Tolerance wearing thin in Triage,Help!

[concededrn]

Ok, this will be my first official rant. It maybe a common on, but here is mine. Any input would be greatly appreciated.

I do triage about 75% of the time since taking the 10am-10pm position a few months ago. Since we are in "peak season" I am finding more and more people are getting "In my face", saying pretty rude things,being argumentative, causing a scene in the waiting area,pacing infront of the triage door,interrupting someone elses triage,etc.

I feel I do a pretty good job doing triage, thus that is why they put me out there. I have saved some people with my rapid assessments. If I get more than 5 triage sheets I stop my triage and go and meet every new person that comes in and "Eye ball them". They really have to "impress me", so to speak. I feel and heve been told that I'm a "good nurse", "(name removed) I'm so glad you're here!"-when there is a code blue) or help another nurse figure a patient out that is circling the drain.

For the most part I have kept my cool. But in the last 2 days my "passive-aggressiveness" has come out.

I have a motto of "you will not yell at me,period!". I take that seriously. I have zero tolerance for that sort of thing. Funny that the first thing I say- tends to aggreviate the patient even more, than they turn around and say "He was rude".

There is no known sign that I can think of that says "feel free to yell at the nurse" that is outside my door.

If you have ever triaged , PLEASE let me in on the secret to your success. Been with the same hospital for 5 1/2 yrs. I have always worked nights and did a pretty good job. This new role can seriously jeapordize my career at this facility.

I told my charge nurse to "get me out of triage!" She promised to give me an ER position instead.

Please help!

[canoehead, BSN, RN]

You deserve a break from triage. Sometimes the milk of human kindness wears thin.

I advise just sitting and listening to the yelling, and invite them to sit down because the sickest people get seen first. Say it repeatedly, with no change in inflection, and eventually people give up and go away.

[jessiern, BSN, RN]

You deserve a break from triage. Sometimes the milk of human kindness wears thin.

I advise just sitting and listening to the yelling, and invite them to sit down because the sickest people get seen first. Say it repeatedly, with no change in inflection, and eventually people give up and go away.

Or the police will show up to escort them awayin some cases....

[time4meRN]

you need a brake from triage. it really get tough. i'm with you i'm sooo sick of being yelled at , racial statements etc... etc... etc... you know the story. i don't put up with it i, call security or city police. but if i do that i document out the wazooo. it amazes me , if they were at mcdonalds their butt would be out the door...never to return there again. but oh noooo..... not with us. admin thinks we should just sit there and take it. i went to a "coustomer service" class a few weeks ago. i was sitting beside the nusring admin. they were talking about how we should approach rude clients. of course the people teaching the course wern't nurses. so, i raised my hand they smiled and yes, i said and so what does the company say my response should be when a pt comes within 2 feet of my face and yells at me "you fu**^%g bih", throws papers in my face and leaves, because other people went back before them ( you know the tooth pain that is allergic to ultram, naprosyn,motrin and just plain tylenol upsets their stomach). the nice ladies said , well now that would be inapropritate of a pt. ha ha ha.........pretty approprate in my world of triage. just thought you might like a laugh.

[Blee O'Myacin, BSN, RN]

Ok, this will be my first official rant. It maybe a common on, but here is mine. Any input would be greatly appreciated.

I do triage about 75% of the time since taking the 10am-10pm position a few months ago. Since we are in "peak season" I am finding more and more people are getting "In my face", saying pretty rude things,being argumentative, causing a scene in the waiting area,pacing infront of the triage door,interrupting someone elses triage,etc.

I feel I do a pretty good job doing triage, thus that is why they put me out there. I have saved some people with my rapid assessments. If I get more than 5 triage sheets I stop my triage and go and meet every new person that comes in and "Eye ball them". They really have to "impress me", so to speak. I feel and heve been told that I'm a "good nurse", "(name removed) I'm so glad you're here!"-when there is a code blue) or help another nurse figure a patient out that is circling the drain.

For the most part I have kept my cool. But in the last 2 days my "passive-aggressiveness" has come out.

I have a motto of "you will not yell at me,period!". I take that seriously. I have zero tolerance for that sort of thing. Funny that the first thing I say- tends to aggreviate the patient even more, than they turn around and say "He was rude".

There is no known sign that I can think of that says "feel free to yell at the nurse" that is outside my door.

If you have ever triaged , PLEASE let me in on the secret to your success. Been with the same hospital for 5 1/2 yrs. I have always worked nights and did a pretty good job. This new role can seriously jeapordize my career at this facility.

I told my charge nurse to "get me out of triage!" She promised to give me an ER position instead.

Please help!

First of all, telling someone not to yell at you is not passive aggressive. I tell people not to yell at me, or grab at my arm while I am starting their IV or hit me. Even a "please don't yell at me, I am doing *something* to help you."

There is no reason why nursing has to equal doormat. Document in the triage note that patient (or family member) was yelling at you in the exam room and you asked them to stop.

Other people also need to take a turn because IMO, triage is way more stressful than charge even.

((Hugs)) & keep standing up for yourself, because no one will do it for you!

Blee

[concededrn]

racial comments. I don't really get the comments but I do get looks. No one wants a spanish person telling them they are not that sick to comeback. "our beds are full, the hallbeds are full, if an empty bed opens up it's you're! Til then you have to wait in the waiting area". That upsets people.

