slightly Practiced (SP); 1.00 – 1.49: Not Practiced (NP)

Overall, on the Emergency practices in Responding to Critically Ill Patients along responding to challenges an average weighted mean
of 4.53 or “Highly Practiced.” It showed that the nurses have the capability to handle situations requiring critical care. According to
the Critical Care Nurses Association of the Phil., (2024), critical care nursing is the specialty within nursing that deals specifically with
human responses to life-threatening problems. These problems deal dynamically with human responses to actual or potential life-
threatening illnesses. In this aspect, nurses are ready to face these challenges in the care of critical patients.
ANOVA Results on the Difference in the Emergency Practices of Nurses in Responding to Critically Ill Patients across Age
Table 8. ANOVA Results on the Difference in the Emergency Practices in Responding to Critically Ill Patients across Age
Aspect Source of Variation Sum of Squares df Mean Squares F-value Sig Remarks
Monitoring Life Between Groups .426 3 .142 1.597 .200
Not Significant
Support Within Groups 4.983 56 .089
Equipment Total 5.410 59
Administer Between Groups .644 3 .215 2.063 .115
Not Significant
Emergency Within Groups 5.826 56 .104
Care Total 6.470 59
Patient Between Groups .433 3 .144 1.230 .307
Not Significant
Evaluation Within Groups 6.579 56 .117
Total 7.013 59
Medication Between Groups .283 3 .094 .935 .430
Not Significant
Management Within Groups 5.643 56 .101
Total 5.926 59
Responding to Between Groups 1.109 3 .370 1.694 .179
Not Significant
Challenges Within Groups 12.223 56 .218
Total 13.333 59
Overall Between Groups .369 3 .123
1.399 .253 Not Significant
Within Groups 4.929 56 .088
Total 5.298 59

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Table 8 presents the difference in the emergency practices room nurses in responding to critically ill patients across age.
The computed F-values have corresponding significance values which are higher than the set .05 level of significance. This implies
insignificant results, therefore, emergency room nurses, regardless of their age, share the same practices in responding to critically ill
patients. This revealed the fact that emergency room nurses regardless of age can perform the related nursing care to critical patients.
According to the Critical Care Nurses Association of the Phil., (2024) The critical care nursing practice is based on a scientific body
of knowledge and incorporates the professional competencies specific to critical care nursing practice and is focused on restorative,
curative, rehabilitative, maintainable, or palliative care, based on identified patient’s need.
t-Test Results on the Difference in the Emergency Practices in Responding to Critically Ill Patients across Sex
Table 9 shows the difference in the emergency practices of nurses in responding to critically ill patients across sex.
Table 9. t-Test Results on the Difference in the Emergency Practices in Responding to Critically Ill Patients across Sex
Standard Error
Aspect Sex n Mean Mean Difference df t-value Sig Remarks
Difference
Monitoring Life Male 31 4.84
Support Female 29 4.86 -.013 .079 58 -.168 .867 Not Significant
Equipment
Administer Male 31 4.76
-.111 .085 58 -1.309 .196 Not Significant
Emergency Care Female 29 4.88
Patient Evaluation Male 31 4.77
-.112 .089 58 -1.261 .212 Not Significant
Female 29 4.88
Medication Male 31 4.83
-.091 .082 58 -1.119 .268 Not Significant
Management Female 29 4.92
Responding to Male 31 4.34
-.392 .113 58 -3.481 .001 Significant
Challenges Female 29 4.73
Overall Male 31 4.71
-.144 .076 58 -1.901 .062 Not Significant
Female 29 4.85
No significant difference exists along monitoring life support equipment, administer emergency care, patient evaluation and medication
management. This is indicated in the computed t-value and significance values.
On the other hand, a significant negative mean difference exists along responding to challenges. This indicate that female nurse’s
better response to challenges concerning critically ill patients than their male counterparts. This finding may be is related to the fact
that female nurses are more compassionate in giving care where that same findings were noted in the study of Tong et al., (2023) where
female nurses rated higher on caring than male nurses.
ANOVA Results on the Difference in the Emergency Practices in Responding to Critically Ill Patients across Civil Status
Table 10 shows the difference in the emergency practices in responding to critically ill patients across civil status.
