Rules for Triage

Specialties Emergency

Published

Here are some of my rules. Feel free to add your own.

When I ask you what brings you in today, please don't tell me your life story. I just need to know what symptoms you are having Right. This. Minute. that are concerning enough to bring you to the ER.

Please be ready for me to take your VS. I know it's starting to get a little nippy outside, but when I have to wait for you to take off your three sweaters and overcoat before I can take your BP, it really bogs things down. You did know you were going to have your BP taken, right?

If you tell me that you've been having your symptoms for over a year, please know that your acuity level will be downgraded accordingly.

If you have multiple complaints, pick one.

Don't ask me how long the wait will be. The nature of ER flow is unpredictable. If I tell you an hour and it turns into two, you're going to be grumpy and take it out on me. Also, on a related note, don't ask me where you are "in line". That's not how it works.

Don't tell me you have an appointment/have to be at work/have to pick up the kids in a specified amount of time, as if I'm going to whisk you right back and get the doctor in the room right away just so you can make it to your thing-you-have-to-do. That's not my priority or my problem.

When you come in for a stuffy nose and have to wait, please don't stand in my line of sight and give me the stink eye while I triage another patient. I did not drag you in off the street to come in here for your stuffy nose. You do know what the word "Emergency" means, right?

Sincerely,

Spending Too Much Time In Triage, Somewhere In The USA

Specializes in ER.

It kills me when people are writhing and crying in triage, I move heaven and earth to get them back immediately, and from the time they go back until discharge they show no signs of pain and require no pain meds. There is a reason your triage nurse is a cynical *****. Sometimes I send the dramatic ones to the waiting room to see if they get magically better when they are out of my chair. It looks cruel, but I need to pick out the really sick people

It kills me when people are writhing and crying in triage, I move heaven and earth to get them back immediately, and from the time they go back until discharge they show no signs of pain and require no pain meds. There is a reason your triage nurse is a cynical *****. Sometimes I send the dramatic ones to the waiting room to see if they get magically better when they are out of my chair. It looks cruel, but I need to pick out the really sick people

^^^^this!!!!!

Actually, my dog eats pizza, so the career change may not help. Lol. Some of my favorite c/o: 'my sunburn itches', 'I think I am getting a cold sore', and 'this vein on my hand looks bigger than it used to'

Specializes in Pediatric ED;previous- adult Ortho/Neuro.

"Her nose was bleeding yesterday, but it stopped. We just wanted to get her checked today".

Smh.....

Specializes in Emergency Department.

I love it when they come in for dental pain at 6 AM when there's a FREE walk-in dental clinic that opens at 7AM.

Haha i love your rules!

I hate when someone comes in for something ridiculous, let's say dental pain, and I tell them I'm going to get vital signs. They say, "oh you have to do all that?" I say, "YOU came to an ER for your teeth.. This is what we do here, now take off your coat."

I need this laugh THANK YOU

Specializes in ER.
I get the humour here and being a triage nurse can be a nightmare. However, working with a bad triage nurse can also be a nightmare. Sometimes triage nurses just get too jaded and leave a mess for the rest of the of the department. I have experienced some shocking triage nurses who have missed some really serious issues because they were just a bit too jaded. It is no easy job to escalate the care of a patient who has not properly triaged... just saying.

I find the more difficult triage nurses are those who over triage and put every person in critical care. Sometimes an ESI 2 can just be that. If they decompensate in a main room and need one to one nursing, then move at that time. Where I work, our critical care rooms are VERY expensive. It does come with time and experience, but save the critical care rooms for those patients that are TRULY critical, not a chest pain that "might" evolve.

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