1.1 Introduction
Emergency nursing refers to the provision of immediate nursing care to patients who present with sudden illness, injury, or other conditions requiring urgent attention. Critical care, on the other hand, involves continuous and intensive treatment for patients with life-threatening conditions who require close monitoring and specialized support. The World Health Organization describes emergency care as time-sensitive healthcare aimed at the early recognition, treatment, and management of acute illness and injury, while critical care provides ongoing intensive treatment and monitoring for seriously ill patients (WHO, 2025).
Emergency nursing leadership is the ability of nurses to guide clinical activities, make appropriate decisions, coordinate patient care, delegate responsibilities, and support other members of the healthcare team during urgent situations. In emergency and critical care environments, nurses often work under pressure and must respond quickly while maintaining patient safety. As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the aim and objectives of the study. Others are significance of the study, scope of work, research hypothesis and questions, limitation of the study and definition of terms.
1.2 Background of Study
Historically, emergency nursing is closely linked to the development of organized emergency care and the growth of modern nursing. Early emergency nursing focused mainly on providing immediate care to people injured during wars, accidents, and disasters. Florence Nightingale's work during the Crimean War helped establish the importance of organized nursing, hygiene, observation, and teamwork in caring for injured patients. According to the World Health Organization, effective leadership is essential during emergencies because healthcare teams need clear direction, coordination, communication, and appropriate decision-making to respond effectively (WHO, 2021). In the same vein, Wong and Cummings (2007) reported that nursing leadership is associated with important patient outcomes, including patient satisfaction and the reduction of adverse events.
Penoyer (2010) reported that critically ill patients require increased nursing resources and specialized knowledge because their conditions may change rapidly. Similarly, leadership in such settings helps nurses organize available resources, delegate duties, supervise activities, and respond appropriately when a patient's condition deteriorates. A nurse who provides effective leadership is expected to remain calm, communicate instructions clearly, recognize emerging problems, and encourage other members of the team to work toward a common goal.
Hult et al. (2023) stated that relational forms of nursing leadership are linked with positive staff and organizational outcomes, particularly job satisfaction and better working relationships. According to Grover, Porter, and Morphet (2017), teamwork in emergency departments is important for improving efficiency and safety, with emergency nurses playing a central role in this process. Likewise, communication is a major part of effective teamwork because healthcare workers need accurate information about the patient's condition, treatment, response to intervention, and changes that require immediate attention.
Poor communication and weak teamwork may create difficulties in emergency care. When information is delayed, misunderstood, or not properly communicated, healthcare workers may fail to respond quickly to changes in a patient's condition. According to Manser (2009), teamwork and communication are important components of patient safety in high-risk healthcare environments because healthcare professionals must coordinate their actions under pressure. Supporting this position, Alsabri et al. (2022) found that teamwork and communication interventions in emergency departments have the potential to improve safety culture and patient safety.
Staffing and workload are also important issues affecting teamwork and leadership in critical care. Nurses working in emergency units may have to attend to multiple patients while responding to urgent requests from doctors, relatives, laboratory personnel, and other departments. Along the same line, Griffiths et al. (2021) reported that lower nurse staffing levels in adult critical care are associated with poorer patient and organizational outcomes, including increased risks of patient mortality and infection.
This study is set against the backdrop of the need to strengthen emergency nursing leadership and teamwork in critical care settings, particularly at Federal Medical Centre, Jalingo, Taraba State, where effective coordination among nurses and other healthcare professionals is essential for timely, safe, and patient-centred emergency care.
1.3 Statement of Problems
Investigation revealed that nurses in emergency and critical care units need good leadership and teamwork to provide quick and effective care to patients with serious health conditions. However, heavy workloads, inadequate staffing, poor communication, and limited resources may make it difficult for nurses to work effectively as a team (Cummings et al., 2018). On the other hand, poor leadership may affect proper delegation of duties, decision-making, and coordination during emergencies.
Additionally, effective teamwork requires nurses to communicate clearly, support one another, and understand their responsibilities. When teamwork is poor, delays, mistakes, and problems with patient safety may occur (Rosen et al., 2018).
Furthermore, work-related stress may reduce nurses' ability to communicate and cooperate effectively while caring for critically ill patients (Sani et al., 2024). It is against this backdrop that this study seeks to examine emergency nursing leadership and teamwork in critical care settings at Federal Medical Centre, Jalingo, Taraba State.
1.4 Aim and Objectives of Study
The aim of this study is to assess emergency nursing leadership and teamwork in critical care settings at Federal Medical Centre, Jalingo, Taraba State.
