Stepford Wife Triage Nursing

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Specializes in ER, Psych, Telephone Triage.

I am not a Robot yet they are so convinced of fool proof protocols that they strongly pressure you not to ask your own questions relevant or not. Now I on the other hand always ask questions that are relevant to Pt. care. I am not a Stepford Wife or Robot.

If a Pt. tells me he has a sore throat and that he just went to the Doctor today. I am not supposed to ask what the Dx was. I want to know if it was a Peri tonsilar abscess or Strep I wanna know how bad he was before and after treatment by the Doctor and

We are getting so automated! The protocols even give us the "Recomended Disposition" Which I will frequently upgrade or downgrade as I see fit based on my own clinical judgement. There is no reason we should not be able to ask any question that we feel is relevant.

How do the rest of you Triage Nurses feel about this issue?

Mike

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Specializes in LTC, Disease Management, smoking Cessati.

This one I have to agree with, our quality people act like we should sit there and just spout the protocol information without adding that human touch. I refuse to be that robot and ask a lot of questions, sometimes you find out what is really going especially behind some of the vague symptoms. If it was about reading the protocol without variance why would they need RN's in the first place!

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Specializes in PICU, NICU, L&D, Public Health, Hospice.

Agree with you Mike...it is one thing to provide guidelines for triaging telephone calls, it is quite another to presume to micromanage the interview of the patient by the nursing professional.

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Specializes in ER, Psych, Telephone Triage.

believe in the protocol

and we are told that "there is no need to ask your own questions because the protocols will led you to the correct disposition"

morpheus offers neo two pills. the red pill will answer the question "what is the matrix?" (by removing him from it) and the blue pill simply for life to carry on as before. as neo reaches for the red pill morpheus warns neo "remember, all i'm offering is the truth. nothing more."

http://www.arrod.co.uk/essays/matrix.php

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Specializes in Nephrology, Cardiology, ER, ICU.

And don't forget scripting: "I have the time."

lol

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I think that is nuts. So if the patient went in and was dx with strep and on abx for only a day, if you don't know that, you just send them right back in? I am so glad our protocol isn't like that. That is nuts. We even have a "failure on abx" protocol, so if they call b/c they aren't getting better, we can go to that protocol and say "has it been 72 hours? etc."

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Specializes in ER, Psych, Telephone Triage.

response to ruthiegal

it is a shame though that administration does not support that type of think outside the box critical thinking! " just trust the protocol is the response". "asking your own questions will slow you down"

what the hell do they think we are factory workers on an assembly line? traffic cops at the end of the month with a quota to fill on how many tickets we give out?

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Specializes in L&D, ER, PACU.

This practice is incensing! The practice of protocols is also imposed on physicians. We are all in the same boat. Never let a protocol interfere with logic, critical thinking or a "good gut instinct".

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Specializes in ER, Psych, Telephone Triage.

I always add questions which I feel are appropriate to determine the acuity of my Patien. I have even been advised not to ask what the diagnosis was of the pt. Example-I went to the Doctor today for a sore throat, runny nose and earache and he put me on medication. So I asked and what did the doctor diagnose you with? Strep throat. I would like to know what I am dealing with. Wht the hell is wrong with asking what the result of their Doctor visit was?

This is ********!

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Specializes in PICU, NICU, L&D, Public Health, Hospice.

Mike, my guess is that they don't want you to have some preconceived notion of what their problem is...still stupid.

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Specializes in ER, Psych, Telephone Triage.

Our final disposition is based on present complaint but I think we should also take into account scenario of onset, recent medical treatment, past hx-But the program will take care of all of that!

I guess I am to used to good concise and relavent Hx taking as a former Paramedic and long time Ex ER Nurse

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Specializes in OB, Telephone Triage, Chart Review/Code.

Mike, I agree with you. Protocols are guidelines, but some companies use them as carved in stone. I have to use a book of protocols and have to document which one I used (sometimes, I've had to use 3 depending on the sx) but have been told to use nursing judgement but then be counseled because I did not use the "recommendation" in the book....geez! If they want cut and dry answers, them mail everyone a book and let them come to their own "recommendation" and they won't have to call a Nurse anymore!

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