Triage

[JOErotorRN]

Looking for some triage ideas for an ER that see's about 300 patients every 24 hours. Let me know how your ER does it......ONLY if it runs smoothly ! We have 45 beds but really get bogged down during busy times and it seems like you end up with pts that didnt necesarily need to be in a room immediately taking up space for EMS or chest pain, CVA patients. Tell me what ya think.

[curley64]

We were told to like it or leave....

We just remodeled our ER so it's new, big and beautiful....I just wished we could take better care of our staff and our patients...I don't know what it will take to make a change...we have already lost several staff members in the last 2 months...very sad...

[MassED, BSN, RN]

llgccu, "like it or leave it??" Well, it would appear the writing is on the wall.... or... you could approach higher up (than this like it or leave it person) and have an idea in mind about how to rework the staff to make the NEW, BEAUTIFUL ED to work to its potential. They would love a positive spin on their new facility. Tell them why it's not working and how it could work - have some evidence. Have more than just you go in on a plan. If you can. Sounds cruddy, though, to be in a position that everyone hates.

[Lunah, MSN, RN]

We just remodeled our ER so it's new, big and beautiful....

Geez ... it's like putting pretty cake frosting on a turd! Crass, but there it is. I hope something changes there.

[Altra, BSN, RN]

Our pt's are not triaged based on ESI levels because the manager is not on board with that....we have a RN greet.(cake job of the day! waste of an RN I believe)...looks at the pt and has the CNA place them in a room...no vitals, ekg nothing...the greet RN calls the charge RN and said I placed a CP in rm 1, I placed a abd pain in rm4 , toothache in rm 3...ect, we can see any type of pt in any of our rooms they all have monitors; then the charge RN calls the RN and says...can you take the pt in rm 1...then the RN goes in the room and does a quick triage...name, cc, wt, ....then later goes back and does the full triage..the doc can get in there pretty quick but then the RN can't seem to get the IV's started...complete the triage...meds...before they have 2 more patients...we have several LWBS and AMA daily, or pt sat scores are low...our staff is soooo very unhappy...I don't know what to do to help them..

We were told to like it or leave....

We just remodeled our ER so it's new, big and beautiful....I just wished we could take better care of our staff and our patients...I don't know what it will take to make a change...we have already lost several staff members in the last 2 months...very sad...

You must work for my former manager ... LOL

Your patients and your staff are miserable because the manager has drunk the Press Ganey Kool Aid that preaches that every patient is equally STAT priority and no one should wait in the waiting room ever -- and therefore everyone gets lost in the shuffle to some degree or another.

I hate to sound harsh, but I've seen this play out before and until someone with power points out the obvious -- that ER patients must be treated according to medical priorities and the toothache can and should wait until after the CP, neuro s/s or abd pain is assessed and treatment initiated -- things will not improve.

Someone needs to have the cojones to insist that patients get triaged and treated according to systematic, medically-sound protocols.