Triage

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Hi guys. I thought I'd come ask you all since I can't get answers from my employer on this. I'm trying to learn how to triage people properly (as a clerk) but it seems each nurse wants it done a certain way and it confuses me. I feel like I'm not putting people back in rooms when I should and telling them to come on back when I shouldn't. !?! I was told to "use my best judgment" when deciding who needs an EKG immediately and apparently my judgment is poor. I told a 19 year old complaining of chest pain to sit down and wait when I should have sent her to the cardiac room. She's young, looked healthy, wasn't laboring to breathe and had no history of heart problems. Turns out she was just having a panic attack. How was I wrong in this situation?

Also, I thought a man might be having a stroke so I wrote his chief complaint as "possible cva" and sent him into a room and told the nurse immediately. She got irritated and said "There's like 10 people in front of him. Now I have to send him back out in the waiting room and he is going to be ******!"

?!?! I just thought...a stroke is serious and demands priority? No? Maybe I don't have enough medical experience to be working this job yet.

Any input/advice is greatly appreciated.

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Specializes in ER, ICU.

No offense but if you're a clerk, you have no business using "your best judgement" to make medical decisions. I'm telling myself that this can't be true, that some manager is putting a clerk in charge of triage. Can you clarify your training or qualifications? Triage must be done by a nurse. A clerk can be a greeter and start registration, but not make any medical decisions. You should not be put in this position. For us to teach you all you need to know means sending you to nursing school. Please report this to your state board of nursing as your employer is creating an unsafe environment.

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Specializes in ER, IICU, PCU, PACU, EMS.

Please don't take this the wrong way, but I'm wondering why a clerk is performing triage in the first place.

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Specializes in PICU.

Agreed. As a nursing assistant i took names, birthdays, and vitals. As a unit clerk i just put in orders, none that weren't written or yelled. Something is wrong there. You're confused as to what you should be doing because you shouldn't be doing it. (Again, no offense)

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Specializes in Nephrology, Cardiology, ER, ICU.

Triage is to be performed by a nurse. Sorry, this isn't in your job description and heading for a disaster.

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Specializes in Critical Care.
Triage is to be performed by a nurse. Sorry, this isn't in your job description and heading for a disaster.

Not to mention could probably land some people in legal hot water...

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Let me know what hospital you work at so I can choose another one! :D

Check with your state BON--triage needs to be done by an RN.

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:) Okay, perhaps I need to be a little more clear. I am not "triaging" the patients (taking vitals and asking them very detailed questions to further narrow down a diagnosis). That's what the triage nurses are for. They have asked me to perform a very basic assessment to establish if a patients needs to be go back in one of the 5 triage rooms or if I should tell them to sit down in the waiting room. If a patient complains of chest pains, I need to get them into the cardiac room so a nurse can perform an EKG within FIVE minutes! It's my job to decide if they get to jump ahead of the 20 people that have been sitting in the waiting room for hours. But yes, I have them fill out a form first and chat with them very briefly about what's wrong. Today, I thought someone was having a stroke so I sent them back immediately. Nurse got irritated because she wasn't...which I understand why, but at the same time, I don't feel comfortable telling someone I think is in a life threatening situation to go have a seat for 3 hours. I realize my opinion is medically ignorant but is still of concern.

Is this different from your hospitals? Do you not take patients back to be triaged based on the severity of their condition? I'm probably over-thinking it all. I'm sure I'll figure out the correct process soon enough.

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Specializes in ER, ARNP, MSN, FNP-BC.

If the nurses are asking you to make a judgement call, then they need to shut up when you do. So what if the suspected stroke wasn't a stroke. What if it had been? Just keep doing your job and tell anyone that gives you any crap "bite me" LOL.

by the way, a paramedic performs this function in my ER. You are being asked to do more than you are trained to. I would highly recommend you get specific written protocols i.e. "chest pain complaints go right to triage/back of ER whatever." you are not trained to assess.

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
They have asked me to perform a very basic assessment to establish if a patients needs to be go back in one of the 5 triage rooms or if I should tell them to sit down in the waiting room.

You should not be performing any assessments, basic or otherwise. What you are doing is the definition of triage: sorting out patients. This is a very bad idea.

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Specializes in ER.

the hospital could get the same result by asking patients to fill out a slip as they arrive with name and complaint. Then the triage nurses look through the slips and pick out any they want to see first, or eyeball everyone in the triage area and call the sickest looking in. I think the current practice puts you and the hospital at risk.

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the hospital could get the same result by asking patients to fill out a slip as they arrive with name and complaint. Then the triage nurses look through the slips and pick out any they want to see first, or eyeball everyone in the triage area and call the sickest looking in. I think the current practice puts you and the hospital at risk.

Hm. I don't guess I understand. If someone comes in and says they think they're having a heart attack, your clerks ask them to fill out a form and sit down? Or do they make a judgement call and interupt the nurse and tell them they need an open room? We usually have about 7-10 reg. forms stacked up waiting to be looked at. Does your er not have patients stacked up like that?

Sorry, don't mean to be difficult here I'm just trying to figure out if there is something seriously wrong with what's going on or if my ED is just a lot busier. ?!

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