The world in four patients, plus interruptions.
Who’s next? Come in.
Do you have your Health Card?
Take off your hoodie and sit down. What brings you in today?
Where exactly is the pain?
On a scale of one to ten, if ten is the worst possible pain, what number would you give the pain?
How long have you had it?
Three months?
What changed tonight?
How would you describe it? Sharp? Dull? Knife-like?
Is it constant?
Does the pain go anywhere else?
Any nausea or vomiting?
Any diarrhea?
Does the pain get worse after eating?
Last bowel movement?
Last menstrual period?
Any problems peeing? Feeling like you have to go all the time? Blood in your pee?
Any allergies?
What medications are you on?
Any medical conditions we should be aware of?
Here’s urine bottle. There are directions on how to collect a sample in the toilet.
Your blood pressure is okay.
Take this to the registration clerk over there. We’ll make up a chart, get some blood work done, and have you seen by the doctor, okay?
Yes, over there.
Hi there, who’s next? Come in.
I can’t estimate the wait time. Today is very busy. Do you want to see a physician?
Sorry.
Who’s next? Come in.
Do you have a Health Card?
Do you mind taking off your jacket so I can check your vital signs?
Thanks.
What brings you in today?
When did the chest pain start?
Does the pain go anywhere else?
What kind of pain is it?
Heavy?
On a scale of one to ten, if ten is an elephant sitting on your chest, and one is a chihuahua, what number would you give your pain?
Any nausea or vomiting?
Were you sweaty?
Any shortness of breath?
Any weakness or dizziness?
I’m going to to do an electrocardiogram now. Come over here , take off your shirt and lie down on the stretcher, okay?
This will take just a minute.
It won’t hurt.
You won’t get a shock.
Okay, I’m going to bring you in to a bed.
Can you register your husband?
Can you call the doc to Resus 2 stat please?
This is a 53-year-old patient, two hour history of retrosternal chest pain radiating into the jaw and axilla, positive associated symptoms, ST elevation in II, III and AVF. He’s a bit hypotensive. I’ve called for the doc. Okay?
Hi there, who’s next? Come in.
Nuclear medicine is on the other end of the hospital.
I’ll find a volunteer to take you there.
Thanks. You’re welcome.
Hi there, who’s next? Come in.
Do you have your health card?
Can you take off your sweater? Thanks.
What brings you in today?
What medication?
I’m sorry, the doc won’t renew your prescription for Percocets?
You’ll need to get a new prescription from your family doctor.
Sorry.
I can get you in to see the doctor if you’re having pain, and we can treat that here.
I’m pretty sure any other emerg will tell you the same.
Sorry.
I’m sorry. This is the best we can do
You have to see your GP.
Sorry.
Who’s next? Come in.
Do you have your Health Card?
What bring you in today?
I”m sorry about the wait.
Your family doctor said you would be admitted right away?
The emergency physician will have to see you first.
Do you mind watching your language, and can you please tone it down?
Please don’t swear at me.
Look, I mean it. There are small children in the waiting room.
Can you call security?
Do you mind taking her to the quiet room for a few minutes so she can calm down, and I’ll triage her when she’s settled?
Who’s next? Come on in.
Do you have your health card?
.
Those Emergency Blues 
#1 by Connie on Sunday 17 July 2011 - 1132
please add…
What brings you in today?
Would you mind getting off of your cell phone so that we can discuss your medical needs?
I’m sorry ma’am we don’t have enough counter space in here to accommodate your purse, cell phone, zip-lock baggie of medicine bottles, extra large cola and Biggie meal from Burger King. You will have to place your food items with your friend in the waiting room or on the floor so that I can obtain your vital signs.
Again, what brings you in today?
I’m sorry ma’am, I’m having trouble understanding what your saying. Please refrain from eating your french fries while I assess your medical needs.
Did you say you’re having stomach pain?
Okay, and this is the first time you’ve been able to eat in 3 days?
Ma’am, now we will need to wait at least 7 minutes before I can obtain an accurate oral temperature on you because you just took another drink of your soda.
No ma’am, you may not smoke during this time. It is important that you neither smoke, eat or drink over the next 7 minutes so that I can obtain an accurate oral temperature.
Can you rate your level of pain on a scale of zero to ten, ten being the worst pain you’ve ever had and zero being no pain at all?
10? Okay.
While we are waiting could you provide me with a urine specimen so that we can determine your pregnancy status and check you for a urinary tract infection?
…10 minutes pass…patient returns to Triage Room…
Oh, you are unable to urinate at this time?
Ma’am, your oral temperature is not registering, did you have anything to eat or drink while you were away?
I see, you drank your soda in the hopes of being able to provide a urine specimen. Ok, let’s move forward…
…loud knock at the Triage Room door…
Excuse me, ma’am…
Can I help you?
No sir, I am with another patient. I am not able to provide you with an accurate time on when you will be seen for your headache.
I understand your frustration in having to wait to see a doctor. 1-hour is a long time to be waiting, I agree.
Yes, sir, others have gone back before you and they will continue to do so if their medical needs constitute a medical emergency.
What is a medical emergency, you ask?
Anyone experiencing a life-threatening or potential life-threatening condition.
What is a life-threatening condition, you ask?
Well, of the 3 persons that went ahead of you, the first person had an extremely high blood pressure, the second had a loss of consciousness after being hit in the head with a brick and the third was having chest pain with vomiting.
Really, you are having chest pain now and feel “sick to your stomach?”
Ok, have a seat in this second Triage Room and I will have another nurse reassess you.
I’m sorry for the interruption ma’am.
Now, let’s take your temperature again. I believe enough time has passed.
What? You drank the rest of your soda?
…
#2 by Matt M on Sunday 17 July 2011 - 1527
I absolutely detested triage. I would much rather have juggled an entire zone with the other two nurses on a break than be assigned to triage. I would rather have another colonoscopy at the Upper Canada Lower Bowel Clinic (not making it up – best name ever) without appropriate anaesthesia as happened the last time with the sadist/gastroenterologist with a grudge against nurses.
#3 by TheNerdyNurse on Monday 18 July 2011 - 0201
sounds about right.
Glad there are pros like you around to handle the upsets and save lives.
#4 by Maha on Monday 18 July 2011 - 1150
You swallowed that? How long ago? Someone page GI. FML :S
#5 by CC on Tuesday 19 July 2011 - 1545
it’s what I do day in and day out. :)
Love the elephant vs chihuahua. I’m gonna use that.
#6 by Nightingale is my Homegirl on Wednesday 20 July 2011 - 2033
Spot on.
The best was when I triaged a little girl who had come back from swimming. She complained of water in her ear, and that it was uncomfortable.
I told her to go home and jump on her bed. That’s how I managed to relieve water from my ear!
#7 by Cheap Nurse on Tuesday 26 July 2011 - 1845
Gosh triage was too rough, especially with people in Connie’s example. Argh!
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