SCOPE: Triage Nurse, RN, Registered Nurse
POLICY: Although guided by nursing judgment and decision support tools (protocols), it will occasionally be necessary for the triage RN to consult with the on call physician regarding patient management. While the provider is ultimately responsible for the patient’s healthcare management, the nurse maintains accountability for his/her decision making and may not implement an order which is felt by the nurse to be contraindicated for that patient.
PROCEDURE: If a telephone triage nurse believes that a patient is in imminent danger, the nurse will direct the patient to the nearest Emergency Department via 911.
If there is no perceived life-threatening emergency, and the nurse believes it would not increase the likelihood of a bad outcome, the nurse may choose to consult with the provider. The triage nurse may also contact an on call provider per provider request for certain recommended dispositions as listed in the practice notes section of Anytime Pediatrics platform.
In the unlikely event that there is a disagreement between the nurse and the patient’s provider regarding patient management, the patient will be managed per the wishes of the provider with the exception as noted below. The triage nurse is not permitted to lower the recommended disposition. However, the nurse is permitted to convey to the patient or caller the provider’s recommendations.
EXCEPTION: Triage nurse believes the MD decision is unsafe or contraindicated for the patient.
DEFINITIONS: Provider: physician or mid-level