Table 10. ANOVA Results on the Difference in the Emergency Practices in Responding to Critically Ill Patients across Civil
Status
Aspect Source of Variation Sum of Squares df Mean Squares F-value Sig Remarks
Monitoring Life Between Groups .481 3 .160 1.821 .154
Not Significant
Support Equipment Within Groups 4.929 56 .088
Total 5.410 59
Administer Between Groups .650 3 .217 2.084 .113
Not Significant
Emergency Care Within Groups 5.820 56 .104
Total 6.470 59
Patient Evaluation Between Groups .876 3 .292 2.666 .056
Not Significant
Within Groups 6.136 56 .110
Total 7.013 59
Medication Between Groups .427 3 .142 1.448 .239
Not Significant
Management Within Groups 5.499 56 .098
Total 5.926 59
Responding to Between Groups 2.387 3 .796 4.071 .011
Significant
Challenges Within Groups 10.946 56 .195
Total 13.333 59
Overall Between Groups .822 3 .274 3.426 .023
Significant
Within Groups 4.476 56 .080
Total 5.298 59
The computed F-values with significance values higher than the set .05 level of significance suggest that there exist no significant
differences along monitoring life support equipment, administer emergency care, patient evaluation and medication management.
However, significant difference exists along responding to challenges. It connotes that nurses respond differently to the challenges in
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critical nursing. This have similarity in the study of Aktar (2023) that majority of the nurses were having favorable attitude toward
caring the critically ill patients, and there was no significant association of the attitude. Majority of critical care nurses have favorable
attitude. If they have supportive environment at workplace, their willingness to work toward quality care.
ANOVA Results on the Difference in the Emergency Practices in Responding to Critically Ill Patients across Highest
Educational Attainment
Table 11 displays the difference in the emergency practices of ER nurses in responding to critically ill patients across highest
educational attainment.
Table 11. ANOVA Results on the Difference in the Emergency Practices in Responding to Critically Ill Patients across Highest
Educational Attainment
Aspect Source of Variation Sum of Squares df Mean Squares F-value Sig Remarks
Monitoring Life Between Groups .065 2 .033 .348 .708
Not Significant
Support Within Groups 5.345 57 .094
Equipment Total 5.410 59
Administer Between Groups .015 2 .007 .065 .937
Not Significant
Emergency Care Within Groups 6.455 57 .113
Total 6.470 59
Patient Between Groups .030 2 .015 .123 .885
Not Significant
Evaluation Within Groups 6.982 57 .122
Total 7.013 59
Medication Between Groups .007 2 .003 .033 .968
Not Significant
Management Within Groups 5.919 57 .104
Total 5.926 59
Responding to Between Groups .139 2 .070 .300 .742
Not Significant
Challenges Within Groups 13.193 57 .231
Total 13.333 59
Overall Between Groups .010 2 .005 .051 .950
Not Significant
Within Groups 5.288 57 .093
Total 5.298 59
The computed F-values with significance values higher than the set .05 level of significance indicate no significant difference along
all aspects. This means that emergency room nurses, regardless of their highest educational attainment, have the same practices in
responding to critically ill patients. It connotes that the ER nurses had the knowledge and the skills in handling to critically ill patients.
According to Orwelius (2024), higher educational attainment generally leads to improved care for critically ill patients as individuals
with greater education tend to have better health literacy, allowing them to understand complex medical information, actively
participate in decision-making, and better adhere to treatment plans, potentially resulting in improved outcomes for critically ill
patients; however, this can vary depending on the specific healthcare setting and patient population (Orwelius 2024).
ANOVA Results on the Difference in the Emergency Practices in Responding to Critically Ill Patients across Position
Table 12 presents the difference in the emergency practices of ER nurses in responding to critically ill patients across position.
Table 12. ANOVA Results on the Difference in the Emergency Practices Nurses in Responding to Critically Ill Patients across
Position
Aspect Source of Variation Sum of Squares df Mean Squares F-value Sig Remarks
Monitoring Life Between Groups .243 3 .081 .879 .458
Not Significant
Support Within Groups 5.167 56 .092
Equipment Total 5.410 59
Administer Between Groups .342 3 .114 1.043 .381
Not Significant
Emergency Within Groups 6.128 56 .109
Care Total 6.470 59
Patient Between Groups .231 3 .077 .636 .595
Not Significant
Evaluation Within Groups 6.782 56 .121
Total 7.013 59
Medication Between Groups .064 3 .021 .205 .892
Not Significant
Management Within Groups 5.862 56 .105
Total 5.926 59
Responding to Between Groups 1.271 3 .424 1.967 .129
Not Significant
Challenges Within Groups 12.061 56 .215
Total 13.333 59
Overall Between Groups .292 3 .097 1.088 .362
Not Significant
Within Groups 5.006 56 .089
Total 5.298 59

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The results indicate no significant differences. This means that the position that the ER nurses hold in the health facility does not affect
their practices in responding to critically ill patients. It revealed that the ER nurses regardless of their positions share the same
competencies in handling critically ill patients. According to Doering 2023), a nurse's position within a healthcare hierarchy can
significantly impact the care of critically ill patients, with factors like experience level, decision-making authority, and workload
influencing the quality of care provided, potentially leading to variations in patient outcomes depending on who is primarily responsible
for the patient's care.
