how to manage the waiting room?

Specialties Emergency

Published

Specializes in ED, ICU, PSYCH, PP, CEN.

Our ER admin now wants us to to go back out to waiting room and re-triage pts if they have been waiting for more than an hour or so. How is there time for this when I have 12 people still waiting to be triaged? Besides you are taking your life in your hands if you go out there when there is a long wait. What do you do so you don't end up with someone having a heart attack out there after sitting for 2 hours?

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Specializes in Nephrology, Cardiology, ER, ICU.

We had the same issue...the solution was to put two nurses at triage or an EMT-P on with the RN during the hours of 1100-0300. That way one person could rotate out to the waiting room.

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We added a paramedic too, as circulator. Still have RN making assessments.

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Specializes in Cardiac, ER.

We have two nurses and a tech,..have even started drawing blood,.sending people to xray,.etc,..from the waiting room....it works great in theory,.still have a hard time keeping up when it's really busy though!!

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Specializes in ER, Outpatient PACU and School Nursing.

still a problem here esp. when we had a another pt die out in the waiting room on night shift. 2nd one in a few years. both drug induced. looks like by the cameras he was on the floor and people were walking over him, housekeeping was mopping around him and nurses from other floors- walking over him to get to the vending machine... guess it was one of those nights when there patients backed up, etc and they were short staffed. anyhow our new thing once again is to have a person in triage 24/7. we all have beepers and the triage nurse will get beeped if two hours have gone by- they need to reassess the waiting room patients even if they are fast track, etc.. we are now doing computer charting so it takes that much longer. Our triage area is not in the best view either. they put a camera in the area and when JACHO was here last month that is one of the things we got dinged on.. I felt bad when I left tonight- once again bare minimum staff on a sunday night and backed up already in the waiting room..

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Specializes in Emergency Room.

triage is never easy. i feel overwhelmed just reading the posts. if patients only knew.....

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Specializes in ED, ICU, PSYCH, PP, CEN.

we are trying to decide how often we need to recheck the people that are waiting, and how best to accomplish that. Also who should do it? Obviously, the triage nurse can't because she is already busy.

Also we wonder where? Do we call people back up to the triage room, or recheck them in the waiting room. Is that a HIPPA violation. What if we go out to the waiting room and everyone wants a warm blanket and ice water. We are really stumped with this one. Told them I would put it to the allnurse family.

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Specializes in ER, ICU, Infusion, peds, informatics.

we don't do a full re-triage, but we are supposed to recheck vs on wr patients q2hr. at that time, they are asked if anything has changed.

however, it seems silly to recheck vs on patients who have been waiting when there are some patients that haven't been triaged yet, so they haven't even had one set of vs done. meaning, that unless some intervention has taken place (we will give clonidine in triage to someone who is hypertensive, but has no other pressing issue -- such as cp), all of the new patients have to be triaged before the triage nurse starts going through the list again, to get repeat vs.

we are occasionally able to do this, but not often.

my understanding is that all of that is going to change soon, that we will be getting additional triage staff, and should be able to get "caught up" enough that wr patients should be able to get looked at every few hours.

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Specializes in Tele, ICU, ER.

This is a problem in our triage too. We're supposed to, at the least, re-vitalize every 2 hours, but when they just keep coming, I have to keep triaging. We have a hard enough time being properly staffed in the ER, without even thinking about an extra triage nurse. No idea what the answer is, but I live in fear every time I have my 12 in triage, that I'm gonna miss something and someone will be hurt (or god forbid,die). I will go walk through the WR on the assumption that if they're all complaining and asking about the wait, they're all alive. It's the quiet ones that scare me.

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Specializes in ER.

When people ask about the wait I usually say "the person that has been waiting the longest has been here for xxx hours." They may feel grateful it's not them, or give up and go home at that point.

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Specializes in ED, ICU, PSYCH, PP, CEN.

thanks to everyone for the info. Sounds like this is a problem all over and the answer is probably more staff, which will never happen.

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Specializes in critical care,flight nursing.

We have 3 nurse at triage. Triage A do the main triage("the window"), triage B take care of the EMS and reasses pt in the waiting room. Our policy is CTAS 3 or less every 2 hour et CTAS 2 every 30 min ( not me that did those, some adminiatrators that wanted to cover the little donut from being sue). Triage C replace A and B for break and is responsible to find bed. There even talk to put and orderly at triage to bring warm blanket and help by bringning pt to triage.

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