triage - page 2

hi all, got a quick question for ya: do you work in a unit with a triage and how does it work out for ya? what kind of patients do you see and how long are they in triage? thanks in... Read More

  1. by   Aneroo
    Quote from greyhorse
    We triage our own as well. ER is expected to send anyone to OB that presents at 16wks gestation or greater. Most patients present directly to L&D. Doctors made the 16 week rule because our ER was sending anyone that said they were pregnant to OB. Doctors didn't like seeing someone that had missed one period and had the flu :-) as what they needed wasn't an OB/Gyn!
    Greyhorse
    Our ED send patients after 20 weeks, sometimes before depending on the situation.
    If a patient presents to the ER, is greater than 20 weeks pregnant and has a medical (non-ob) related complaint, they are usually seen in the ED. If the MD decides the patient needs FHR monitoring, then an OB RN gets called down to stay with the patient.
    If a patient presents to the ED with an OB complaint and is greater than 20 weeks, well pooey on her. She hasn't had prenatal care, because if she had, she would have been told by her MD to go to L&D! I didn't know that was the norm until my OB told me that- I honestly thought you had to go thru the ED to get to OB after a certain time! Anyways, she gets triaged (water broken, contractions, etc...) and then gets a transport to L&D unless labor is imminent.
    If a patient is less than 20 weeks, they are seen in the ED, and it's up to the ED MD's to call the on-call OB/res if needed.
    Not really sure how the OB triage that is in OB works here. I'll let you know sometime in the next month.
  2. by   midwife2b
    Our hospitals L&D triage unit is staffed only with experienced RN's who have at least one year experience at the hospital.

    It is a 3 bed unit where we evaluate most anything from R/O labor, PTL, PROM, PPROM, falls, MVCs, etc.

    We are a regional trauma center so pts in MVC's or sustaining any type of trauma beyond a fall are seen and cleared by the ED MD.

    We sometimes have quite a wait to be seen (just like any ER) so urgent type cases are sent directly to a L&D room.

    While we try not to admit anyone less than 20 weeks, we occasionally have a hyperemesis patient and there is no where else in the hospital she can get IV fluids.

    We are building a new Women and Children's hospital so things hopefully will get better! Often the triage nurse is the busiest one on the floor!
  3. by   rpbear
    We have an 8 bed triage area on our L&D floor, we see everything from r/o labor, SROM, PIH to tooth ache, cold symptoms, and UTI's. Anyone past 20 weeks gets to see us first, even if it is a broken bone. It can be very busy. We have lots of protocols and we use the 20/40 rule with the physicians. They have to return a page in less than 20 minutes, and must be at the bedside or have a plan of care within 40 minutes. This makes pt's move in and out of triage as quick as possible. The RN's have the ability acording to protocols to discharge or admit a pt with a reactive NST and vag exam that are full term without a MD actually seeing them, you have to talk to the MD or CMN by phone, but they don't have to see the pt, this helps to quickly move out the wanna be labor pt's and the I gotta push pt's without waiting for a doc who is in back to back c-sections for 2-3 hours.

    Triage can be a very busy place, it is staffed with at least one very experienced RN and a helper RN, but your night sure does fly by!!!
  4. by   RNnL&D
    Quote from rpbear
    The RN's have the ability acording to protocols to discharge or admit a pt with a reactive NST and vag exam that are full term without a MD actually seeing them, you have to talk to the MD or CMN by phone, but they don't have to see the pt
    Same here. We have 2 triage beds covered by one of the 4 staff nurses on shift. On a good day, the triage nurse is just the triage nurse. But on a bad day...... the other night, I covered triage, and was assigned an antepartum pt and had a delivery with a shoulder dystocia (one of my triage pts I admitted).

    Some nights, the triage nurse is only busy for sporadic periods. Other nights, you run all night.

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