ER triage over phone

[nurse4theplanet]

I was wondering, how many hospitals allow ER nurses to triage over the phone. I was having a problem the other day, and I called the ER to see if they thought it was serious to be seen immediately, as it was sunday (doctors office was closed), and they told me that they could not give me any info over the phone.

I do realize that they can not make decisions like a doctor would make, but it seems to me that if you were allowed to tell them s/sx, the nurses would be able to tell you if you had a serious enough problem that you should come to the ER. I think, it would help the patient and decrease the unnecessary patients coming into the emergency room.

[ClaireMacl]

Hi Pam,

Actually there are two cases at the moment going on against NHS Direct, in both cases, the patients were told to see their health practitioner in the morning and died, they were both under 30 years old. I don't know the in's and out's of it, but suffice to say, if there is a lawsuit, well....

We aren't supposed to give out advice in our ED, though seeing as our number is readily available, we do get alot of phonecalls. I either give them the number of NHS Direct or tell them its their decision and if they wish to come up, they can.

Telephone triage is difficult and I've had a few meetings with themselves, I won't go into details, but sometimes common sense comes first :)

Cx

I dont think there have been any serious errors (it would have been in the national papers otherwise). Doctors were generally aginast it at first, because it was manned by nurses and they must have thought we are a bunch of eejits! But I think that they realise the benefits now

[sjrn85]

We always said something like, "We would be happy to see you if you come in, but we can't advise you as to whether or not you should do so."

This is just the type of situation that will get a nurse burned. ("But the nurse said she didn't think I needed to come to the ED...")

[nurse4theplanet, RN]

As you can tell, I live in the UK & we have a national system called NHS Direct. It is a telephone help-line which anyone can call for medical advice. Manned by Registerd Nurses, they have strict protocols to adhere too and I believe that the computer software prompts them to probe a bit deeper & ask pertinent questions. The range of calls they get is enormous, from heart attack to child-birth to the common cold.

I dont think there have been any serious errors (it would have been in the national papers otherwise). Doctors were generally aginast it at first, because it was manned by nurses and they must have thought we are a bunch of eejits! But I think that they realise the benefits now

this would be a really awesome resource to have in the us...but we tend to be a little too sue happy i think...

I do understand the liability aspect, and the fact that patients might leave out symptoms, but that could be overcome by experienced, qualified nurses who specialize in triage and know what questions to ask...taking into account that if something sounds like there should be more to the story, have them come in just in case.

but this hospital would not even let me tell them my signs and symptoms...all they said was to come in. I ended up waiting to see my PCP because of cost, luckily he was open and an appt was available that saturday, and now they are sending me to a GI doctor for possible petic ulcers.

[chryl61]

Anyone with a method idea for registration of er patients in triage area. Triage pt first or register first. At our hospital the pt are greeted by registration clerks not medical personnel, they ask the triage nurse case by case if the pt canbe register first or triaged first? How do other er work?

[sjrn85]

Triaged first, then registered. Registration does not have the skills to make acuity assessments.