[pinktermite]

I work in a level I trauma center and wonder if there have been any issues, good or bad, with changing from a classic ENA approved five level triage system to a physician-directed system where patients get a quick set of vitals and chief complaint at triage and are taken directly to a room, and met by a physician. In this system, the assessment is done by the doc, leaving the nurse to be there just for starting IVs and drawing blood, etc. Are we robots, there to be inferior to the docs? Has this been tried in other busy ERs? Has it worked? thoughts?

[ClaireMacl]

They tried it here, it didn't work!

[alakaea]

That sounds like it would totally overburden the doctors.

[bessfish]

We are going to that and wanted to do away with RN assessment for our fast track ER (sprains, strains, simple stuff) but the State of PA requires a RN assessment. They are now thinking about putting the fast track doc in triage, have him see pts first then have a PA or RNP in fast track and in the main ER do bedside triage. I am not sure how this will work when we are full in the middle of flu season and get slammed with 5 ambulances at once. I work in a small ER. Will let you know when we go to it.

[Sarah, RNBScN]

5 level CTAS (Canadian Triage Acuity Scale) - system we use in Ontario, Canada and it works well. We do have standing orders for acute asthma, chest pain, sprains, etc. to initiate and then notify the MD. If your interested in any of this, p.m. me and I can email it to you.

Sarah

[angel337]

would never work in our ED. we are way to busy and most of the docs can't keep up with the volume of patients we have now. it is funny though how some docs try to minimize the impact that RN's have on how well the ED runs. can you imagine how many patients would die if we waited for the docs to do everything?

[traumaRUs]

I work in a level one trauma center 65,000 visits/year, so its pretty busy. However, when we have rooms available, our patients go straight from triage to the room with only their name, birth date and complaint put in the computer at triage. Everything else is done in the room. Works for us. Has to have buy-in from the staff and there must be understanding that patients might still have to wait.

[TazziRN]

I work in a rural ER and our new MD director wants to try something similar: bedside registration for ALL pts, but so far it hasn't worked. Charts were getting lost because he was seeing pts and starting charts and laying them down, and we didn't know who was registered and who wasn't. He finally agreed to back off on it until our RN director could come up with a game plan that might work, but I'm not holding my breath.