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.
I can only tolerate triage in minute doses. I hate being screamed at..."Someone could die out here before they get taken care of!" while I'm holding pressure on an arterial bleed, trying to manuver the wheelchair to the back with my other hand and left big toe.
"Okay, ma'am, what are you here for?"
"A toothache."
Puhhhlease!!
I'm sure I managed an eye roll that was too obvious. I get in trouble in triage too much. I don't like it. I used to get stuck there every weekend because I did a 9a-9p shift. I would do 9-3 in triage and then come to the back and get stuck in code for 6 hours. :scrm:
Every time I go to work I work in triage. Why? Cause I asked to be put out here by myself for the most part, permenantly. I have rheumatoid arthritis and ankylosing spodylitis so it's musch easier for me to wsit on my can than run my feet off like all ER nurses do. Sometimes I still miss it, I haven't stuck a person in more than 2 years. For the most part I enjoy my job, I am good at it and most times I never get behind because I will go and get the patients before registration has them registered. We have a nurse who works nights who likes to triage but I can see 4 proplr in the time it takes her to do one patient. I don't like confrontation at all, I try to avoid it but if someone is in my face, I'm calling security and letting them deal with it!
We have a pretty nice setup for triage. #1 RN takes the complaint, then the #2 RN takes the patients back to one of 3 triage rooms and does a triage assessment and vitals( along with a tech). If, based on the #2's assmt., vitals, ect., the patient needs to be urgently seen, a room is assigned. Otherwise, the patients go back to the triage waiting room until an appropriate bed opens up. When we get the complainers, as all ERs do, we tell them that when an appropriate bed opens up they'll beable to go back. There is no reason people can't wait in triage, for hours if "they" choose. Many of those patients shouldn't be there anyway. I do not have a problem telling someone they have to wait if there is not a bed open. If they "walked" into triage and they are breathing with a pulse....they can wait. This mentality that people think a cold, a wart, std, pregnancy check, ect. is an emergency is for the birds. Our management doesn't like seeing people waiting to come back but too bad.....it's an emergency room....not a drive through McDonalds. ("Would you like some fries with those narcotics sir?" )
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!!!
I love triage!! I sometimes consider it to be the equivalent of the Walmart greeter of the ED!! HAha! I just don't let people get to me. I can be a real passive aggressive b!t(h if you know what I mean. And I am sorry, I never bump people up because they are complaining unless they truly need to be. I think that sets a precedent of the squeeky wheel gets the grease and I don't want to model that for the other people in the waiting room.
I just try to explain why they have to wait in a nice way. But I also feel that I have a good back-up in our ED. Security will not tolerate any violence, verbal or otherwise. And if it comes down to it. A MD will see them and rule out an emergency and then their butt gets kicked out. We hardly ever have that problem.
Specializes in ER, ICU, Infusion, peds, informatics.
i'm another weirdo that liked to work in triage.
i no longer work er, and sometimes find myself missing triage.
i liked sitting in the little room by myself. i liked that my contact was brief, and i was able to send the patient off to another nurse. i liked trying to figure out what was wrong with the patient based off my initial assessment.
of course, i wasn't all that fond of getting yelled at, threatened, argued with and harrassed.
my saving grace was trying to find the humor in the situation. like many nurses, i have a very dry, sometimes-inappropriate sense of humor.
in my own little mind, i would give out different "awards" to my patients (or their family members) each night. i tried to see the humor in the often-manufactured drama.
all that said, triage certainly isn't for every nurse.
I hope this makes you feel better, it certainly helped me...
Working triage with a few people waiting to be seen, one of which is a lady with back pain. At this time a gentleman comes to the window c/o chest pain. He fits the profile, looks a little crappy, so he comes in for immediate triage and bed placement. Well, the little lady's family did not like that one bit so she approached the window to remind us that her cousin was here first and she is hurting and "don't we care at all that she is in pain?" THe other nurse replies with our standard "patients are not seen first come, blah, blah, blah...". She still doesn't get it, her cousin is really hurting, you see. When all of a sudden, the man's daughter yells at her "SIT DOWN AND SHUT UP!! SHE IS TAKING CARE OF HIM, CAN'T YOU SEE THAT!??" Needless to say, we bought her lunch that day (after her father went to the cath lab for a couple of stents, of course). :yeah:
Occasionally, all we have to do is sit back and watch the fun. I love when that happens!
Specializes in ER/Nuero/PHN/LTC/Skilled/Alzheimer's.
Where I work we switch assignments since our staff comes in staggered. We are in triage no more than three hours, though I'm 33 wks along and sometimes will take two triage assignments so I'm not running around too much on my feet.
My approach is to be as polite as I can possibly be at that moment and remind the person that we can't get everyone back in the number of their arrival but we will get them back as soon as possible. If that doesn't work (and believe it or not I've had people threaten me and my baby)I pull the biggest meanest looking male nurse into triage with me and we wait together while the security shows up.
My thought is that I can't change how they react (though I wish I could) to us, but I can change how I react to them. If I take off yelling back at the patient then I look just as stupid as they do. Most people understand but some don't and that's fine with me. Besides, only thirty or forty more years and I get to retire!!!
Somehow I get the feeling that if Florence Nightingale was working in triage today, she would spend the entire shift with smoke boiling out of her ears, and would probably be swearing like a sailor.
soapaddictOH
33 Posts
I can only tolerate triage in minute doses. I hate being screamed at..."Someone could die out here before they get taken care of!" while I'm holding pressure on an arterial bleed, trying to manuver the wheelchair to the back with my other hand and left big toe.
"Okay, ma'am, what are you here for?"
"A toothache."
Puhhhlease!!
I'm sure I managed an eye roll that was too obvious. I get in trouble in triage too much. I don't like it. I used to get stuck there every weekend because I did a 9a-9p shift. I would do 9-3 in triage and then come to the back and get stuck in code for 6 hours. :scrm: