Sailnaway: It sounds like you have your work cut out for you. Organization has to start somewhere. Why not a unit meeting and present possible triage rules and agree together on what is the policy? Then post the triage rules in your triage areas. Not everything falls into clearly into these rules....I am a firm believer in intuition and that is why you need someone with experience to do the triage/teach others....I have worked in the ER at a small hospital for 17 of my 18 years. I love ER but hate the improvements that keep happening!!! I'm not talking about medical advancements.....I mean administrations ideas of advancement/cost savings or improvement... we average 20-25 patients per day plus outpatients. We have 1 RN per shift (12 hour shifts) and 1 MD. The Rn is responsible for all the ambulance calls, triaging, answering the phones( which we are the operator also after 11 pm), caring for the patients plus advise phone calls. Most days the phones ring endlessly!!!!!

My family doen not understand why I hate the phone so much when I am at home. On night shift, we are responsible for registering patients and being the operator after 11 pm and security since the only unlocked door is the one that leads to the ER.....When we need help, we have to beep someone like the house supervisor or maintance.....Sorry so long but it is so frustrating!!!
I work hard to give my patients the best care possible and when my needed help arrives, I have to end up doing their job too!!!! Even the Doc's can tell because they will by pass the person who is their to assist and give the orders or ask the question of the ER RN......You need to take a stand about getting things organized there or things will not improve...Why work harder when you can work smarted for everyone!!!! Good Luck!!
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