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Background: With a growing older population, new challenging illnesses such as the pandemic, and limited resources registered nurses in the emergency room are responsible for life-threateningly ill patients who are vulnerable with complex care needs. In emergency rooms, there is a biomedical focus, which may reinforce a culture of valuing the medical and technical aspects of nursing care and increasing the risk of patients’ care needs being neglected.

Aim: To deepen the knowledge about how person-centred fundamental care is performed in emergency rooms to enhance quality care and patient safety

Method: Observations (n=108) of registered nurses everyday work in the emergency room and interviews (n=14) with registered nurses working in the emergency room, analyzed with descriptive statistics and thematic analysis.

Results: Mainly the patients’ physical needs are met, and more often in the beginning of the care episode. Patients can, after the initial assessment be left without nursing care for hours, both physical and emotional needs seemed to be left unattended. Meeting patients fundamental care needs in a person-centred way has proven challenging for registered nurses in the emergency room, as the organization is perceived unclear and nursing care is not a priority. Registered nurses’ work approach for meeting patients’ fundamental care needs was not adapted to provide person-centered care.

Conclusion: An organizational focus on patient flow and the promotion of guidelines and checklists provide a structured approach for the initial care of patients, but are not adapted to provide person-centered care. Nursing care needs to be prioritized not only by the registered nurses but also by management and leaders.

Implication for caring in a changing world: A deepened knowledge about fundamental care in the emergency room is vital for providing optimal, dignified, high-quality care to a patient group with many needs, in a consistent and person-centered way.