Triage

Triage

Welcome to the Emergency Department
This leaflet has been designed to help guide you through the process of your assessment, care, diagnosis, and treatment.

You should now have booked in at the reception desk and be waiting in the waiting area for the Triage Nurse to call your name. We make every effort to assess all patients soon after arrival; at busy periods it may take longer. We will attempt to resolve any long waits for triage as soon as possible.

Please use this time to consider if you have come to the right place for your injury or illness. In general, our role is to see patients who have had an accident or become very unwell within the previous 48 hours. If your injury or illness has been going on for much longer than this you may need to see your GP. If you are unsure as to whether you should be here, the Triage Nurse will be happy to discuss your concerns and advise you of alternative services. They will also be able to give you self-care advice if appropriate.

You may have been sent here by your GP to see a particular Doctor to whom they have referred you. The Triage Nurse will call you and in most instances we will be expecting you.

If you arrived by ambulance the ambulance crew will ensure that you have been booked in. You will initially see the Nurse in Charge who will make a brief assessment and allocate you to an appropriate area of the Department.

Sometimes this will be to wait in the waiting room to see the Triage Nurse. If not you will be allocated a Nurse who will be responsible for taking a handover from the crew and triaging you.

Triage
The role of the Triage Nurse is to assess each patient and prioritise their care. Most patients in the waiting room can wait to see the doctor in order of time of arrival. However, occasionally someone may present with an injury or illness which requires attention from a Doctor more quickly. If you have arrived by ambulance you also may need to see a Doctor sooner than others. The Nurse who assesses you will ensure that care is prioritised appropriately.

The Triage Nurse may also send you for an X-ray. This means that when you are seen by the Doctor the X-ray results are available.

If you are waiting in the clinical trolley area to see a Doctor the nurse may instigate some investigations such as blood tests.

The Triage Nurse can also give you painkillers and advice.

If you have been referred to a Doctor by your GP the Triage Nurse will contact that Doctor to inform them of your arrival. If there is no bed available on the appropriate ward, the Doctor will come to the Department to see you.

When you return to the waiting area following triage, you are waiting to see a Doctor or an Emergency Nurse Practitioner (ENP).

Emergency Nurse Practitioners (ENPs)
ENPs are nurses who have trained to see and diagnose patients instead of a Doctor.

They work within strict criteria and can only see certain types of injury or illness, therefore please bear in mind that some patients may be called before you by an ENP if their injury fits the criteria and yours does not.

Waiting times
The waiting time to see a Doctor is written on the board at the reception desk. The time is calculated from the point at which you book in at reception. During busy periods we will try to make announcements to keep you informed.

We generally have a Doctor working to see waiting room patients at all times. However, there are occasions when this is impossible such as in cases of extreme emergency.

Please be reassured that we will make every attempt to keep you informed of the waiting times.

At night
If you have booked in at night please be aware that X-ray offer a full service until midnight. After midnight, if your injury can be safely managed without an X-ray, e.g., minor limb injuries, you will be asked to return after 9 am the following day. The Triage Nurse will advise you.

Once you have seen the Doctor
In most circumstances the first Doctor you see in ED will diagnose and prescribe a treatment for you. The Nurses in the Department will carry out that treatment. You will sometimes be given an appointment for follow-up at an Outpatient Clinic.

If your condition requires more detailed or specialist treatment or admission, the ED Doctor may refer you to one of the Medical, Surgical or Orthopaedic teams.

You may have to wait again to see a Doctor from that team before an eventual diagnosis and plan is made.

Statistics and general information The statistics below show that we generally see and treat patients quickly and smoothly, discharging or admitting them within a short period of time.

On an average day, we see and treat 160 patients, admit 40 patients to beds/wards. We aim to see, treat and discharge or admit 98% of patients within 4 hours.

During 2010 we will see approx. 60,000 patients. We can never predict what types of injury or illness we will see each day. Obviously some may need much more nursing and medical care than others; this can increase the waiting times as well as the numbers of patients we see.

We know that it can be very stressful to wait when you are unwell, in pain or worried about your relative or friend. If you have any concerns about your treatment please see the Nurse in Charge.

Aggressive behaviour will not be tolerated under any circumstances.

We make every effort to see all patients as quickly as possible. We have found that frequent interruptions asking about waits can slow us up. It would really help us to help you if, while you are waiting to be seen, you only make enquiries if your condition changes.

Transport home is only available for patients who cannot travel by public or private transport due to their condition. This becomes even more limited at night when only Emergency 999 Ambulance Crews are available to provide this. There are sometimes long waits for such transport.

Finally, the Nurses and Doctors here enjoy Emergency Department work and take pride in being able to offer the best care we can, along with an efficient and friendly service. We work hard to try and achieve this. We hope that your visit here will be a satisfactory experience.

GP out of hours service: 0300 123 3211

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you.

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]
Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.
If you are unable to understand this leaflet, please communicate with a member of staff.

For additional medical advice, if your symptoms or condition worsens:
Contact your GP
NHS 111: Telephone 111
Get help with your symptoms, NHS111: https://111.nhs.uk/
Information to help you manage your health: www.nhs.uk
In an emergency telephone 999

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