What’s it like to decide which patients get treated first in BC’s busiest Emergency department?
Fever and cough, chest pains; stepped on a nail; scalp laceration; swollen eye, stabbed in the stomach…a triage nurse in an Emergency department gets them all. Often at the same time. Deciding who gets treated first is a heady responsibility and at Surrey Memorial Hospital Linda Gormley makes those decisions all shift long.
The Emergency department is a team environment. It’s about relationships and communication – paramedics, nurses, doctors, security, and ER attendants all working together. But ultimately, someone has to do the juggling, and making sure that nothing gets dropped can be stressful.
Being an effective Emergency department triage nurse in a busy, big-city hospital requires being good at a lot of things. Obviously, experience helps. A triage nurse is also a trauma nurse and must be able to make quick medical assessments, based on information that’s gathered on the fly.
Up-to-date medical skills? Essential. Ability to perform under pressure and deal with whatever comes through the door? An occupational hazard and requirement. People skills? Warm and fuzzy doesn’t immediately come to mind.
Linda Gormley isn’t warm and fuzzy. That description is far too patronizing. But she is a people-person. Gormley has been working in Surrey Memorial Hospital’s Emergency department for 22 years and when she’s on duty at the triage desk, she’s clearly in charge.
SMH’s Emergency department is one of the busiest in the province with more than 70,000 visitors per year (200 per day, on average). Beyond the triage desk, the sliding glass doors that lead outside to the ambulance bay open and close intermittently as people come and go. There are two triage desks, which means Gormley will often see more than 50 people during a 12-hour shift.
Gormley ranks them all according to a system that categorizes patients by both injury and physiological findings and ranks them by severity from 1-5. Patients assigned a #1 should see a doctor right away; #2 within 15 minutes; and #3 within about half an hour. Patients who are assigned a 4 or a 5 could have gone to a clinic and probably didn’t need to come to Emergency at all. They will spend time in the waiting room; many of them will be in pain and unhappy about the wait.
It’s busy; there’s a never-ending line of people to see, but Gormley takes the time to listen, to ask questions, and to order a quick test, if needed.
‘Caregiver burnout’, as Gormley calls it, is common among triage nurses, but it’s not a description that fits her. Compassion and commitment are evident in the way she interacts with her patients.
“You have to remember, that for whatever reason patients are there, it’s an emergency to them,” says Gormley.
Article by Roy Thorpe
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