Left behind: Exploring the concerns of emergency department staff when personnel are utilised for inter-hospital transfer.

BACKGROUND: Inter-Hospital Transfer (IHT) may require an escort from the referring hospital, either a Registered Nurse (RN), physician or both, leading to a sudden drop in staffing levels within the referring department potentially increasing risk to patients and staff.

AIMS: To explore the perspectives of RNs and physicians of differing experience levels when left behind due to an escorted IHT, and the decision-making protocols for IHT.

METHOD: A qualitative exploratory approach of 5 RNs and 4 physicians selected using purposeful sampling. Data were collected through semi-structured interviews and thematically analysed.

FINDINGS: Five themes were identified: the impact of being left behind; the burden of transfer; missed care; a triangulation of competing needs upon the decision-making process; and the effect of inter-hospital transfers on staff with different experience levels.

CONCLUSION: IHT is described differently by less experienced RNs compared to their more experienced counterparts especially concerning safety and risk. Physicians described the department as vulnerable with ad-hoc decision-making protocols surrounding IHT the norm.