ANOVA Results on the Difference in the Emergency Practices in Responding to Critically Ill Patients across Number of Years
in Service in the ER
Table 13 presents the emergency practices of ER nurses in responding to critically ill patients across number of years in service
Table 13. ANOVA Results on the Difference in the Emergency Practices in Responding to Critically Ill Patients across Number
of Years in Service in the ER
Aspect Source of Variation Sum of Squares df Mean Squares F-value Sig Remarks
Monitoring Life Between Groups .649 2 .325 3.887 .026
Significant
Support Within Groups 4.761 57 .084
Equipment Total 5.410 59
Administer Between Groups .644 2 .322 3.149 .050
Not Significant
Emergency Within Groups 5.826 57 .102
Care Total 6.470 59
Patient Between Groups .511 2 .256 2.240 .116
Not Significant
Evaluation Within Groups 6.501 57 .114
Total 7.013 59
Medication Between Groups .518 2 .259 2.731 .074
Not Significant
Management Within Groups 5.408 57 .095
Total 5.926 59
Responding to Between Groups .313 2 .156 .684 .509
Not Significant
Challenges Within Groups 13.020 57 .228
Total 13.333 59
Overall Between Groups .422 2 .211 2.467 .094
Not Significant
Within Groups 4.876 57 .086
Total 5.298 59
No significant difference exists along administer emergency care, patient evaluation, medication management and responding to
challenges. However, significant difference exists along monitoring life support equipment. It connotes that the practices of the ER
nurses differ with one another depending on the needs of the patients. In the study of Kuyler, (2023) suggests that a higher number of
years in service among nurses can generally lead to improved care for critically ill patients, as experienced nurses often possess greater
clinical expertise, decision-making skills, and a deeper understanding of complex patient situations, which can result in better patient
outcomes and more efficient care delivery in critical care settings; however, factors like workload, burnout, and ongoing training also
play a significant role.
ANOVA Results on the Difference in the Emergency Practices in Responding to Critically Ill Patients across Number of
Relevant Training in Critical Nursing
Table 14 shows the difference in the emergency practices of ER nurses in responding to critically ill patients across number of relevant
trainings in critical nursing.
The computed F-values and significance values indicate no significant difference along monitoring life support equipment, administer
emergency care and patient evaluation. On the other hand, significant differences exist along medication management and responding
to challenges. The findings are confirmed by Karikari et al., (2023) that nurses attending to patients with potentially life-threatening
conditions are required to possess capabilities in emergency care Updating knowledge to enhance the confidence of nurses through
training can be an important tool in the delivery, timely assessment and resuscitation of trauma patients.
Table 14. ANOVA Results on the Difference in the Emergency Practices in Responding to Critically Ill Patients across Number
of Relevant Training in Critical Nursing
Aspect Source of Variation Sum of Squares Df Mean Squares F-value Sig Remarks
Monitoring Between Groups .272 2 .136 1.512 .229
Not Significant
Life Support Within Groups 5.137 57 .090
Equipment Total 5.410 59
Administer Between Groups .294 2 .147 1.355 .266
Not Significant
Emergency Within Groups 6.176 57 .108
Care Total 6.470 59
Patient Between Groups .532 2 .266 2.341 .105
Not Significant
Evaluation Within Groups 6.480 57 .114
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Total 7.013 59
Medication Between Groups .670 2 .335 3.634 .033
Significant
Management Within Groups 5.256 57 .092
Total 5.926 59
Responding Between Groups 1.787 2 .894 4.412 .017
Significant
to Challenges Within Groups 11.545 57 .203
Total 13.333 59
Overall Between Groups .588 2 .294 3.560 .035
Significant
Within Groups 4.710 57 .083
Total 5.298 59
t-Test Results on the Difference in the Emergency Practices in Responding to Critically Ill Patients across Category of Health
Facility
Table 15 presents the difference in the emergency practices of ER nurses in responding to critically il patients across category of health
facility.
No significant difference exists along monitoring life support equipment, administer emergency care, patient evaluation and responding
to challenges. Significant positive difference exist along medication management. This indicates that private ER nurses claim to
provide better medication management practices to critically ill patients than ER nurses from public health facilities. It reflects that this
is their perception however, both group of nurses are responsible in giving of medications. Nurses in the private handle lesser number
of patients compared to those in the public health care due to numerous numbers of patient.
