triage

SmilingBluEyes · Jul 15, 2003

we ARE the triage unit...LDRP..we triage and admit our own. I suspect the units that have separate traige units are in the LARGER hospitals, not the ones like mine where only 70-75 deliveries occur per month.

wsiab · Jul 16, 2003

We have an 8 bed triage unit staffed with 2 nurses. It works great, the goal is to get an NST and assessment in 20-30 minutes. Women that get sent home are usually there from under 1 hour to 3 hours. For long term observation we will put them in a room based on availability. Women who get admitted are can spend 5 minutes to a few hours there depending on why they are admitted. Of course the clerks and charge nurses are very good about wheeling anyone who has that look (you know, like she is going to pop out a baby on the floor before she can manage to say her name) directly back to a room and getting help.

layna · Jul 18, 2003

We triage our own labor patients as well. The only problem we have is with patients walking directly up to OB needing an evaluation. There are times when the two RN's on are in the delivery room while this patient is waiting. I would like all pregnant patients to see the ER triage nurse first before coming up to OB so that we receive a call and can attend to a patient right away without making her wait. The other thing this would eliminate are pregnant women in need of ER care verses OB care. There are times when patients experiencing exacerbation of asthma etc. are sent to us just because they are pregnant.

Our pregnant patients in need of an OB eval are usually with us anywhere from one to six hours depending on what is going on. After that, the doc has to decide if the patient should be made a 23 hour admit or if she should be fully admitted.

greyhorse · Jul 22, 2003

We triage our own as well. ER is expected to send anyone to OB that presents at 16wks gestation or greater. Most patients present directly to L&D. Doctors made the 16 week rule because our ER was sending anyone that said they were pregnant to OB. Doctors didn't like seeing someone that had missed one period and had the flu :-) as what they needed wasn't an OB/Gyn!

Greyhorse

acuteobrn · Jul 27, 2003

hey all thanks for the responces!

my understanding is alike wsiab's, true triage...i am orienting in a unit that has a triage unit set up, but it is the first time they are using it so they didn't hire extra staff to cover it and allow for adequate coverage for the LDRs. so it has become a sore point for many, including the techs and secretary. not to mention the triage nurse must assess all patients regardless of the look and the positive wheel chair sign flooding the floor. so there has already been a delivery and many near misses in this four bed unit. not to mention that they are holding pts d/t lack of LDRs and RNs to care for these patients...ugh very frustrating. anyways i do enjoy the unit b/c i was getting 5-8 admits in a day, we were responsible for the entire assessment, starting the IV and getting labs done. so good learning experience in that respect. again thanks for the responces

acuteobrn · Jul 27, 2003

ok all, it must seem to you all that i am a habitual complainer/b*tcher, but it is good to get it out of your system right so for those of you all not in the mood...don't read on;)

anyways i am so increadibly frustrated right now i almost don't care if i pass my boards on monday. i really enjoy nursing and really love and have a passion for labor and delivery but i am finding it hard to make a good fit. my orientation has been scattered. one day i am observing no hands on next day i have 8 admits, totally on my own, with a very experienced nurse who trusts me, i refer back to her ask questions, chart and re chart trying to get it right, accurate and defensable. next day have one patient, no one to really bounce questions off of, next day doing a delivery, next day observing, ugh you see where i am going. i was with a great nurse who progressively had me advancing in my responsiblity, gave great advice was always there when i had a question and was extreemly supportive until yesturday, when she was in a bad mood and wouldn't let me do squat except start an iv and finish a recovery and argued over the post partum bleeding, which i really wan't trying to argue, just gut instinct said it was a little too much too many little clots, wouldn't let me notify the md, and ends up notifying him herself latr on...so she gets a new patient and i get nothing. um this is around 11 am so i have 4 hours to go, covered for her lunch, then was ignored while she got another nurse in to take the new patient and i ended up stocking and hanging around until i got fed up and asked to go home early...what am i supposed to do play tech or learn to be a good nurse, guess she is tired of precepting. not to mention i am already on edge because of boards and the moral is sh8tty, no 'good luck' or 'hope all goes well' and definately no support when there is a problem, it is looked at like i am the problem...ugh are there no good places to work out there any more or what???? maby it is just my attitude that needs adjusting who knows i have little feedback, some like oh, good iv start or you speak spanish well or good sve you where right but days will go by and i don't know if i am doing good or bad, did i screw something up or am i doing too much, i have no clear picture of what is going on....i am just so frustraited, tired, not happy at all...not really looking forward to finding another job either, maby it's just a lull and all will be better or maby it will just get worse. never thought nursing would be this depressing

OB/GYN NP · Jul 27, 2003

Hey acuteOBRN, I feel for ya'. Those of us who were fortunate enough to have a good preceptor will never forget what they did for us. We are unfortunately one of the professions who still eat our young! Try and focus on the good she has done for you so far, and not on the bad day. The first 6 months are the hardest, because you want so badly to learn everything you can quickly (yesterday, even!) and it just doesn't happen that way. The other thing you might consider is that she's trying to "toughen you up" a little. My preceptor, on my fourth week in orientation, put me in a room with a mom having variable decels, 5cm, nothing but position changes every 3-4 minutes for hours! It was awful! But it toughened me up, made me deal with a tough situation, and I later appreciated her for throwing me to the lions. ACtually, she was out at the staion the whole time watching the monitor, but I felt all alone! Someday you will be self-sufficient. And don't give up on your "gut". L&D demands a good gut instinct, whether your preceptor agrees with your decisions at the time or not. If you can stick with it, I'm sure it will get better. Good luck in your career!

Janny

packerfanrn · Aug 8, 2003

My unit has a triage area, and we love it. We have such a high delivery rate each month, that a traige area allows us to evaluate pts. before dirtying an entire room. We have 3 triage beds. We do all our labor checks, r/o srom, hydration, r/o uti's, sterile spec exams for ptl, initial r/o pih. We use this area a lot. It really works out great. I love being the triage nurse. It really keeps your day going.

HazeK · Aug 28, 2003

Mine is a 400+ del/month unit.

We have a 6 bed Triage unit, staffed by 2 EXPERIENCED RNs.

Some days, a nice place to work:

Some days, oh my gosh!

Usually see between 10 and 30 patients in 12 hr shift.

very autonomous practice in there, w/ many protocols to save time and lives.

skdauriaRNC · Aug 28, 2003

Originally posted by acuteobrn
ok all, it must seem to you all that i am a habitual complainer/b*tcher, but it is good to get it out of your system right so for those of you all not in the mood...don't read on;)

There were lots of days I went home crying in the first 6 months in l&d. I am sorry about the preceptor thing..it may help to be vocal with her or whoever you are with. Tell them what you need to do that day. Tell them what you haven't done and what you have done over and over. This will better help her know what to do with you that day and it will mean you will be better experienced once you are off orientation. You dont want to miss anything or be in the dark when you are on your own. Good luck.
Sheri:cool:

kathiecnm · Dec 15, 2005

Hi HazeK!

I am also in a Nevada hospital, learning to be a CNS. We are doing 400 births per month with not enough room for all the bodies, thus the need for a Triage Room. This is all new to me so any chance I could beg, borrow or steal your "many protocols to save time and lives"? The nurses are willing & I'd like to make it a safe & nice place to work. Any help would be appreciated.

Mine is a 400+ del/month unit.
We have a 6 bed Triage unit, staffed by 2 EXPERIENCED RNs.
Some days, a nice place to work:
Some days, oh my gosh!
Usually see between 10 and 30 patients in 12 hr shift.
very autonomous practice in there, w/ many protocols to save time and lives.