• Lack of anonymity within the community: This may result in a nurse being contacted at home, or within a social setting, to perform a triage assessment, and can present issues related to confidentiality. It may result in a nurse caring for a friend, acquaintance or relative. Personal relationships can also be unwittingly abused by patients seeking special treatment, which may make triage decisions more difficult to make.
• Decisions may carry enormous financial or social ramifications for patients and their families: This may be the case especially when a decision is made to triage away from the local health facility.
• Decisions may carry collegial ramifications: This may be the case especially if a decision concerns the local doctor in a one-GP town, as a working relationship must still be maintained.
• Awareness of budgetary pressures: Within a small facility this can be heightened, due to there being fewer buffers between hospital administration and the nurse.
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• Knowledge of the community: It can be easy to make assumptions when you know the community and the individual community members well. The Triage Nurse needs to be very careful to obtain detailed and clear information concerning the patients that they are triaging and the history of their current complaint.
It is vital that Triage Nurses in rural and remote emergency service areas are aware of the difficulties that these differences may present when assessing a patient using the ATS scale. Identifying strategies to preserve privacy, enhance communication and facilitate provision of appropriate emergency care are as important as ensuring that the nurse is supported in the role by having access to education and support. The latter may not be provided locally, but may be addressed through national initiatives such as this guide or through professional collegial memberships.
Department of Health and Ageing – Emergency Triage Education Kit