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Sure, your extended'triage' (with initial obs - sometimes useful)has a role on selected patients: if you need a lot of obs then in my book you cease being a minor. What you do or call them depends on your department geography case mix and staffing. My experience is that a lot of the triage nurses work is unnecessary and frankly not triage but overthorough assessment. Example - extensive 'triage' notes including full pmh on a cut finger which is then carefully dressed and bandaged by junior nurse. 2 hours later you see pt, take off bandage & dressing, to find pt needs only....bandage and dressing. Even taking the history gets duplicated. How many times has an irritated patient told you he is fed up with being asked the same questions over and over? And no, we won't have a consultant in minors more than a small proportion of the time, mainly to get it up and running. The major end is too busy. As I said, we've no additional resources and I'm not aware any more are coming. Am I wrong on this? My feeling - and that of HMG (what a happy coincidence) is that ultimately it wil be nurse led with limited doctor input . Steve > Hang on a minute Steve, I could understand this if > my docs were sitting at > the waiting room door, champing at the bit, waiting > for the patient to > emerge from the triage room. But it doesn't seem to > be that way 'round these > parts. The patient goes through the triage process > and, including > registration, triage and various initial obs and > tests, they "emerge" to sit > in the waiting room at the 20 to 40 minute mark. > They then wait for another > 2 to 4 hours before being entertained by one of the > cas docs! I cannot > therefore see how triage is "monolithically" holding > us back! > > > We have been experimenting in Frenchay with our > > version of see and treat (sorry, not made it to a > > roadshow yet)and 'go live' in early december with > our > > new minors system 12hours a day, 8 at weekends. > > An average of 12 hours each day equates to 24 > "sessions" per week. This will > require 4 consultants, if we assume consultants work > 6 clinical sessions per > week. And should you remove triage before you've got > the "see and treat" > resources in place? > > > we think > > massive time savings can be had with the same > staffing > > levels by cutting out the duplication. > > But we don't duplicate what the triage nurse does > Steve. I tend not to > repeat her history (remember, I'm monosyllabic!) > except to expand on certain > points, and no-one duplicates the obs, urine, ECG, > PFR, BM, x-ray, > analgesia, checking the CPR etc etc... > > Adrian Fogarty __________________________________________________ Do you Yahoo!? Yahoo! Mail Plus - Powerful. Affordable. Sign up now. http://mailplus.yahoo.com