Nurses in Admitting Office

[sweetie01]

I am a Case Manager in Bed Management. Initially our role was to Interqual direct admits to determine if the patient meets Inpatient or Observation criteria. We then make recommend what unit the patient should go to. The bed specialist then gets the bed.

Our role has also expaned into what I consider Triage. When patients come in for admission we often do not have a bed available immediately. Patients often wait over an hour for a bed. If 3 patient are waiting on the only available bed, we determine who gets it first, based on diagnosis, orders, assessment. Our Manager expects us to assess the patients. She has even provided us with a BP cuff, thermometer, and pulse ox.

We have been told that we are NOT a treatment area & we can't treat patients. We have been told that if a patient is in distress, we need to get them to a bed immediately ( if appropriate) or send to ER. The problem is that when we do send symptomatic patients to the ER, our manager does not support us. Also, none of us are trained in triage. We have explained our concerns to the manager with no results.

Even if someone has normal VS and pulse ox of 98%, but is complaining of SOB, i feel they do not need to be sitting in the admitting office waiting for a bed. I can't do anything for them. They need to go to ER or room, as far as I'm concerned. Now maybe if I had been trained as a triage nurse, I would be more comfortable with this, I don't know. What are we supposed to do with these patients?

Questions:

#1- Is this triage? ( I belive it is)

#2- Am I assuming care of the patient when I assess them or even ask are you having chest pain, etc...? (I believe I am)

#3- What is my liability?

Thank you! Sweetie01