Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Joan Cranford

Second Advisor

Ptlene Minick Pender

Third Advisor

Meredith Greif


People with mental health conditions (PWMHC) represent the fastest-growing population in emergency departments across the United States. Generally, PWMHC experience extended lengths of stay and poorer outcomes when compared to patients with medical problems. The purpose of this study was to examine emergency nurses’ intentions to care for PWMHC. A descriptive correlational design was used to recruit emergency nurses in a health care system in the Southeast United States and from the Emergency Nurses Association. Responses from 104 emergency nurses were used to test two hypotheses and answer one research question. Nurses who had personal contact with PWMHC and more work experience were more likely to express a positive attitude of PWMHC. Nurses with more experience, higher positive attitudes, and more confidence to care for PWMHC were more likely to report positive intentions to care for PWMHC. Nurses with higher subjective norm scores had more negative intentions to care for PWMHC. Managers had significantly lower subjective norms scores than did staff nurses. Nurses, in responses to open-ended questions, felt that support, adequate staffing and resources, time to assess patients, designated areas, and a low stimulating environment were important factors that facilitate caring for PWMHC. Emergency nurses reported that they learned to care for PWMHC from experienced staff. The nurses also indicated that having mentors who were passionate and expressed positive attitudes toward PWMHC promoted learning. Nurses noted a lack of training in emergency psych situations and on-the-job training was not enough to be able to notice early warning signs needed to act quickly and effectively to care for PWMHC. According to the theory of planned behavior, the more favorable the attitude, subjective norms, and perceived behavioral control, the greater the intent to perform a behavior. Findings from the study suggest that nurses with more positive attitudes, more favorable subjective norms, and higher care competency scores have higher manifestations of early recognition skills caring for PWMHC. Future research is needed to identify the care PWMHC actually receive. In addition, future research should focus on testing education and training interventions designed to enhance nurses’ attitudes and competence in caring for PWMHC.


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