Need Info On Walkin Clinic Triaging

[angelique777]

Hi

Does anyone here do walkin clinic triaging that could tell me about there protocols. Tell me how there particular clinic prioritizes. I would just like to get a feel for what other nurses do. Iam new to triaging. My specialty is Cardiac. Currently work on a Cardiac Step Down Unit in Intermediate Cardiac Critical Care. This is first time in clinic setting and so far its been a pleasant enviornment for me. However, I would like to hear from other nurses who do this work.

A lot of the patients use the walkin as if it where a primary care setting therefore many come in with multiple complaints and hard to distinguish which of the complaints to focus on since patient want to be seen for all there multiple complaints.

There whole system here is great cause it is all computerized so no writing in a chart I write directly into the computer. I definitely need to make my complaints more concise. Yet at the same time a lot of what they have to say is relevant to there complaint therefore learning to be concise is very important. Doctors donot like to read thats for sure. They often come to ask about stuff I wrote already in the c/o area. At the same time when I do not write about the other stuff they say you didnt mention it in the complaint

Example Pt comes in with burning on urination but has not had her period x 3months and the protocol is only one c/o. I had been doing both dip stick and pregnancy test for this individual what do you do in this case. Urinary tract infection definitely a priority but need to know if pregnant if you going to prescribe medication.

Pt complains of pain in left arm but also complaining of SOB dizziness, bleeding in the rectum, They want me to pick one c/o however LEFT arm pain SOB dizziness bleeding in the rectum can be related incident all though different c/o. Pt could be bleeding have low HCT which can produce some dizziness and SOB and some left arm and chest pain if having a cardiac problem 2nd to bleeding. Pt diabetic not on meds so as a female my not present with obvious chest pain. On other hand all complaints my be separate problems that can all be explained away. Ex Vertigo., pt has some undected diverticulitis, the weather recently has been terrible and air quality is poor patient may just be having some mild allergy symptoms relating poor air quality.

Doctor wants one c/o so what do you do as Triage nurse in this case.when dealing with not very educated population, added to that fact they are elderly and not able to truely focus in on there main complaints what do you do.

I want to discuss this with my Director but before I do I would like some feed back from Triage Nurses who do this work

Thanks for your time

Angela

[eltrip]

Angelique777,

I wish I could answer your question. Unfortunately, I cannot. Telephone triage does not involve face-to-face patient contact. We use protocols and assist the patient over the telephone to find the appropriate level of care.

Perhaps your question would be better answered by ED nurses who do hands-on patient triage.

all the best,

eltrip