Lived Experiences of Emergency Room Nurses in Patient Advocacy During Vehicular Accident Emergencies

Abstract

Introduction: Road traffic injuries remain a significant public health concern, particularly in low- and middle-income countries where emergency healthcare systems face high trauma caseloads. Emergency room nurses play a critical role in trauma care and patient advocacy, ensuring patient safety, timely intervention, and protection of patient rights during emergency situations. However, limited research exists on the lived experiences of emergency nurses in performing patient advocacy during vehicular accidents, particularly in the Philippine context. Aim: This study aimed to explore the experiences of emergency room nurses in patient advocacy during vehicular accidents in selected hospitals in Cabanatuan City, Nueva Ecija, Philippines. Methodology: This study utilized a descriptive qualitative design. Purposive sampling was used to recruit eight emergency room nurses with at least five years of clinical experience. Data were collected through face-to-face semi-structured interviews using a an expert-reviewed interview guide. Five experts validated the content and clarity of the questionnaire. Interviews were audio-recorded, transcribed verbatim, and analyzed using Thematic Analysis guided by Braun and Clarke’s framework. Ethical approval was obtained from the Institutional Review Board, and written informed consent was secured from all participants. Results: Four major themes emerged: (1) patient advocacy as protection of vulnerable trauma patients, (2) emotional and moral burden in managing vehicular accident cases, (3) system challenges affecting patient advocacy in emergency departments, and (4) advocacy as part of Filipino nurses’ professional and personal values. Findings showed that Filipino emergency nurses play a crucial role in advocating for trauma patients despite emotional stress, heavy workload, limited resources, and ethical challenges. Patient advocacy was strongly influenced by the Filipino value of malasakit. Conclusion: Emergency room nurses in the Philippine setting demonstrate strong commitment to patient advocacy despite clinical, emotional, and systemic challenges. Advocacy remains an essential component of emergency nursing practice and professional identity. These findings highlight the need for strengthened institutional support, structured patient advocacy protocols, and policy initiatives that protect and empower emergency nurses in delivering trauma-focused, patient-centered care. These findings have important implications for emergency nursing practice and health policy, highlighting the need for strengthened institutional support, structured patient advocacy protocols, adequate staffing and resource allocation, and mental health support programs that enable emergency nurses to effectively advocate for trauma patients in high-pressure clinical environments. Recommendations: Hospitals should strengthen emergency department resources, staffing, and mental health support for nurses. Nursing education should enhance training in trauma care and patient advocacy. Policymakers should support emergency healthcare system improvements and develop policies that strengthen patient advocacy practices in emergency settings.