Dealing with triage - page 3

by canoehead

My last triage shift two babies with colds came in, stable vitals, low grade fevers. Both to the waiting room, and one was a 3, one was a four triage level. Obviously the three went in first, but the four was fussy and crying in... Read More


  1. 0
    Quote from Rhi007
    Our ED has a giant sign that basically states people are categorised and the people who are the sickest are seen first, also above the triage windows are signs saying 'you may think someone is jumping the queue but all patients are seen in order of need. '
    LOVE THIS IDEA!!! In my department this is also a huge problem, among others, so I had the idea to write up cards that adress the most common complaints, and hand them out to all patients on arrival to ED. My manager helped me get them approved all the way to the director of the hospital, they were printed up and everything. The problem is that no one hands them out, and even if they do, the patients do not read them. So much for that.
  2. 0
    I only did 4 hours as triage yesterday. Started off good, just several people.. Took em back to main ER.
    Returned and my sign in basket exploded. 20 people walked in, nobody put time on sheets. The other staff try to go in order of arrival, I was going by complaint. Obviously I need to check in the pregnant gal doubled over and the chest pain before the gentleman who returned to get his stitches out..
    These people come through the doors so often they know the 'routine' and I apparently broke it. Pt after pt coming to the window to tell at me that they were there first, why am I going in alphabetical order. All I said to them was that I was going by reason for visit.
    It didn't help that the very last pt didn't want to wait so she came to the window all dramatic, complaining she can't breathe and thinks she's having a heart attack so I bring her right back. I swear she snickered at the people waiting. All the while chatting on her cell phone 'ill call you right back, I'm at the doctors office'. I guess if I had crack/cocaine on board Id feel like I was having a heart attack too
  3. 0
    Quote from Pudnluv
    Triage can be frustrating. I am often assigned the "door whore" position. The triage nurse is looked at as the guardian to the er doors. Patients think that if they can woo us or intimidate us, we will let them through the magic gateway. My routine answer "patients are seen in order of acuity." End of discussion. If they want to argue with me, I refer them to the charge nurse, (which in many instances is me) or the nurse supervisor. I am too busy to stand and argue with anyone about their stuffy nose. I should note, that after triage, before the patient leaves the triage room, I let them know that all the rooms in the back are filled and we will bring them back as soon as an appropriate room is cleaned. I also tell them to let me know if they feel worse and that I will check on them periodically. Most people are okay with this. Of course, if they are truly acute, I bring them back and make room for them. I'm pretty thick skinned, so I don't let it get to me. Really, they are not attacking you personally, they are attacking the position and would be doing the same to anyone in triage that day.
    "door whore" in the penalty box...gotta love triage. Great advice Pudnluv.
    If they want to argue with me, I refer them to the charge nurse, (which in many instances is me) or the nurse supervisor. I am too busy to stand and argue with anyone about their stuffy nose. I should note, that after triage, before the patient leaves the triage room, I let them know that all the rooms in the back are filled and we will bring them back as soon as an appropriate room is cleaned. I also tell them to let me know if they feel worse and that I will check on them periodically.
    I'm pretty thick skinned as well.....they just aren't worth the time to get upset with...it's a hazzard of the job...pass it on to the super or charge.
  4. 0
    Quote from Sassy5d
    very last pt didn't want to wait so she came to the window all dramatic, complaining she can't breathe and thinks she's having a heart attack so I bring her right back. I swear she snickered at the people waiting. All the while chatting on her cell phone 'ill call you right back, I'm at the doctors office'. I guess if I had crack/cocaine on board Id feel like I was having a heart attack too
    People with crack cocaine on board have legitimate angina and are at a high risk for having an mi. Like it or not, she's got us there. For my money, canoe head, there are places that use a triage/float pool so that no one triages for more than four hours without taking a break to float. You could suggest to management if you are feeling frisky.
  5. 1
    Quote from VICEDRN
    People with crack cocaine on board have legitimate angina and are at a high risk for having an mi. Like it or not, she's got us there. For my money, canoe head, there are places that use a triage/float pool so that no one triages for more than four hours without taking a break to float. You could suggest to management if you are feeling frisky.
    I guess my sarcasm came because the dramatics at the window stopped as soon as I hit the button to open the doors.
    The story changed once I got her back to the room.
    I guess I just chuckle at how people gasp for air at the window like they just ran a marathon but are magically healed once the doors open.
    canoehead likes this.
  6. 0
    Quote from Sassy5d
    I guess my sarcasm came because the dramatics at the window stopped as soon as I hit the button to open the doors. The story changed once I got her back to the room. I guess I just chuckle at how people gasp for air at the window like they just ran a marathon but are magically healed once the doors open.
    oh yes.. I felt that burn but what can you do? It is what it is.
  7. 0
    Hey, we have people that walk in from the parking lot and immediately collapse in a wheelchair, or even on the floor. I' d be all for leaving the floor folk where they are, but apparently that's an infection control issue.
  8. 1
    Quote from canoehead
    Hey, we have people that walk in from the parking lot and immediately collapse in a wheelchair, or even on the floor. I' d be all for leaving the floor folk where they are, but apparently that's an infection control issue.
    Haha that's funny! This didn't happen in triage, but I had a frequent flyer abd pain pt who frequented our ED so much and got so accustomed to how pt's were triaged and that the "less acute" (4s and 5s) were sent to fast track that her almost monthly visits began to consist of her writhing in pain and misery on the floor. It grossed me out beyond belief because of the crap that floor's had on it. So one day I fibbed, told her during her floor routine that she she should probably stay off of the floor because a patient earlier that day had "every kind of bodily fluid possible" all over it, and the environmental services crew that day wasn't "our best." From what I hear, the floor routines have stopped
    canoehead likes this.
  9. 0
    On a positive note I was really grateful for the crowd in triage the other day. We have a separate area for triage pts who need to lay on stretchers, and its usually crowded by family members too. Anyway this one obnoxious guy was being so rude to me, I finally had to stand up to him, I said "sir you are being extremely rude right now, I think you should consider the way you speak to people." I was really glad to have witnesses to his behavior at that point...


Top