Factors to be aware of include:
• Physical environment: The presence of barriers such as bullet-proof glass, desks, lack of privacy, distracting noise and movement of people throughout the area all impact on the triage communication process. It is often the effort displayed by the Triage Nurse that will overcome these barriers, and reassure the patient that their communication with the nurse is private, thorough and confidential.
• Time constraints: The triage assessment generally should take no more than two to five minutes with a balanced aim of speed and thoroughness being the essence. 2
• Language use: The use of jargon, be it medical jargon or‘ street talk’, can result in misinterpretation as profound as that which would occur between two people actually speaking different languages. For example,‘ voiding’ is a term commonly used in medicine, but may mean something completely different to a layperson, whereas‘ doing a wee’ would be understood by most people.
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• Non-verbal behaviours: Body language, facial expressions and tone of voice in both the patient and the nurse during the encounter are equally significant aspects of communication.
• Cultural diversity: These include differences in age, gender, ethnicity, language, religion, socioeconomic status and life experience. For example, an elderly man may be reluctant to discuss some issues with‘ a lass who looks younger than his granddaughter’, so effort must be put into building a professional rapport.
• Nature of the health concern: Health concerns that are highly sensitive, embarrassing or anxiety-producing will influence the way in which the information is communicated by both the patient and the Triage Nurse. The avoidance of key terms and the use of euphemisms may lead to distortion of the messages sent and received.
• Expectations and assumptions: Individuals present to triage with expectations of what will happen. These expectations are influenced by their perception of the urgency of the health concern and by their past health care experiences, and may at times be unrealistic. The Triage Nurse’ s familiarity with the triage environment and with patients, together with the attitudes and behaviours of other emergency staff, can all have both positive and negative influences. Although such influences can aid in early symptom recognition, they can also potentially lead to inappropriate assumptions and bias.
• Emotions: Individuals – including both patients and nurses – react to stress and anxiety in different ways and with varying intensity. These reactions can impact upon the person’ s ability to provide coherent information and their ability to answer questions clearly. The Triage Nurse’ s ability to remain calm and achieve effective communication within this environment is paramount.
Department of Health and Ageing – Emergency Triage Education Kit