Here are some of my rules. Feel free to add your own.
When I ask you what brings you in today, please don't tell me your life story. I just need to know what symptoms you are having Right. This. Minute. that are concerning enough to bring you to the ER.
Please be ready for me to take your VS. I know it's starting to get a little nippy outside, but when I have to wait for you to take off your three sweaters and overcoat before I can take your BP, it really bogs things down. You did know you were going to have your BP taken, right?
If you tell me that you've been having your symptoms for over a year, please know that your acuity level will be downgraded accordingly.
If you have multiple complaints, pick one.
Don't ask me how long the wait will be. The nature of ER flow is unpredictable. If I tell you an hour and it turns into two, you're going to be grumpy and take it out on me. Also, on a related note, don't ask me where you are "in line". That's not how it works.
Don't tell me you have an appointment/have to be at work/have to pick up the kids in a specified amount of time, as if I'm going to whisk you right back and get the doctor in the room right away just so you can make it to your thing-you-have-to-do. That's not my priority or my problem.
When you come in for a stuffy nose and have to wait, please don't stand in my line of sight and give me the stink eye while I triage another patient. I did not drag you in off the street to come in here for your stuffy nose. You do know what the word "Emergency" means, right?
Sincerely,
Spending Too Much Time In Triage, Somewhere In The USA
I get the humour here and being a triage nurse can be a nightmare. However, working with a bad triage nurse can also be a nightmare. Sometimes triage nurses just get too jaded and leave a mess for the rest of the of the department. I have experienced some shocking triage nurses who have missed some really serious issues because they were just a bit too jaded. It is no easy job to escalate the care of a patient who has not properly triaged... just saying.
My official rule is when you are a triage level 4 or 5, each time you come to ask me about the wait I add 1 hour. After the 4th trip it becomes "I don't know." I work in an ER seeing 300+ patients a day, wait times generally 4-6 hours so it is not hard to do.
I get the humour here and being a triage nurse can be a nightmare. However, working with a bad triage nurse can also be a nightmare. Sometimes triage nurses just get too jaded and leave a mess for the rest of the of the department. I have experienced some shocking triage nurses who have missed some really serious issues because they were just a bit too jaded. It is no easy job to escalate the care of a patient who has not properly triaged... just saying.
I tend to triage up if I'm on the fence about someone's acuity.
I've seen some pretty bad triaging, too, and I won't hesitate to change the acuity level if I feel it's appropriate.
But, that's not the topic of this thread. Do you have any of your own rules you'd like to share?
I did have a twofer that counted, the toddler was okay but the infant was admitted with severe RSV.
Don't complain and put down the daughter/son that has been catering to your multiple needs, and brought you in for care. Tell me why you made them come out in the middle of the night, yet again.
I had a twofer a while back that while the original two were BS, one of the many children that were brought along ended up being admitted. I was bringing another warm blanket or some such into the room, and noticed the kid was working to breath a little, ended up being a fairly nasty pneumonia.
If you stopped en route for coffee, or fast food, clearly you don't think it's an emergency. I am going to have to agree.
Ha! That is the best when they get done triage and they tell me that they are going to "run across the street to Del Taco" and to make sure they don't lose their place. Aaaaannd you just went from an ESI 3 to a 4, and documentation as to why.
If I recognize your name, you are gonna wait a little longer. Sorry but I know you, I know why you are here, we have other people here that are probably, doubtful but probably more sick than you are.
Sassy5d
558 Posts
I'll take all the fluffy cc.. Just eliminate the dramatic pts who come to the window and act like they are dying so I get them back quick.
I have yet to master the 'art' of really sick vs dramatic