Overcrowding in the emergency unit was a great concern for participants. Participants expressed that inadequate space in the unit hinders quality nursing care delivery. Participants described the emergency unit as a ‘chamber’ meaning it is too small to be used as an emergency ward. Others described the ward as very hot due to poor ventilation.

“Currently the bed capacity in the emergency unit is only two but you can sometimes have as many as five to eight patients at the same time and some may end up sitting down or we use worn-out stretchers as improvised beds that are not comfortable for them to receive their treatments. The overcrowding caused by limited beds and space makes it very difficult for us to move between patients to deliver care. We are at risk because anything can happen to us as caregivers. (Participant 129).

Almost all the participants expressed their frustration in having to nurse patients on wheelchairs and stretchers making the performance of some nursing procedures practically impossible. Participants reported not performing the full iterative circle of the nursing process due to an unconducive working environment. Manoeuvring through defective stretchers, wheelchairs, and benches in the delivery of quality emergency care is frustrating and poses hazards to both the nurse and the patient.

“…at times, we can have fifteen patients at once, and we have two beds in the emergency room and there are times that we have to nurse patients in chairs…and this makes work very difficult” (Participant 127).

“…the stretchers, wheelchairs with the beds make the place so congested…the environment is very small and the way many patients are rushed in makes the place not conducive” (Participant 125).

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