TeresaEDRN06

I simply say that I am trained to know who is sicker- that's my job. That's it. I don't get into a big discussion because of what was stated above- the more you try to rationalize, the more people will argue. Teresa

NickB...you go to an ED, refuse the MD's plan of care...refuse an LP, tell them which meds you DON'T and DO want, and leave. Go to another ED and do the same thing. What did you expect? I don't get why you are so upset. I wouldn't walk into a law firm and tell the lawyers how to do their job. I have no idea what lawyers do...just please do your job if I need you! If you walk into an ED, let them do their job, as well. Those who work in an ED know that for every "typical" presentation of meningitis (and every other disease), there are 5 atypical. Knowing that makes ED people effective nurses and doctors. You should have let them do their job. Simple. Teresa

I just said this same thing in a similar post...many people do not have the capacity to look beyond themselves. It is an EMERGENCY ROOM!!! There are emergencies. And those emergencies do NOT include food, pillows, or coke instead of the apple juice we gave her. Seriously.

Thanks for the replies. Yes, we have ANI's...Advanced Nursing Interventions. These ANI's allow the triage nurse to initiate labs, urine, a few CT scans, and a few meds on a variety of symptoms. (chest pain, renal colic, head injury, pneumonia, upper and lower abdominal pain, etc...) What we see happening is if I order an abdominal pain ANI, labs may not be drawn for 3 or 4 hours later. I am not sure why. We are working on that, also. That defeats the purpose of ordering an ANI. Our triage process has gone through alot of changes over the past couple of years. We are doing a quick triage now and sending pts straight back if there are open rooms. The problem lies with when our wr times increase. Do you guys have a process when you triage a pt and know you will draw their labs in triage? We are presently trying to come up with a solution to that process. Thank you! Teresa

Hi guys, My ed is trying to restructure drawing labs in triage...specifically, we are trying to expedite lab times...How does your ed make sure labs are drawn in a timely fashion? Thanks in advance! Teresa

My ED uses T-system. It's super easy and user friendly. Love it!

I have cried with patients families, too, in certain heartbreaking situations. However, let me tell you, in regards to what Stargazer is saying, those whiney people make me sick. They have no clue. None. Those are the heartless people who truly can't look beyond their own world, even if someone else's is ending right in front of them.

edited because I responded to the wrong thread! lol I am usually very honest..." ER's go by the acuity of the patient, not how long you've been waiting. The people who are trying to die get seen first." I sometimes will add, "I am not saying you do NOT need to be seen...it's just there are some patients who must be seen quickly/first because of how sick they are." I also get that some people will never be happy no matter what. I'm ok with that.

Wow!!! That is smokin fast!! I triage super fast, but you blew me right out of the water! Teresa

What's an SVE?

You absolutely did the right thing.

Thanks, everyone. I appreciate your replies! Crux1024, your links are very helpful and answered my questions clearly...thank you. Teresa

I have a question for you guys. In our ED, when a pt comes in to be seen, they'll fill out a slip and have a seat in our waiting room. The registration person will put them into our system and their name will come up as a new pt. At that time, the triage nurse will see this new pt and call their name into the waiting room for triage. Is this a HIPPA violation? Does anyone do anything different? Thanks in advance for your input! :nurse:Teresa

Thanks so much guys! Your responses are so helpful. One more question. At what point do you take the initial vital signs? When they first walk in? When they sit with the triage nurse? (even if that's an hour or more later?) Thank you!!! Teresa:heartbeat

Thanks! These posts are so helpful! I really like the triage plus idea.

I have several questions. The hospital I work in, an 80 bed ED, is having some triage difficulties. We use the ESI system. The problem is, we get VERY backed up in triage. Sometimes we have people waiting 2 to 4 hours just to be triaged. It's very scary. How long is your average wait time. How big is your ED? How do you guys staff the triage team? Do you start lines and draw labs before going back into the treatment rooms? How long does the average pt wait to be triaged? Thanks in advance! Teresa

lol. That's funny.

It's in FL. We actually just opened up Sunday night. We went from a 44 bed ed (not including peds) to this huge one. The ratio is 4 to 1 for the nurses, except out trauma/critical care rooms where it's 2 to 1. Each pod contains 20 beds, 5 nurses, 2 techs, a resource nurse, and a transporter. The doc situation is still getting put together. The last 2 nights there have been with 4 to 6 docs, depending on the census. Last night we had 2 docs after 4 am. How does this compare with your ed? I looked up Parkland in TX. They see almost 400 pts per day! Unreal!

Wow! That's a busy ED. We were wondering about the largest. We work in a 104 bed ed (including 20 peds beds) Thanks for the fast reply. Thanks!

My boyfriend and I were having a discussion and we were wondering what the largest ED is in the US. Thanks! Teresa:nurse:

That is awesome! I took my test in June 2006 so I remember that horrible panic very well. Good for you!

I was drawing labs on a 30-something year old. As I attached the tubes to fill them, he was watching. He looked up and said to me, "How are you going to put that back?" I said, "Put what back?" "My blood." Huh?

I just wanted to add that in our ED, we make sure the pt is on a monitor, since it can lower blood pressure. We infuse it using a pump, as well.

I would stay home and study, no question. While I was studying for boards, I looked at it as my full time job. Good luck!

I am so sorry for that baby, too. Someone said that God spared him. I believe that, too. What a tough experience for you, too. I had my first OB experience in the ER about a month ago. 18 weeks. So tragic.