[erdiane]

a question.........the er where I work generally sees 80-100 people per day, but can go much higher in the busier winter months. (130).

How many triage nurses do you have for this type of pt. load? We only have 14 beds, + 5 fast track beds.

We have one triage nurse, which can be [b]really[b] over whelming. esp., when you are out there, on your own, for 12 hours.

At times, I may have 20 people to triage, with more coming in the doors. I'm hoping for ammunition to ask for a second triage nurse before winter falls on us.

[Rio]

we see about the same volume without the winter influx where I work per-diem. we have one triage nurse. If the powers to be ever expand with more rooms I think they'll need to add two more triage booths and bump up the staffing to three triage nurses during peak hours. Historically the peak times are on a bi-modal curve between 9-11AM and again at around 6-7PM where we'll see up to 10 pts/hr presenting. Until they add more rooms and at 80-100 ppd we'll have just one triage nurse. Check within the ENA database for staffing guidelines at www.ena.org

[traumaRUs]

A tech to do vitals helps tremendously. Otherwise the level one where I worked (200-250 pts per day) had one RN, one tech, one hostess or transport and sometimes two techs. They recently increased to two RN's recently.

[bill4745]

We do 100-120 per day with one triage nurse. When the list gets long the float nurse will help out, or we will bring Fast Track patients back aand triage them there.

[erdiane]

when you triage pts. in fast track, who does the triage? I am usually trying to triage as fast as I can, so can't see it being ME who triages them in fast track.The nurse is fast track is usually an LPN.

We also don't have a "greeter" RN. Which would be nice.............$$$$

A tech would be great also, but according to State rules, the first person to greet a pt. coming in to the ER for treatment has to be an RN. As I am normally either A. triaging a pt., or B. taking a triaged pt. to the back to a rm., or C. triaging a pt. (that I think is critical, such as the lady with sats of 42 ) IN a room.....it is unrealistic to think that I can also be the one to greet them at the waiting room counter: like McDonald's or something. Our state has also issued that an RN must be the one to take initial vitals. The tech can place the b/p on the pt, and place electrodes but the nurse is supposed to push the button. How insane is that?

We get incredibly insanely busy in the winter months. I have no objection to working my butt off (& expect everyone elso to also); but I do object to working in unsafe situations.

hoping to hear from others, and other suggestions. thanks

[erdiane]

BTw, float nurse! who has float nurses?????????

If I am charge, I take a full assignment or I take Charge & triage. No win. no how.

[Miss Mab]

mjjjmol

[vaughanmk]

Granted I work in a peds ER, but during the day and up utnil 2300 we have 2 nurses in triage, The first to sign in the patients and determine if one needs to be moved ahead. The second is dedicated to actual triage. We are also lucky in the fact that we only triage for 4 hour periods. We get moved around the department every 4 hours so no one gets burned out on a crazy family.

[Gussiegoose]

Presently, we have one triage nurse "in the box", and an ambulance triage nurse inside. The ambulance triage nurse does not have an assignment. This position was created a few years ago in an effort to have someone acknowlege the EMS personel. In the past, the "charge" nurse would place the ambulance pts, be in charge, and often had a pt assignment. Of course if a nurse is already overwhelmed with x amount of pts, the last thing they want is to look up and see 3 people staring you in the face with yet another patient.

For a short time, we even had a secondary triage nurse in the box to draw bloods, and initiate standing orders (which have been rescinded, due to legal aspects of RNs initiating orders).

[erdiane]

exactly the same in my er. If I am charge, then I have a full assignment. It is no fun to be running around trying to take care of your pts., and keep an eye on the entire ER as well. (for 75cents extra per hour, I may add. that may be another thread entirely).

But the idea of an ambo triage nurse might fly. If I was charge, I would do this. Then perhaps they can be 2nd triage & float nurse also. When an ambo comes in, we usually all try to help....situate pt. vitals, sit with fire at the computer, and put pt. info in to generate chart. Usually if you are the one at the computer, someone else will get rest of info, vitals, put them on monitor prn, etc. I would be interested how the ambo triage RN accomplished this when 5-6 ambos are in hall all at once. ?