I wanted to see if you guys use techs for triaging patients. I was working in triage last weekend and came back from a bathroom break to find a tech triaging patients. She was marking the man as non-urgent and writting a note about him. I asked her to stop thinking this was something a nurse should do. I asked one of the other RNs in the department and she said they are allowed to do this sometimes.
"In a hospital providing basic emergency medical services or comprehensive emergency medical services, the licensed nurse-to-patient ratio in an emergency department shall be 1:4 or fewer at all times that patients are receiving treatment. There shall be no fewer than two licensed nurses physically present in the emergency department when a patient is present.
At least one of the licensed nurses shall be a registered nurse assigned to triage patients. The registered nurse assigned to triage patients shall be immediately available at all times to triage patients when they arrive in the emergency department. When there are no patients needing triage, the registered nurse may assist by performing other nursing tasks. The registered nurse assigned to triage patients shall not be counted in the licensed nurse-to-patient ratio.
Hospitals designated by the Local Emergency Medical Services (LEMS) Agency as a "base hospital", as defined in section 1797.58 of the Health and Safety Code, shall have either a licensed physician or a registered nurse on duty to respond to the base radio 24 hours each day. When the duty of base radio responder is assigned to a registered nurse, that registered nurse may assist by performing other nursing tasks when not responding to radio calls, but shall be immediately available to respond to requests for medical direction on the base radio. The registered nurse assigned as base radio responder shall not be counted in the licensed nurse-to-patient ratios.
When licensed nursing staff are attending critical care patients in the emergency department, the licensed nurse-to-patient ratio shall be 1:2 or fewer critical care patients at all times. A patient in the emergency department shall be considered a critical care patient when the patient meets the criteria for admission to a critical care service area within the hospital.
Only registered nurses shall be assigned to critical trauma patients in the emergency department, and a minimum registered nurse-to-critical trauma patient ratio of 1:1 shall be maintained at all times. A critical trauma patient is a patient who has injuries to an anatomic area that : (1) require life saving interventions, or (2) in conjunction with unstable vital signs, pose an immediate threat to life or limb. "
Posted by mommatrauma: "I think it was a punctuation error...ie "I asked her to stop, (insert comma) thinking this was something a nurse should do."
I don't think it was meant that only nurses should think.."
That does sound better.
However, believe it or not, about 6 months ago we got a new ED Clinical Educator, she actually said to one of our ED Techs/ Paramedics " Techs are not to think. They are only to do what the nurse tells them."...?!?
Thats why I asked. The OP made me afraid I was seeing a trend.
They won't even let medics do it here at our hospital, unless an RN co-signs it.
With the shortage, they even went as far as hiring PA-C's, which was not totally thought out.
Apparently the PA cannot take direction from nursing, which is what they were hired under. They must take direction from a physician in Ohio. However, the ER physicians are a contracted out group and won't take responsibility. The PA was not an employee of the group.
Our hospital must be extra tiny (probably 12 med surg beds). We have three regular beds, a gyne room and two trauma rooms. One nurse and one tech staff during regular hours, then just one nurse from midnight till about 10:00 am. There is some exception on weekends when we staff a 1 to 1 additional nurse. We have a 15 minute rule about triage. You would have to see our triage area to understand that unless I am in a trauma room I can often hear the triage being performed....so feel comfortable having my tech perform it if needed as long as they come and tell me what they have. If I (we) didn't do this some patients would never get triaged until the trauma/critical patient was stable/shipped/admitted, ect. I figure they could staff us a little better if they object to this.... oh yeah, our techs are mostly paramedics.
z's playa
2,056 Posts
Goes to show how crucial a comma is. :chuckle
Z