ETD

• documentation burden and burnout
• emergency department
• nursing documentation
• nursing responsibility in triage
• performance management nursing
• tuscan triage system

The Emergency Department (ED) is one of the most complex and challenging environments within modern healthcare systems, requiring healthcare professionals to combine advanced clinical expertise, rapid decision-making, and adaptability to high-pressure situations. Demographic changes and the growing prevalence of chronic conditions have intensified issues such as overcrowding, variability in care pathways, and heavy workloads. These dynamics particularly affect nursing staff, who are directly involved in ensuring timely and safe patient care.

Within this context, the triage nurse plays a pivotal role as both the initial point of patient contact and the coordinator of care priorities. This position demands the integration of clinical knowledge, critical thinking, and the capacity to manage uncertainty in settings characterized by multitasking and frequent interruptions. Alongside clinical tasks, nursing documentation remains essential for patient safety, traceability, and continuity of care. However, it also introduces a significant bureaucratic burden, which, despite the benefits of digitalization in terms of efficiency and interoperability, often reduces the time available for direct patient interaction and contributes to professional stress.

This thesis critically examines the relationship between clinical complexity and bureaucratic obligations in the Emergency Department, with a particular focus on triage nurses. The study explores the impact of bureaucratic practices on nurses’ workload and well-being, identifies the procedures perceived as most demanding, analyzes time allocation across different shifts, and investigates the emotions associated with these tasks. The findings aim to foster reflection on strategies to balance clinical and bureaucratic dimensions, safeguarding both quality of care and the sustainability of nursing practice.