We also triage in three tiers, Emergent - go to the shock rooms or shock room halls. Urgent are taken to the holding area and must be evaluated within an hour. (the holding nurse does a quick foc used assesment again just to make sure this patient has not changed and needs to go to the shock rooms instead.) Nonemergent go to the waiting room and will be called one day. These should have gone to a clinic.. The problem comes when we change shifts. Depending on the previous triage nurse, we go back and reeval waiting room patients to make sure they are still non emergent , or triaged correctly. We also have anywhere from five to twenty patients waiting to be triaged, so the nurse will walk down the line, ask for chief complaints, look to see if anyone does not look so bueno. We do not want a cp wainting at the end of the line. The second problem is the urgent patients.
We have "slots" for twenty four in holding, but if they are urgent, they have to go back so we end up double and tripling slotting beds. This can get pretty crazy. We may need to look into bunk bed stretchers!
We have talked about goiing to a six tier system, but are having so many other changes right now, that has been put on the back burner. We are an inner city level one, county, so we have a lot of volume. Our Ems tries to help us out, but many wish to come here due to finances.
We also have a high DNA rate in the waiting room which helps us out, but upstairs frowns on.
Sorry, I really do not have bad spelling
, but am typing in the dark on a little keyboard. I don't want to wake everyone up. I have also forgotten what the original question was!!
I'm having a geriatric moment.
Hope everyone is having a good day, night, or inbetween.