A qualitative study of emergency department nurses’ experiences in caring for unaccompanied chronically ill patients in a tertiary hospital in Greece

Providing healthcare to patients with chronic conditions is challenging, especially when patients are unaccompanied. In the context of emergency departments, the absence of a companion or family is not just a matter of convenience, it has clinical, ethical, and organizational implications. The study explores the experiences of Emergency Department nurses when providing care to chronically ill patients without a supportive environment, focusing on the challenges, emotional burden, and systemic support needs. Data were collected through semi-structured face-to-face interviews with nine Emergency Department nurses in a tertiary hospital in Greece. Interviews were conducted in a private office within the Emergency Department, audio-recorded using a digital recorder, and transcribed verbatim. Data were analyzed using Colaizzi’s phenomenological method. Ethical approval was obtained from the relevant institutional committees, and written informed consent was secured from all participants. The analysis highlighted six thematic areas: (1) The experience of caring for chronically ill patients in emergency departments without a supportive environment from accommodation structures (2) Challenges in caring for chronically ill patients who are unaccompanied (3) Impact of lack of family support on quality of care and treatment decisions (4) Ethical and emotional burdens of nurses / Emotional reactions and management (5) Collaboration with accommodation structures and systemic needs and (6) Support and training of nurses for caring for unaccompanied patients. Nurses face complex situations that require increased professional alertness, emotional management and adaptation to systemic gaps. Caring for chronically ill unaccompanied patients in Emergency Departments is clinically demanding and emotionally burdensome for nurses, highlighting systemic gaps in continuity of care. Beyond institutional strengthening and staff support, the development of structured social and community-based support systems for unaccompanied patients is essential to ensure equitable and safe care.