The specific objectives of this study are to:
- Assess the leadership practices among emergency nurses at Federal Medical Centre, Jalingo;
- Determine the level of teamwork and communication among nurses in critical care settings;
- Identify factors affecting effective nursing leadership and teamwork in emergency care;
- Examine the challenges faced by nurses in coordinating emergency and critical care activities; and
- Determine measures for improving nursing leadership and teamwork in critical care settings.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The following research questions will guide the study:
- What are the leadership practices among emergency nurses at Federal Medical Centre, Jalingo?
- What is the level of teamwork and communication among nurses in critical care settings?
- What factors affect effective nursing leadership and teamwork in emergency care?
- What challenges do nurses face in coordinating emergency and critical care activities?
- What measures may improve nursing leadership and teamwork in critical care settings?
1.6 Research Hypotheses
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There is no significant relationship between nursing leadership practices and effective emergency care at Federal Medical Centre, Jalingo.
- H1: There is a significant relationship between nursing leadership practices and effective emergency care at Federal Medical Centre, Jalingo.
Hypothesis Two
- H0: There is no significant relationship between teamwork and communication among nurses in critical care settings.
- H1: There is a significant relationship between teamwork and communication among nurses in critical care settings.
Hypothesis Three
- H0: There is no significant relationship between the identified workplace factors and effective nursing leadership and teamwork in emergency care.
- H1: There is a significant relationship between the identified workplace factors and effective nursing leadership and teamwork in emergency care.
Hypothesis Four
- H0: There is no significant relationship between the challenges faced by nurses and effective coordination of emergency and critical care activities.
- H1: There is a significant relationship between the challenges faced by nurses and effective coordination of emergency and critical care activities.
Hypothesis Five
- H0: There is no significant relationship between identified improvement measures and effective nursing leadership and teamwork in critical care settings.
- H1: There is a significant relationship between identified improvement measures and effective nursing leadership and teamwork in critical care settings.
1.7 Significance of Study
The outcome of this research will provide factual information on the state of emergency nursing leadership and teamwork at Federal Medical Centre, Jalingo. The study will also help nursing managers identify specific problems affecting communication, supervision, delegation, and cooperation among emergency nurses.
Furthermore, the findings will provide nurses with information on areas that require improvement in leadership, communication, and teamwork during emergency patient care. It will also provide healthcare administrators with evidence about workplace factors that affect effective coordination of emergency and critical care services.
Lastly, the study will provide a useful academic reference for students and researchers studying nursing leadership, teamwork, emergency nursing, and critical care in Nigeria.
1.8 Scope of Study
The study focuses on emergency nursing leadership and teamwork in critical care settings at Federal Medical Centre, Jalingo, Taraba State, Nigeria. It covers nursing leadership practices, teamwork, communication, factors affecting teamwork, challenges faced by emergency nurses, and measures for improving leadership and teamwork.
The study is limited to nurses involved in emergency and critical care services within the selected healthcare facility.
1.9 Limitations of the Study
During the course of this study, there were some problems encountered which stood as limitations to the research work. Some of the limitations include:
- Delay from Respondents: Some respondents delayed completing and returning the questionnaires because of their clinical responsibilities and workload. This was particularly relevant in emergency and critical care areas where patient needs required immediate attention.
- Financial Constraint: Financial limitations affected transportation, printing, photocopying, communication, and other expenses associated with data collection and project preparation.
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
1.10 Definition of Terms
Emergency Nursing:
Emergency nursing refers to the specialized nursing care provided to patients who require immediate assessment and treatment because of sudden illness, injury, or other urgent health conditions.
Emergency Nurse:
An emergency nurse is a registered nurse who provides immediate assessment, treatment, monitoring, education, and support to patients presenting with emergency health conditions. The emergency nurse also works with other healthcare professionals to coordinate patient care.
Nursing Leadership:
Nursing leadership refers to the ability of a nurse to guide, coordinate, supervise, support, and influence other members of the nursing team toward effective patient care.
Teamwork:
Teamwork is the process through which two or more healthcare professionals cooperate, communicate, share responsibilities, and coordinate their activities to achieve a common patient-care goal.
Critical Care Setting:
A critical care setting is a hospital unit where seriously ill patients receive continuous monitoring and specialized treatment.
Critical Care:
Critical care refers to specialized healthcare provided to patients with serious or life-threatening conditions that require close monitoring, advanced treatment, and continuous professional attention.
Leadership Practice:
Leadership practice refers to the actual activities performed by a nursing leader, including delegation, supervision, decision-making, communication, staff support, conflict management, and coordination of patient care.
Communication:
Communication is the process of sharing relevant information between healthcare workers and patients in a clear and timely manner. Effective communication is important in emergency care because changes in a patient's condition often require immediate attention and coordinated action.
Nursing Teamwork:
Nursing teamwork refers to the cooperation of nurses in planning, providing, monitoring, and evaluating patient care. It involves mutual support, clear communication, shared responsibilities, and coordinated action.
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