Reception and orientation nurse (IAO) in the Casamance emergency department

Amélie, Céline, Clément and Ramlata talk to us about the job of reception and guidance nurse.

What does the IAO job involve?

When a patient comes to A&E, they meet directly with the RN and the medical secretary. While the secretary takes care of the administrative registration and the creation of the medical file, the CAO conducts the intake interview with the patient. During this interview, we gather information about the patient's symptoms, life situation and emotional state, so that we can pinpoint the reason for the consultation - which helps us to make the diagnosis! We then prioritise treatment and organise care according to the degree of urgency, a process known as "triage". If the patient presents a risk of rapid complication or is in intense pain, they are placed in a cubicle and the emergency doctor is immediately notified. We also have to optimise the availability of cubicles to anticipate the arrival of serious patients, and work with other departments to validate the availability of hospital beds. That's exactly what the IAO's job is: " Prioritising, anticipating and organising care ".

How do I become an IAO?

First of all, you need to be an experienced nurse with a desire to work in emergency, which is a very special department. Then you need to specialise and take an RN course.

What do you like about your job?

We have to draw on all our knowledge, both of technical care and of the organisation of the emergency department and the running of the whole hospital (specialist consultations, radiology, laboratory, etc.). The CAE is at the centre of emergency care, which means we get to work with lots of different professions (firefighters, paramedics, nurses, doctors, etc.). It's stimulating!

Do you encounter any difficulties?

Yes, because we're on the front line of everything! We have to deal with the aggressiveness of stressed-out patients and their anxious families. Sometimes we have to wait several hours to get test results and give the family news. Some people get impatient and force their way into the ward to get into the cubicles... We have to calm down conflicts, both with the patient's family and with the various professions that are waiting and even the nurses on the inpatient wards. Some of us have benefited from training in "Supporting and preventing the risks associated with managing the stress and aggression of patients and their families", which helps us to find the right words to calm the situation down. The hospital has also introduced a lean management approach called "Better living in emergencies", which has improved communication between departments.

Will you still be doing this job in 10 years' time?

For Clément: " It's interesting because it's the opposite of what we learn at school! They teach you how to plan your day, but in emergency you can't, because everything depends on when patients arrive. It's the only department where you work with the other nurses, and this strong interdependence is rewarding. I'd like to be able to spend more time with patients, because the first contact can influence the whole course of treatment, but the workload is intense and we sometimes run out of time. Emergency is a service that generates a lot of emotions for the carer. There are days when we're in the thick of things and everything's going well, so I go home happy with my day, and other days when we're confronted with aggression, so I leave feeling down! In 10 years' time, I can't see myself in A&E, I'd like to be in a 'technical' department like intensive care.

Amélie: " It's great fun, I like it, but I might not stay for 10 years! For the time being, I like it and it's fascinating, but it can become tiring in the long run because you're often confronted with sad situations. You'll have to ask Ramlata for her secret to longevity!

So Ramlata, what's your secret?

" I know La Casamance well, I've been a nurse here for 22 years, and I've been working in emergency for almost 10 years. It's a very dynamic department and I get tired sometimes, but my faith and pleasure keep me going. You have to be technical, thoughtful and independent. You have to be able to stand back, because people are increasingly demanding, impatient and difficult to please... Patients go easy on us, but sometimes it's complicated with the people around them... But I've always wanted to do this job and I won't do anything else!