Yesterday, here is the scenario.

Lady comes in s/p jaw procedure. Lido wearing off. She's hysterical moaning, pacing. 3 people infront of her. After a few minutes she is irrate. I "eye ball" her and talk to her. Script for pain med not filled yet. This could have solved the problem. Instead she called her md, and he turfed her to the ER. She yelled at me "I can't believe you're not going to bring me back!". I stopped the triage of the other person. Yeah I was ticked! "ok, come here (as I opened the ER doors) ..Come here, pointing to the floor,...(we walk to the gurney that JUST OPENED UP. slapped the bed, "this is your bed, (name removed) this is your nurse, (name removed) will triage you,now you're back here". Her reply "you are so rude (I mine yelling it to me). I turned around, my reply "how am I rude? I bumped you infront of 3 people". Her reply "It's not what you said , it's not you, it's what you are doing". (name removed) looked at me and told me to "walk away". I walked back outside to the w/a and told the family "she's back there now". I get a "thank you" from him. I walk up to the chrage nurse and tell her "That's it! I'm over it, I'm going outside!!!!".

Point is, we can only do what we can. The script should have been filled right after the procedure, the md should not have turfed her to us. Now I might be in trouble for the way I acted. Again passive-aggressive. I'm human too!

As you can tell, I'm upset about it as well. The governing bodies who are not nurses always tell us what to do, how to act. Have they been in my shoes? Nope!

They're surrounded by 4 walls and a door and have the luxury of having a secretary keep the "visitor they have an appointment with at bay!" Not in the ER.

[Altra, BSN, RN]

Everyone needs a break from triage, and you are past due.

I'm a firm believer in no more than 8 hours in triage at a time, preferably no more than 4. Rotate qualified triage nurses in & out to break things up, keep people fresh, and prevent the point-of-no-return to bad mojo that sets in after the 38th person (A&Ox4,VSS,no obvious distress) yells, "THIS IS UNBELIEVABLE THAT I HAVE TO SIT HERE LIKE THIS."

[Altra, BSN, RN]

i went to a "customer service" class a few weeks ago. i was sitting beside the nusring admin. they were talking about how we should approach rude clients. of course the people teaching the course wern't nurses. so, i raised my hand they smiled and yes, i said and so what does the company say my response should be when a pt comes within 2 feet of my face and yells at me "you fu**^%g bih", throws papers in my face and leaves, because other people went back before them ( you know the tooth pain that is allergic to ultram, naprosyn,motrin and just plain tylenol upsets their stomach). the nice ladies said , well now that would be inapropritate of a pt. ha ha ha.........pretty approprate in my world of triage. just thought you might like a laugh.

this reminds me of an ems blog i sometimes read. an experienced paramedic crew chief related a similar story about having to attend a customer relations inservice. after listening to the spiel he asked the consultant teaching the class, "has anyone ever called you a big fat white (expletive)? how would that make you feel?" the instructor had no reply. the paramedic continued, "how would you feel if someone said that 6 inches from your face 4 times?"

[concededrn]

Everyone needs a break from triage, and you are past due.

I'm a firm believer in no more than 8 hours in triage at a time, preferably no more than 4. Rotate qualified triage nurses in & out to break things up, keep people fresh, and prevent the point-of-no-return to bad mojo that sets in after the 38th person (A&Ox4,VSS,no obvious distress) yells, "THIS IS UNBELIEVABLE THAT I HAVE TO SIT HERE LIKE THIS."

Yeah. One of the chrge nurses I work with , when she comes in at 1900, she gives me 15 min of freedom from triage. I already worked 9 hrs in triage. I appreciate that greatly!

One thing I have noticed that there are two types that complain alot. The wealthy and the poor. The wealthy think they are entitled to be moved up in front of the line. "my doctor told me to come in!" I always point out, "sir/mam, they will always tell you to come in, it's a liability not to!"

The poor b/c they are unfortunately too ignorant and poor to get the help they need before the problem gets out of hand. They have no social grace and fighting and agruing are part of their social structure. Mainly due to being uneducated. Hard workers yes, I will not take that away from them. But uneducated.

Thanks for the "cheering me up"!

I want this to be a vent/rant w/o the hatred theme. I just need to vent and know that I am not alone!

[scattycarrot, BSN, RN]

I think you should be proud of the fact that you have handled being in triage for so long without becoming 'intolerant'. That says alot about your character. The fact that your tolerance is wearing thin now is only natural and most people will have cracked a while back! As every one else says..you need a break! Talk to your charge nurse and be honest. Tell her you are in danger of losing it out there and need some time away.

[AfloydRN, BSN, RN]

The good news is... you get to go home at the end of the day.... We Thanks God- hire RN's who actually LIKE triage. I am SO glad for that. I don't mind it once in a while but it does get super old really fast. Just take a breath and think of all the crazy stories you'll have to tell your kids!!!

[Spidey's mom, ADN, BSN, RN]

I agree - you need out of Triage for awhile . . . where I worked, a different person did Triage each shift. There wasn't a "Triage Nurse". We all took turns.

I wish you peace and quiet. . . .

steph