I am delighted to be asked to write the Foreword for Management and
Practice in Emergency Nursing. More than any other nursing speciality
Accident and Emergency work reflects change in society because it is the
casualties of social upheaval, imbalance and inequality that you face
every day. Here, unfortunately, A and E staff are confronted on a
regular basis with child abuse, family violence, the result of terrorist
activities, social violence, motor car accidents, personal loss of loved
ones, the frustrations and aggression of life. Sometimes, though, some
pleasant and funny episodes do occur but all too infrequently to become
the norm. My own experience of A and E nursing is very limited; in fact,
it goes back to the days of the Department being linked with
Orthopaedics and being called 'Casualty' . It could, though, appear that
in this day and age the wheel is tuming full circle and moves have been
made in the last reorganization to link the two new distinct
specialities again. This proposal was met with lots of protest from A
and E staff which appears to have been defused. The arguments stemmed
mainly from the fact that orthopaedics and A and E are two quite
difficult specialities of care and skills and as such must be seen as
autonomous.