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

Lol on having symptom for 1yr. This happens all the time. "what brought you to er today" "I stepped on glass and it's killing me!!! " " when did this happen? " " 2yrs ago I... " " level 5"

Specializes in Emergency.

Doing time in the box. Seems just like yesterday.....

"Why are you here today? No, seriously, why are you here?"

Specializes in Emergency, Pediatrics.

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."

Specializes in All areas of Critical Care, ED, PACU, Pre-Op, BH,.

I agree with all of the comments made on these posts! I think there is a fine art to redirecting the patients to stay on track when they go into an ED for triage. Very difficult to do with some patients.

Specializes in ER, PACU, ICU.

My response "Uh huh, and why is this an emergency today?"

Specializes in Emergency, Telemetry, Transplant.

Even during the summer some people were wearing the puffiest jackets. That's what needs to be checked out--why you are wearing a thick coat on an 85 degree day!? (and I'm not talking LOL or chemo pts…I am taking 25 year old male coming in for his monthly STD check)

This one kinda plays off not telling your life story--start you triage conversation with the system you wrote on your chief complain. I had a guy with a CC of "abdominal pain." I asked what brought him in today. He starts with his knee surgery 5 years ago and how the knee still bothers him when it rains, then moves on to his headaches, then on to something else. I asked him about his abd pain. "Oh yeah, last week I had a scope…they never told me what it showed…can you look it up? I guess my stomach hurts…I'm not sure." :facepalm:

If you stopped en route for coffee, or fast food, clearly you don't think it's an emergency. I am going to have to agree.

If our your spouse/partner dropped you off and is doing errands, and those errands don't include taking care of your small children or saving the world, clearly he or she does not think this is an emergency. I am going to have to agree.

I have only been doing this for ten years, but in that time I have never seen a twofer in in which either was serious. I'll accept the possibility that you may be the first.if you can accept my skepticism.

Now, you and I both know you aren't allergic to NSAIDs, Tylenol, and Tramadol. But thank you for telling me that. It tells me more about you then everything else you have said.

The customer service model of ERs was not developed by an ER nurse. I am an ER nurse. To whatever extent in my power, I will try and see that patients are seen by acuity, not wait times. If you ever show up actually sick or injured, you will thank me for that.

Please, just give the kid some Tylenol at home. I believe he had a fever.

No, I don't want to see it. I know you went through the trouble of collecting some god-awful thing that came out of some part of your body. None the less, I don't want to see it.

You are a grown up. I absolutely expect you to know what drugs you take. If this is too much for you, carry a list.

Specializes in Cardiology, Cardiothoracic Surgical.

I do phone triage for our clinic. Always amazes me when patients c/o cramping, abdominal pain, or some

other symptom, and the first question out of my mouth is "what have you done about it? heating pad?

Tylenol? Motrin? rest? changed positions? fluids?" And the response I get is "nothing, I wanted to see how bad it was" when we explicitly tell them to take something OTC first before calling us.

:banghead:

Specializes in ER.

"If you have multiple complaints, pick one."

Love it!

Two nights ago - "had a pain in my side for 25 years and thought i would get it checked out."

Seriously???

After 25 years you show up at 2am???

Then there are the ones after a free meal. Don't even get me started on the 'abdo pains' that show up late at night and ask if we have any sandwiches left. or "Can I have a cookie?"

And the amazing one last week on Bipap trying to find ways to stuff pizza under the mask.

Seriously considering a career change to become a vet nurse. Animals don't eat pizza.

Last night I had an ER patient ask me, "Do you serve refreshments back here?" as I showed him to his room. He had been waiting less than 2 hours. I replied, "This is the emergency room not the cafeteria."

:dead: Have you ever had them ask what channel the FOOTBALL game was on, right after they told you their pain was "20/10" and the general "I'm allergic to everything but... (generally fentanyl or dilaudid).

My favorite is "but we were here first!":angrybird9:

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