Tuesday, February 26, 2013

Triage Day

Triage. The definition of triage is to sort. The purpose of triage in an ED is sort a patient's severity of signs and symptoms and prioritize the need for treatment.

I was the triage nurse the other shift. Ugh. I felt like putting a sign over my head which states "Just answer my questions, please do not tell me your whole life story."

Here's a sample of the endless droning:

Chief Complaint: pregnancy symptoms
Me: What brought you to the ED today?
Patient: I have pregnancy symptoms.
Me: And they are?
Patient: Nausea and vomiting.
Me: How many weeks pregnant are you?
Patient: I don't know.
Me: When was your last menstrual cycle?
Patient: I don't know.
Me: Have you seen a doctor yet?
Patient: No
Me: Have you taken a home pregnancy test?
Patient: No
Me: Soooo....you want a pregnancy test then.
Patient: Yes. I want a blood pregnancy test.

Makes sense. Instead of peeing on a $5 stick from Walmart, use the resources of the ER and waste hundreds of dollars.

Chief Complaint: facial bleeding 
Me: How did you injure yourself?
Pt: I don't know. It just started bleeding.
Me: Let me look at your face. You have to stop picking at it. If you stop picking at your face, it will stop bleeding.
Pt: (states while picking at face) I was here a couple of days ago and they put stuff on it. Now it's not working.
Me: Did you pick it off?
Pt: Yes.
Me: You have to stop picking at it. Take your right hand and put this bandage on it and place your left hand in your lap so you don't pick at it. What medical problems do you have?
Pt: I don't know.
Me: Do you take any medications? What are they?
Pt: Yes....pills. I don't know.

Of course you don't. Eye roll.

Chief Complaint: Sick kid

Me: Does Johnny have any allergies?
Mom: Well....the one time about a year ago, he took some medication and he got sick off of it and now I don't know if he's allergic to it, but the doctor said it wasn't an allergy, but I'm unsure.....
Me: What was the medication?
Mom: I don't remember. But it was a pink pill. What is that?
Me: I don't know based on the pill description. So, what is he allergic to?
Mom: Well.....blah blah blah blah ( I stopped listening at this point)
Me: (interrupting her blahing) Did the doctor ever tell you to never give him a medication because he's allergic to it?
Mom: No
Me: Does he have any medical problems?
Mom: Well....a long time ago....

<smacks forehead> In reality, I just wanted to smack the mom.

Other patient:
Me: Do you take any illegal drugs?
Pt: Yes.
Me: (kind of surprised that someone actually answered a question of mine directly and told the truth) What drugs do you do?
Pt: Any I can get my hands on.
Me: Ok, what have you gotten your hands on recently?
Pt: Cocaine, meth, and some pot.

This was the only patient in triage I liked that day. I asked a question, the patient answered it honestly and briefly. Go figure.


  1. Exactly why I chose not to do ER, although I seem to have a steady stream of idiots, anyway.

  2. Unfortunately, they are not limited to the ER.