Should all EDs have a Triage Nurse?

[ED RN]

I’ve work in the ED for almost 2 1/2 years now. They did away with our triage nurse when Covid first started and census was down d/t patients being afraid to come to the hospital. Census is back up to normal now, and they’re expecting our charge nurses to do triage as well. It’s leading to patient harm, and administration is still refusing to give us back a triage nurse. We’re also cardiac certified, and some patients are having to wait forever to even see a nurse and some just leave. We have no way to monitor the waiting rooms with any medical staff. Registration are the only ones out there. I’m not OK with putting my patients safety at risk nor am I OK with putting my license on the line over something I have no control over. Are any other EDs doing this? It just blows my mind. 

[speedynurse, ADN, BSN, RN, EMT-P]

Sometimes free standing ERs don’t have triage nurses. However, when I was in a regular ER, we generally had a triage nurse (except when short staffed or too high acuity patients). In general, I think a dedicated triage nurse is needed especially when there is a significant waiting period.

[melissakp]

We are required to have a triage RN 24/7.  Even if we are short handed in the back, if there are pts in the waiting room the triage nurse must remain up front.

[bitter_betsy, BSN]

So I literally came here to post this question also. We have a registration person - usually a tech - but not a triage nurse.  To make matters worse - sometimes we only have 3 nurses on at night period - and we are a trauma hospital.  Sometimes 3 nurses is enough - and sometimes its not. I guess the answer to our question is NO - we don't have to have a triage nurse.

[azhiker96, BSN, RN]

I think all ERs should have a triage RN. When I work triage we occasionally have bypassed registration or sent a family member there while taking a pt to critical care. Most times we get an initial set of vitals but if they look sick enough we even bypass that step. 

[ApplePineApple]

Perfect world? Yes. Realistically? How is the ER staffed? 

[Goodneighbor52]

My understanding is that there needs to be a nurse who can see all of the patients in the waiting room at all times based on joint commission requirements. Thus, if there are no registered patients in the ER, no RN is needed but if there are registered patients in the waiting room, a nurse must be present to monitor them. I am sure that you guys can recall all of the incidences where patients collapsed in the waiting room? That’s the thought process behind keeping an RN in the waiting room. :-)