While many symptoms are serious and require an emergency care visit, many patients seek the advice of a triage nurse to keep them out of the Emergency Room. There are many times when the triage nurse is able to redirect the caller to a safer and less expensive treatment option, while also educating them on what symptoms to monitor for that would warrant a need to be seen in the Emergency Room. The following article presents a typical case study of a college student debating on whether or not he needs to go to the ER and the role of the nurse in helping this student.

CASE STUDY: 

Saving an Unnecessary ER Visit 

Patient call

Meet James[1], he is a 19-year-old freshman at the local university.  He is staying on campus and this is his first time being away from home.   It is 9 pm on Sunday night and the student health department is closed until the next morning.  As he is getting dressed to head to the Emergency Room, he remembers that his university’s app includes a free nurse triage service. James pulls up his app and calls the triage nurse line.

James has come down with a sore throat and fever of 101.  He is able to drink and eat normally but it was “a little painful”.  James tells the nurse that his throat was scratchy feeling yesterday but he was able to attend the university’s football game last night.  He woke up with a sore throat and fever this morning.   James has never been seen in an Emergency Room but wonders if he should go get his throat looked at.

• Nurse triage response

In a short ten to twelve-minute conversation, the triage nurse gathers enough information about James’ current symptoms, pertinent past medical history, and any other significant circumstances such as his willingness to comply with the recommended plan.  The nurse is able to rule out any emergent or urgent symptoms by using protocols and asking James questions specifically about his current symptoms: when they started, how bad the pain was, any recent exposures to Mono or Strep Throat, and if he had any difficulty breathing or swallowing.  With no red flags discovered, the nurse is comfortable reassuring James that he can handle these symptoms without going to an Emergency Room.  She gives him home care advice and warning signs of symptoms that would need to be seen that evening.   James was very appreciative of the care advice and was going to try all the home care recommended.

While not all patients that call nurse triage can safely care for their symptoms at home, there are many that can.   The nurse plays an intricate part by asking the right questions to gather enough information about the patient to make an educated decision about the safest disposition at that time.   James was confident when armed with home care instructions that he would be able to comfortably stay home and avoid a long night in the Emergency Room, saving James time, expense, and possibly being exposed to a more serious infection.

[1] Names and identifying information has been changed to protect the privacy of the patient.