Enf.º José Borges 

Urgent Care Service

Enf.ª Catarina Pacheco

Urgent Care Service

Urgent Care Service:
Its challenges and how they affect nursing care management

HPA Magazine 24 // 2025

Working in an Urgent Care Service (UCS) has been recognized as a challenge in the health area since early on. It is considered one of the most important and stressful sectors of a hospital unit, where every second counts in providing the necessary and essential health care for the lives of users, with their safety being an integral part of the health systems. (Mohammadi et al., 2024; Power et al., 2022)

The stressful environment experienced by nurses in an UCS contributes to them, when dealing directly with situations of risk, illness, and suffering of users and their respective families, facing a variety of challenges. Among them, the neglect of standards and protocols, and basic safety precautions, stands out, thus constituting one of the main difficulties encountered by nurses and other professionals. (Mohammadi et al., 2024; Power et al., 2022)
It is in this sector that the Joint Commission International (JCI), as an accreditation body for health units, based on American quality standards and recognized internationally, finds that health professionals and HPA hospital units are guided by the highest standards of safety and quality in areas such as infection control, care, medical-surgical assistance, and also leadership and organizational management. (HPA Group, 2025)

The work environment of a UCS, although considered challenging, stimulating, and rewarding by those who work there, is also known as a place of intense work, high turnover of professionals, and burnout. (Power et al., 2022) Scientific evidence highlights physical exhaustion, inadequate working conditions, work overload, excessive user influx, and insufficient human and physical resources as challenges to an UCS, which can contribute to fatigue, burnout, and physical and psychological tension, and also lead nurses and other health professionals to feel that the quality of care and the safety of the user and their respective families are compromised. (Power et al., 2022; Rocha et al., 2021) The overload of tasks, the constant alternation of urgent patients, and the high demand for work in UCS often result in physical and emotional exhaustion of nurses.

Among the main factors that compromise the effective management of patient safety are the lack of efficient teamwork, overcrowding of the service, the shortage of experienced professionals, and deficiencies in communication skills. (Grover et al., 2017; Mohammadi et al., 2024; Power et al., 2022) It is from this perspective that professionals also consider it challenging to monitor the needs and individual risk of each user and family in the occurrence of adverse effects, and consequently, in what is their hospital experience, thus contributing negatively to the psychosocial perception of nurses in their care practice. (Power et al., 2022; Rocha et al., 2021) Effective nursing performance in an UCS is strongly associated with the presence of cohesive teamwork, structured support networks, and opportunities for formal and informal reflective analysis - debriefing. These elements are crucial to mitigating the challenging and potentially traumatic aspects of clinical practice in this context.
Identifying and valuing the factors that promote nurses' professional satisfaction contributes to the retention of the class, as well as to organizational well-being. (Mohammadi et al., 2024; Power et al., 2022) The work environment, competent leadership, and effective communication between nurses and other health professionals emerge as central determinants for the quality of care and the safety of users and their families.
Effective leadership, characterized by experience, prioritization skills, coordination, and assertive communication, strengthens team resilience and increases the confidence of professionals and users in the services provided. (Grover et al., 2017; Mohammadi et al., 2024; Power et al., 2022) The attractiveness of UCS for nurses is associated with the possibility of collaborative work, the clinical diversity of patients, and the continuous opportunities for professional development and skill acquisition. Thus, institutional strategies that prioritize the well-being of professionals and the consolidation of resilient teams should be considered essential in the management of human resources in health. (Power et al., 2022)