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Discussion

Mid levels in triage

How many of you work in an ED where you have a MLP out in triage? How does your process work? How much staff so you have out in triage? Do the MLPs do a full medical screening or just eyeball the patient? Do they only see ESI 4s and 5s or do they also see 2s and 3s? We are experimenting with having a MLP out in triage but we have already ran into speed bumps...now we are trying to fine tune our process so that it will work.

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I don't understand the point. If your triage area is served like a fast track, then there should not be ANY 2 or 3s out there. The triage RN should assign the acuity without any input from the midlevel and then the pt can go back into the triage/walk in area or whatever it may be for their "quick service." The midlevel does the focused assessment necessary for the issue, writes orders, and the MD never sees the pt.

We also have midlevels staffing the back. They see level 3s and work underneath a doctor. The doctor will typically lay eyes on the pt once during their visit and the rest is handled by the midlevel. But this is an entirely different process than the midlevel in triage...

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