Table 15. t-Test Results on the Difference in the Emergency Practices in Responding to Critically Ill Patients across Category
of Health Facility
Mean Standard Error
Aspect Category n Mean df t-value Sig Remarks
Difference Difference
Monitoring Life Private 21 4.94
.145 .080 58 1.808 .076 Not Significant
Support Equipment Public 39 4.80
Administer Private 21 4.90
.118 .089 58 1.329 .189 Not Significant
Emergency Care Public 39 4.78
Patient Evaluation Private 21 4.91
.137 .092 58 1.487 .142 Not Significant
Public 39 4.78
Medication Private 21 5.00
.193 .083 58 2.329 .023 Significant
Management Public 39 4.80
Responding to Private 21 4.54
.020 .130 58 .155 .877 Not Significant
Challenges Public 39 4.52
Overall Private 21 4.86
.123 .080 58 1.531 .131 Not Significant
Public 39 4.73
Flaubert (2021) mentioned that when comparing the care provided by nurses in public and private hospitals for critically ill patients,
private hospitals generally have more resources and advanced technology available, which can lead to a higher level of specialized care
for critically ill patients compared to public hospitals; however, the quality of nursing care itself can vary significantly depending on
individual nurse competency, hospital policies, and overall staffing levels in both sectors.
Conclusion
Based on the findings of the study, the following conclusions are drawn:
Most nurses fall within the age range of 31 to 40, indicating a dynamic group in their professional prime. This age group is typically
capable of managing the physical and emotional demands of emergency room (ER) work. Their alignment with young adulthood
suggests a high level of energy and adaptability, making them well-suited to fast-paced environments like the ER.
The gender distribution among nurses is nearly balanced, with a slightly higher proportion of males. This could be attributed to the
physical nature of certain emergency response tasks. However, ER nursing is not gender-specific and instead demands a combination
of strength, skill, and critical thinking—attributes that are present across both sexes.
Respondents were almost evenly split between single and married individuals, which indicates a workforce with diverse personal
commitments. Civil status may impact on their availability for overtime and emergency duties, particularly in high-pressure ER settings
where flexibility and responsiveness are crucial.
Most nurses reported holding only a bachelor's degree, with relatively few pursuing graduate studies. This may be due to time
constraints, financial limitations, or a lack of incentives. Although a bachelor’s degree provides a solid foundation for ER practice,
further education could enhance clinical expertise and decision-making capabilities.
A majority of the respondents are staff nurses, highlighting their essential role in the direct delivery of patient care in the ER. These

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nurses are at the core of ER operations, and their performance and training significantly influence the quality of emergency services.
Most respondents have 3 to 4 years of ER experience, suggesting that the workforce is relatively young and still in the process of
gaining full professional maturity. The level of experience affects efficiency, confidence, and decision-making during critical situations,
underscoring the need for ongoing skills development.
A significant number of respondents participated in five or more training sessions, which demonstrates a strong commitment to
professional development. Regular training helps improve competency, speeds up response times, and supports better outcomes in
handling critically ill patients.
Lastly, more respondents were from public hospitals, which may indicate a higher patient load or staff-to-patient ratio in these settings
compared to private institutions. Public hospitals often carry a heavier burden in emergency care, requiring more robust support systems
and preparedness measures.
Based on the conclusions above, the following recommendations are proposed to enhance the performance and well-being of
emergency nurses:
Provide continuous professional development and leadership training tailored to nurses in their 30s and 40s to maximize their potential
and prepare them for future supervisory positions. A focus on cultivating leadership within this age group can ensure a strong pipeline
of experienced ER leaders.
Foster a supportive environment for all genders by investing in ergonomic tools and patient-handling equipment. This can reduce
physical strain and promote inclusivity by ensuring that all tasks are accessible regardless of gender.
Implement flexible scheduling systems and offer stress management programs to accommodate both single and married nurses. These
initiatives will help promote work-life balance and improve staff retention in high-pressure environments.
Offer incentives such as tuition assistance, career development programs, and continuing education units (CEUs) to encourage the
pursuit of higher education. Advanced studies, particularly in emergency and critical care, can enhance nurses' competencies and
leadership potential.
Expand skills development initiatives for staff nurses and introduce structured mentorship programs. These can prepare nurses for more
advanced roles such as triage leadership, charge nurse positions, or supervisory functions, thereby strengthening the ER team structure.
Establish mentoring systems where experienced nurses provide guidance to their less-experienced peers. Additionally, incorporate
scenario-based training to build confidence and competence in managing complex ER cases.
Maintain mandatory and regularly scheduled training programs that focus on updated clinical protocols, trauma response techniques,
and advanced life support. This ensures consistent skill enhancement and readiness for emergency situations.
Finally, ensure equitable access to training, resources, and support systems in both public and private healthcare facilities. Standardizing
these elements across institutions will help guarantee a consistent quality of care for all ER patients, regardless of where they seek
treatment.
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Affiliations and Corresponding Information

Manuel P. Fajardo
Urdaneta City University - Philippines
Priscilla R. Baun
Urdaneta City University - Philippines

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