Crowd Control

Specialties Emergency


I have been having some issues with crowd control lately, especially in the triage area. I am having pts or family members of pts waiting to be seen interrupting me while I am with another pt who deserves my undivided attention. Sometimes they actually surround my cubicle and stare at me ot tap on the window. If I don't move fast enough for them, they bypass me and go to security and tell them that they or their family member is REALLY sick and REALLY needs to be seen NOW. SO then security brings them to me and interrupts my current triage and 9 times out of time, it is bullshit and the pt is in no distress. Abd then when you get the one pt who IS in distress and DOES need to be seen immediately, a riot breaks out because I am seeing this one before that one. Security is of NO help. Last night I was interrupted by a pt who had been there twice already b/c he had gotten kicked in the testicle. HE had had 2 ultrasounds which were normal but he was still in a lot of pain. Some woman who wasn't even a family member told me that she thought we misdiagnosed him and that we should check his appendix because the pain had moved to the lower left side of his abdomen. To ease her mind, I tried to explain to her where the appendix was located and that his pain was most likely related to the injury and that he would defintely be seen asap. She told me that I was confrontational with her and that she didn't like my tone of voice. I asked her to have a seat in the waiting room as she was being disruptive and she refused, pulled up a chair and continued to talk down to me. Meanwhile this poor guy is doubled over in pain. So then she of course goes off to complain about me and management kisses her ass, even though they were on my side. She is probably writing a letter to administration as we speak. My point is she was NOT a family member, she was completely wrong and she prevented me from getting the guy inside in a timely manner.I also had a clerk last night inform me that her sister, who was in NO distress was here. I had 4 pts in front of her, that were actually pretty sick. THe clerk kept calling me to tell me her sister hadn't been seen yet. Duh. SHe then bypassed me and took her sister inside who was d/c 2 hours later. THIS is what I am talking about. I don't know how to deal with the masses because no one seems to back me up. Any advice, before I go off and stick a pencil in my eye? I actually cried last night.:(

Specializes in ICU, CM, Geriatrics, Management.

Terra -- Someone needs to report to those in charge what's going on in your unit. Things are way out of hand. Management isn't happening. And Security isn't performing as if they're on the same team.

Hope this gets addressed soon.


780 Posts

I am serious about this, call a friend with a pre agreed signal and have them call a TV station.

It worked wonders at a Florida county hospital a few years back

canoehead, BSN, RN

6,856 Posts

Specializes in ER.

Call a TV station and say what? I'm sorry, I'm not catching on.

"Attention- the ER is closed"



780 Posts

your screen name seems to fit you.

Let's see, what do TV crew's do, wow, do you think maybe a crowd out of control going nuts with only one triage nurse stuck in the middle of the mess be something newsworthy? Sounds like a kodak moment to me................

canoehead, BSN, RN

6,856 Posts

Specializes in ER.

Don't be mean.

that would be a normal day where I work.

Uptoherern, RN

337 Posts

Specializes in Emergency Room.


If you are upset, it is ok to get MAD!, Then let it go. This is a job, not a 24 hour-take-it-home and worry about it thing. LET IT GO! No job is worth crying over. Especially when you have no control!


1,093 Posts

if your ability to do your job (triage) is effected - then your charge nurse should handle the situation so that you can continue to function in a timely and appropriate manner. That is his/her responsibility as charge nurse/ team leader/ whatever - that person is the go to person to problem solve on a shift to shift basis - should your charge rn be ineffective then you need to take the issue to your manager/supervisor

IF this still doesn't work - find another place to work - because sooner or later - your delay in triage will cost someone !!

Specializes in ER - trauma/cardiac/burns. IV start spec.

When your hospital is too busy kissing butts because they want to be THE Best hospital in town it makes work a *****. I have been in your position and this is basically how we resolved our "crowd control." Every night triage had a problem the charge nurse was called to the lobby to handle it. After several months the hospital hired Police from the local police department to manage our security "problems". Also it was so funny to watch people coming to the ER turn and walk out when they saw ME sitting in triage. :D

I knew too many of them and they knew that I could not be bulldozed and would just smile while I closed my door to protect the patient I was triaging. Also cops learned to go the other way instead of cutting thru my triage room.:chuckle

Remember a quick pulse ox does a lot to settle folks down.

Tink RN

74 Posts

Just call me canoehead Jr. - I didn't get it either. :p


780 Posts

do you remember the white broncho chase watched by millions during the OJ chase..... calling the news got attention really quick


93 Posts


I know it must be frustrating for you, but crying is simply not an option! Remember, at work we think logically, cognitively, not

emotionally! Don't allow work issues to project onto your home

life! This is a very negative situation, and management should

be made aware of it! There is no reason why you should be made a "sitting duck" out in the center of the crowd. Security

needs to run interference and keep the crowd far from you while

you are triaging other patients. Sounds like your Security force

needs to be revamped! Where I practice in a dangerously poor-

urban-based facility, we have armed policemen/women who do

not hesitate to intervene when needed, and who acknowledge

that when the RN says to remove a patient's family member, etc., it is done, no arguments, no negotiations, they are out! Can't

tell you how many times I've heard "just wait until you leave in

the AM!" threatened to me as they are escorted out of the ER.

These types interrupt patient care and are impediments to the

flow of the ER. Don't argue, don't try to explain your methods, etc., they do not need to know, nor do they care. If they are

ignorant enough to harrass you like that, they won't understand

your explanations anyway!

Unfortunately, you need to first make your charge person aware, and if the situation persists, take it up the ladder to ER management. They may have to convene with the management

of Security.

There is no reason for you to work in such a hostile environment, however, you can facilitate change, as long as you do it professionally. No tears!!!! Good Luck! :)

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