When coworkers question your triage acuity

[SnickerDoodle_RN]

I have been working pedi er for 2 years and one thing that annoys me about it is when people question other people’s acuity. For example I usually triage displaced long bone fractures (femur, humerus, tibia) as a 2 acuity and was called out for it. In pediatrics that can also be considered a suspicious injury, it hurts a lot and is higher risk for compartment syndrome. I was once called out for giving a 2 acuity to a patient with blunt trauma and an impressive amount of skull showing. Ugh ? the passive aggressive nature of the ER can really make me hate it...

[JKL33]

I wouldn't entertain these comments. Just tell the person you disagree with their rationale but that they're welcome to change it if they think their rationale is appropriate.

Run it by your educator if you aren't sure of your own rationales.

Hasn't happened to me often but I find a well-place and assertive, "We can change it if you'd like" to be very effective. Mostly these people are reacting to a side issue associated with the triage score (need to assign different nurse, need to find different kind of room, etc.) but will back down when put on the spot to actually provide a rationale or officially disagree with the score.

In short, if you're not confident with your judgments, talk to your educator. If you are, keep moving and don't worry about it too much.

[Dacatster, ADN]

When I worked PEDS ER, that was my biggest complaint from coworkers. I tried not too criticize others, however, I would upgrade them if needed. One of our regular charge nurses, that had worked there for over 25 years placed a patient as a green, level 4 on EIS system. His chief complaint was tongue was big. I am not sure how she triage him, but I settled the patient right away, and he was in full blown anaphylaxis . I ungraded him to a red, level 2. Sometimes brain farts happen. she admitted it was a brain fart.

[canoehead, BSN, RN]

You can get a CTAS app on your phone, plug in your findings and get a score. If you get questioned, just pull out the phone to demonstrate. Or tell them if they are willing to take the patient, they can make the patient whatever triage score they want.

Remember, they may see the patient after they've calmed down from the trip, or after you've given Tylenol and a drink, and the picture can change. The moment they walked in, you scored based on what you saw.

I can recall a doctor in OB that disagreed with our APGAR scores, and would come in after she scrubbed out of a Csection to argue for a 9/10. (the case went for review, if the 1 minute scores were 6 or less.) Of course by the time she scrubbed out the kid was at least 15minutes old.