#United States #Schaumburg #Emergency Nurses Association #ED #Boarding Crisis

Addressing the Emergency Department Boarding Crisis

In the United States, emergency departments (ED) witness an astonishing nearly 140 million patient visits annually. Emergency nurses are the frontline caregivers, dedicated to treating and stabilizing every patient who enters their doors. However, a troubling trend has emerged — patient boarding. This occurs when patients are unable to be transferred to inpatient rooms due to unavailability, causing a backlog in emergency departments.

Statistics paint a concerning picture. The average boarding time in 2019 was recorded at 119 minutes, but by 2021, this figure had increased to 169 minutes. This phenomenon isn't just an inconvenience; it has dire implications for patient care, leading to longer wait times and increased morbidity and mortality among patients. Moreover, the intense pressure faced by emergency care teams contributes to escalating job-related burnout among nurses, aggravating an already strained healthcare system.

Recognizing the gravity of the situation, the Emergency Nurses Association (ENA) has been a vocal advocate for practical solutions to the boarding crisis. Since 2017, the ENA has actively promoted its position statement on crowding, boarding, and patient throughput in emergency settings. In July 2025, the ENA Board of Directors endorsed updates to this statement, reinforcing its commitment to addressing the challenges posed by boarding.

One pivotal initiative is the ENA's support for the Addressing Boarding and Crowding in the Emergency Department Act (H.R. 2936/S. 1974). This legislation aims to tackle the ED boarding crisis head-on by emphasizing data tracking, supporting innovative care models, and conducting studies to enhance emergency care effectiveness. As ENA President Ryan Oglesby noted, "Boarding is at crisis levels in many emergency departments throughout the country. Addressing this issue is essential to improving patient care, increasing the efficiency of healthcare systems, and helping nurses avoid additional workloads and burnout."

The ABC-ED Act proposes several measures to improve patient flow and hospital capacity. Plans include updating infrastructure related to hospital bed tracking systems and implementing Medicare pilot programs that focus on improving care transitions for acute psychiatric patients and the elderly. Notably, the act also calls for a Government Accountability Office study aimed at identifying best practices in tracking hospital capacity, establishing strategies to minimize patient boarding effectively.

The ENA commended Representatives John Joyce (R-Pa.) and Debbie Dingell (D-Mich.) and Senators Chris Coons (D-Conn.) and David McCormick (R-Pa.) for their supportive stance on this legislation, emphasizing their commitment to enhancing the functionality of emergency departments, thereby ensuring optimal patient care.

Founded in 1970, the Emergency Nurses Association has positioned itself as the leading professional organization for emergency nurses. With a membership comprising nearly 45,000 professionals worldwide, ENA is dedicated to advocating for safety, developing leading practice standards, and shaping public policy relevant to emergency healthcare. ENA members possess expertise across various domains, including triage, patient care, and disaster preparedness. For further information, visit www.ena.org.

In conclusion, the ENA's advocacy for legislative action underscores the urgent need for change within the emergency healthcare landscape. As the organization works tirelessly to improve conditions within emergency departments, the focus remains on ensuring that every patient receives the timely and effective care they deserve, while also protecting the well-being of the nurses serving on the frontlines.