J Emerg Nurs. 2026 Sep 9:S0099-1767(26)00281-3. doi: 10.1016/j.jen.2026.07.021. Online ahead of print.
ABSTRACT
INTRODUCTION: Hospitals across the United States experience critical nursing shortages and high turnover across all nursing roles. High nurse vacancy rates present ongoing challenges for emergency departments and may negatively affect patient care. Detrimental effects include overcrowding, longer waiting times, and delayed or missed nursing care. Amid a national nursing crisis, little is known regarding the staffing strategies employed by pediatric emergency departments. The purpose of this study was to provide a foundational description of the current staffing models and unit characteristics of pediatric emergency departments in the United States.
METHODS: Nurse leaders were invited to participate in a 2-phase study using a descriptive qualitative inquiry and a cross-sectional survey methodology. Phase 1 included private, semistructured interviews via Zoom. The themes discovered during Phase 1 informed the development of Phase 2, an electronic survey distributed via email. Descriptive statistics and content analyses were used to summarize the results.
RESULTS: Nurse leaders from 4 pediatric emergency departments participated in Phase 1 interviews. Three recurring themes regarding staffing challenges emerged: staffing nonemergency nurses to fill vacancies, retaining experienced nurses, and boarding patients that impeded patient flow. Nurse leaders from 9 pediatric emergency departments completed the Phase 2 electronic survey, describing their nursing and unit characteristics and available resources. Results indicated that most hospitals determined staffing decisions using census predictions and highlighted variability in nursing and unit characteristics across institutions.
DISCUSSION: A foundational description of the nursing and unit characteristics of pediatric emergency departments demonstrates variation among institutions. Consensus regarding staffing models, resource standardization, and recruitment and retention strategies for experienced nurses requires continued investigation.
PMID:42714356 | DOI:10.1016/j.jen.2026.07.021
